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We are going on one plus years post LBD diagnosis for mom. While the two of us that are with her the most have learned to avoid, or shrug off the verbal attacks, and develop thick skins, others in the family get quite wounded or frustrated. This certainly does not make them want to see her more often. It's so sad. The very persons she wants to see the most are the ones she drives away. It's like she waits to attack them. We were making and helping create opportunities for family events, but mom has done some real damage to the most compassionate family members, those that really do love and miss her. Some say they are done with this. Some have never been back. Is this how it ends up? One by one people get driven away? We have learned a few stategies, never leave her alone with one person, keep visits short, have a quick escape plan because it's usually the end of the visit that goes bad.

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Thank you, that is interesting about the cholesterol. I know a low hemoglobin can make people mean too.
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Momsthirdfav wrote: [ Check to see if her cholesterol is too low. My mom changed back to more normal-ish when she changed meds.

There’s a normal range (you need SOME cholesterol but the doctors are so happy to keep seeing it go down that sometimes they don’t stop at “low enough”. Thank god the nurse noticed.) Mom was enraged all the time until she quit, became normal within a month, ]

Mom'sthirdfav:

Yes. low Cholesterol can make people nasty.

That is where the expression, "lean and mean" comes from. When people are too lean their cholesterol is often too low.

Too low is as dangerous as too high. Low cholesterol can also be caused by a malfunctioning liver.

This is good example of why it is important to maintain the elderly on life-saving medication, rather than removing all medication, except sedation.
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My mother has borderline personality disorder, so I have had these attacks all my life. I have had to distance myself physically and emotionally, but they still hurt. She asked me to be her POA medical and financial. I agreed, but could only do this at a distance. She has been well cared for in ALFs and now is in an NH. She is 106 and I am 80.

I do have PTSD from a lifetime of verbal and emotional abuse and have to limit my visits to her to a few times a year and from 1/2 hr to a couple of hours if there is an occasion. I have educated myself about her conditions, but I am human and the words and behaviours still hurt. You have to look after yourself to be able to do what is necessary. I have CFS/FM, and, as I age, looking after her business as well as my own becomes more and more onerous.
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Check to see if her cholesterol is too low. My mom changed back to more normal-ish when she changed meds. There’s a normal range (you need SOME cholesterol but the doctors are so happy to keep seeing it go down that sometimes they don’t stop at “low enough”. Thank god the nurse noticed.) Mom was enraged all the time until she quit, became normal within a month, then switched to another brand. She’s still a bit fussier on the other brand than she was while she was off it completely, but it’s much much better.
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Of course attacks are not limited to verbal ones. They may and often do include hitting, kicking, biting, and swinging the walker. One way to deal with this kind of behavior is to ask yourself, "How would I deal with this treatment if the person doing it were not (my mother, etc)?" I think that if that were the case most of us would be able to handle it reasonably well by recognizing that it is not the person who is doing it but the disease. That is harder to do when our attacker is a close relative. In my house I am a hated person ("I've always hated you!") as well as "The biggest jerk in the world." But I am proud to be the holder of a world record of some kind. A helpful strategy when attacked is to try to turn it into humor. When whacked in the head respond by saying, "Wow! You sure are one strong woman!" This may have no effect whatsoever on her but it may make you feel better. The same when you are cursed: "Wow! Where did you learn those words?" There is no single workable formula for dealing with attacks. Probably the best one can do is the same as we do with facing most other kinds of problems: We muddle through.
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We found that mother's anger and cruel behavior were linked to her lifelong lack of sleep. When she started taking quetiapine (it is also an antipsychotic) it helped her get a full 8 hrs of deep rejuvenating sleep. Her lifelong agitation and anger disappeared almost overnight. The low dose did not affect her alertness during the day. Lack of quality sleep can make a person crazy and is often overlooked and underestimated. It's worth looking in to. But no matter what, love her back.
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I am experiencing this situation right now. I lived with my Mother for five years in order to take care of her. She is 95 years old. I take care of all her expenses and all her personal paperwork not to mention any household repairs she might need. During this time she constantly berated me, called me the "b" word and treated me like "Cinderella" around the house telling me what to do. One day she had me totally "spun up" and angry, I was literally beside myself ! I went into my room, went online and ended up buying a house in another state !! I just love where I live now, my blood pressure has been reduced substantially. However, before I left, I got her home health care from a local company, bought her a "safety pendent" to wear in case she falls or has a medical emergency. However, I still find myself having to come back from time to time to take care of some personal situations for her because no one else can do it. I have a brother but he is a useless drug user and homeless. I only live 6 hours from her so when I come back I do take the time to see friends and get to spend some "valuable moments" with them. But I usually can't wait to get back home. Because even when she doesn't see me for awhile the "verbal attacks" still come. I know it is the dementia but I am powerless to do anything about it so I try and "maintain" until I can leave again. I know if I were still trying to take care of her full time I will have died from a heart attack myself. Sometimes you have to consider your own mental and physical health. I do as much as I can for her a "safe distance" away.
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I made the decision very early on in my Husbands illness that I would keep him at home as long as it was safe for him and safe for me to do so.
If at any time I felt that I could not safely care for him I would have to place him. Thankfully with the help of JourneyCare Hospice and the VA I always had the equipment, the education and the supplies I needed.
If at any time I though my safety would be at risk I would have to place him. At 6'4'' and 250 pounds he easily could have harmed me. (not the "old" him..but the "new" him if that makes sense!) I was lucky in that respect as he was very easy going, very compliant with everything I did. He did not always make it easy but he never resisted.

