There is nothing wrong with expecting to be greeted nicely after a long day at work. Dementia and routine changes are a good excuses. But dementia is like they are progressing backward to early childhood. If you would not allow a 5 year old to behave that way, then mom should not believe it is acceptable. You deserve to have some peace.
If you sister is making your life hard, unplug the phone so mom can't spend the day getting worked up by her abuse. Having a difficult childhood does not give her the right to "give as good as she got" that is called revenge. You sister needs to heal herself not make your life hell,.

I see what you mean about regressing backward to earlier life re dementia. How can one determine if it is this or just an excuse to be mean? I can not always tell where things are coming from. Just a vast change in mood and personality.
I will say things were easier when she took anti depressants. She seems to be off those now.
Mom has enough function to be in charge of her finances and thus daily care. I live here so that can happen. I do taxes and am POA. Buy most things for the house and take care of all the chores, food, etc,, She has it made really. And when she is down with COPD or some other issue I am right here ( or person who stays here while I work).. Some days she is not well as expected with someone 86, Not certain why she is so lonesome and hateful other than being mixed up about my sister.
Speaking of sister. She called to say sorry for being so disruptive and making things hard on me. I just listened but did remark that she has really deep anger toward life and her therapist needed to hear all the reasons why,
I figure she is afraid and not able to find herself since she has cut back on her meds.

I do agree that civil behavior is the least a person is entitled to in life. It is how to go about it that has me stumped.

P

I would jump on your sister right away since she is apologizing. Set boundaries for her. Like only calling when you are home, ten minute limit on call, and nothing negative or the calls stop. I know it sounds mean but this is a boundary that you need to set.

Right now I'm having a similar issue with my mom. I think my sister is trying to influence mom. Unfortunately my mom doesnt always tell me about these plots but they usually slip out. Really sad that a child would take advantage of their parent, but my sister has been doing this all her life. I don't expect it to change so I just have to be vigilant.

The hard part with dementia is that her ability to comply with normal social expectations can change from moment to moment. It is best to set clear expectations, restate them when issues occur and observe her reaction.
Even during momentary issues, continue to reamiain calm while insisting that expectations be met as normal. Dementia will normally resolve back to normal for her while bad moods generally simply escallate.

Unfortunately, it is a difficult road to travel. You have the right to expect respect for the effort that you are putting out to help her. Remind her of the things that you have done to assist her and restate that you are asking for normal courtesy and nothing more.

Tigg has great ideas about dealing with your sister.

Tigg and Sunny, I think you have sound advice. Tomorrow will be the first step trying things out with mostly Mom. She has been lonesome so maybe a drive and ice cream. Then over weekend when she has a melt down I can recall the drive and events to see if she remembers, and if she just goes back to her lament. Right now, everyone is a disappointment to her and she craves attention no one can stand to give her (because she picks and quibbles).
I will make a point to see my sister to talk about things. She seems to become upset on phone and hangs up. Hoping she can take in my body language and not feel threatened,

P

any changes that are applied can be overwhelming for them at first she will get adjusted but the one who stays with her the most will be the one she will be trusting from now on that seems to be the draw back when someone else takes over it to be expected so don't be surprised if she does turn on you its a part of the course.but if she does not like her daytime caregiver that could be a problem if the match is not a good one.

god bless

We just came back from a short vacation. The cat yammered and complained for an hour. I was impressed, amused and feeling compassion at the same time. For animals, there usually is only one time to be concerned with, that is NOW. I think there's a parallel between hers and what is usually thought of as human behavior. She wasn't happy to see us, because she was so upset that we were gone. She had to let that stress out first. The happy to see us part came later when she laid on my chest and wouldn't move for 3 hours.

My mom would pour ice water on a child who was engaged in a tantrum. No child had a tantrum in her presence more than once. It's probably not a good idea to do that with your Mom. If the dementia is significantly advanced, confrontation, if successful, is likely to be effective for only a short time. I've had quite a bit of success ignoring bad behavior and reinforcing the good. It's very helpful to understand the emotions behind the words, especially when word choice and complex expression is lost. The emotion and true thoughts behind your Mom's words could have been more akin to "I missed you and don't want you to leave again." A time may come when she yells "Shit!" when all she really meant to say is that the soup's too hot. I'm amazed at how common it is that the last language skill to remain is the ability to use profanity.

An essential survival tool is to cultivate the ability to maintain your inner peace, regardless of her behavior. It's a major challenge to do that, especially if at times, she's loving you and hating you at the same time. You will get mixed signals, rage, despair, clinging, giddiness, and sometimes perhaps lucidity and profound insight.

You and your Mom are on a journey together, facing a tragedy that bears gifts. My heart is with you.

Just like constant giving in to a child only creates a spoiled child, constant allowing this behavior will only cause mom more and more problems as she ages. You must consider what will happen to her in this spoiled state if you are involved in any sort of accident requireing hospital care for yourself and skilled care for mom while you are healing. She would experience many issues and serious lonliness by being allowed to develop these bad habits.

We have to think beyond the immediate to make sure we do the best to ensure that they can adapt. We have no guarantee that we will even be alive tomorrow. So we have to be careful not to be selfish and put up with poor behavior.

Dealing with child behavior problems and those of an adult who's cognitive functions are in decline. The learning potential of a child is virtually unlimited. When a person is in the process of forgetting everything, a different approach is needed. After a person has declined beyond the ability to maintain cultural and social standards, demanding such behaviors is abusive.

I meant to say the approach to a child who's learning and an adult who is forgetting needs to be different. It's appropriate to ask for respect. It's also appropriate within limits to avoid rewarding unwanted behavior. But when a person simply lacks the cognitive ability to comply, expecting what's beyond their ability can only produce suffering.

Dealing with an adult who is regressing because of dementia must be handled just as you would with a very young child. Clear expectations for their behavior must be set and gently enforced. Otherwise they progress into ever decreasing tantrums and acting out. Allowing anyone who is ill to decide to be mean to others allows progression into the downward spiral of lost social contact. The anti social behavior will only escalate if it is simply accepted and allowed. You are only asking her to be polite to you. That is not a massive effort. We must all live in social groups to survive and that is all you are asking. It would actually be abusive to allow mother to fall into thinking that care givers are proper targets for her bad moods. Even in end stage dementia, no professional care giver would ever simply accept rude comments, hitting, spoiled behavior and the like. The difference is really the consequence for acting out behavior. Calmly explain that this is not acceptable as often as mother needs to hear the rules explained. Remember that she struggles with remembering what should be happening and reinforce behavior expectations as often as necessary. You would not give her a "time out" unless she was seriously abusive, trying to hit and cursing would be examples of behaviors that require modified "time out". Mother can still learn what is expected. She has not become stupid. She has trouble remembering before she behaves.
It takes more patience to contantly remind them of the expectations. But in the long run, it is much better to maintain standards of interaction.

There will come a time when mother will not be up to these expectations. But if she is able to carry on conversations