So as difficult as it is you have to come to the realization that the person you are now caring for no longer is the same person that raised you, loved you and cared for you.
Safety for all is important. You can not be a good Daughter, Son, Wife, Husband, if you are in the hospital, recovering from any form of attack or worst case if you are killed. (A dear friend made the decision to place their spouse when she woke up when her husband had one hand around her throat and in the other hand was a knife. He also had LBD) LBD tends to be more violent and more difficult to treat psychologically.
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With LBD, a couple of things. Beware that some of the medications that help with ALZ may may things worse with LBD. They are not the same animal. Some mental medications can actually make LBD worse, so you want to make sure the medications fit the diagnosis. As for the verbal attacks, in my opinion there is no good answer. I have learned that with my mother, things go easier when my wife and I visit together. Mother has learned to pick on the one she perceives as being the weaker, which right now is my wife. My wife is retired and is available to take her to her daytime doctor appointments, which I am not because I still work. So, my mother makes my wife miserable on doctor appointment day. I'm learning that I may have to address this situation, as mother doesn't fuss as much when we are together. It's a sad part of dementia that someone we love and do so much to help belittles and attacks the very people who do the most for them. The only advice I can give is to circle up, make sure the elderly parent is cared for and their needs are met, and do what is necessary to protect your own sanity, which will most assuredly be attacked early and often by the very person you are striving to love and help.
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Thanks all for the advice. Sincerely need it.
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It is hard hard hard! Yes you tell yourself-over and over and over again that the brain is damaged, that the person attacking you, the person who walks out the door because you try to keep them from doing something harmful to themselves or others, (grabbing the dog's collar to keep me from "kidnapping" him and holding too tight, or burning holes in the patio cushions), this person is not, yet is, the one you married, "for better or worse". You begin wishing for a disease that presents with anything BUT the horrible and irrational symptoms of dementia.
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My mom fell down the stairs and had traumatic injuries, which she died from. While she was in the hospital they did a brain scan and she had a huge empty spot in the middle of her brain, aging her brain more than 10 years than she actually was. It explains perhaps why she was so mean to me. I didn't know she had been so affected by dementia because from what I knew about dementia, it wasn't the typical signs that I thought was dementia. She had been awful to me and my daughter for many years, so I think it had taken hold years ago.

I was the only sibling around her, since the others moved away years ago, I was the one who had to watch out for her. It was extremely difficult and I feel she has stressed me out so much she has aged me and left me with a little PTSD. Seriously!

I try to remember it was the disease talking and she was a great Mom when I was little. It is hard though. These mean words came out of my mother's mouth. I couldn't abandon her. She fought for me when I was ill. I went to therapy and was told to limit my time with her, which I did.

Now that she is gone, I can spend more time with my dad who has dementia, but who is grateful for whatever people do for him. My siblings miss our mom, and I do too, but I have more of a sense that I don't have to battle her to care for her and my dad, which has made my life easier. It makes me feel bad that I am relieved that she is safe in her urn on my piano. And I hope that I don't do what she did to me to my kids. I hope I am grateful like my dad is, but one never knows how we will age.

My advice is to limit your time with her and treat yourself well. Remind yourself that this really isn't your mother speaking, but disease speaking. It is such a sad and difficult time in our lives. It is temporary. Best wishes to you.
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jeannegibbs May 2018
Good advice, kallettla. And having mixed feelings of sadness and relief when a loved one dies after a long period of suffering is very common and normal.
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Your mom didn't leave you when you were bad. Try and remember those times when you are upset with her .
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Nightowl:

You are such a kind and caring and wise person to try to facilitate family meetings and to understand how upsetting her verbal attacks may be to others.

Many not so moral caregivers would see this as an opportunity to manipulate a parent to cut the upset children out of her will or to orchestrate joint bank accounts or changes of POD beneficiaries on bank accounts and life insurance policies.

I often see family caregivers who are rejecting all their siblings offers to help from afar, yet they revel in complaining bitterly about the lack of help they receive.

There are a lot of thing siblings can do without being in direct contact with the parent.

For example: Some can pay bills, others can research competent doctors or five star assisted living facilities.

I suggest you continue to hold family gatherings so that all of you can see be together and witness her attacking behaviors all together at the same time.

Blessing to you for even bothering to consider your siblings feeling. Many caregivers would simply choose to play the martyr as a way to isolate the elderly parent, for self-dealing and personal gain.
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I would make sure to talk to family members before the visit to let them know that mom has some challenging behaviors because of her dementia. Try to get them to understand it's the illness and not mom talking and the minute she starts, you leave.

If there are family members who understand dementia, maybe have them also talk to the ones who have been hurt to help them understand it's not personal and it's the nature of the illness. Let them know you've learned how to handle visits so that they're not so stressful. I feel sad for all involved but glad you're still trying to be there for your mom.
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Did you discuss these verbal attacks with the family member after they happened? Are family members willing to be educated about dementia?
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This is the hardest thing. For all the times my mom tries to be pleasant, one of these attacks is still hard to get over and separates all her further.
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Eyerishlass: "In theory it's the dementia talking unless you're at the other end of a verbal attack. It still hurts and when one is hurt it can be difficult to look at the situation clearly and understand that your mom's brain is sick. Many people don't understand dementia. I understand it completely but would still be upset if verbally attacked by someone with dementia. Words hurt regardless of where and who they come from."

SO TRUE! My mother has verbally attacked me (she doesn't have dx'd dementia, but I'm starting to wonder if she might have the beginnings of vascular dementia). Her insults and attacks have changed my relationship with her permanently. I have really cut my contact with her, and it's a shame for her, because she's a shut-in except for when I take her someplace. And I've really limited my availability.
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There's little that can be done if your mom's actions drive people away. They're hurt. In theory it's the dementia talking unless you're at the other end of a verbal attack. It still hurts and when one is hurt it can be difficult to look at the situation clearly and understand that your mom's brain is sick. Many people don't understand dementia. I understand it completely but would still be upset if verbally attacked by someone with dementia. Words hurt regardless of where and who they come from.

If family members are done with her respect that. What else can you do? Force them to come and see your mom?

Never leaving her alone with a guest and keeping visits brief are good boundaries. Continue to do these things.

As for how this ends up? I don't know. Someone with dementia tends to become isolated in time for many reasons. They can't be taken out in public because of their behavior or they stop recognizing people so people stop visiting, or they descend into their own world where we can't go. It's a horrible disease.
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Have you brought this up with her doctor. Maybe a medication will help especially if this is not the norm for her. Its the Dementia talking but I can see where these people are coming from. My Mom did it rarely but when she had a melt down it was aimed at me. Yes it hurt and I had no idea how to handle it when it happened, so called my daughter in.
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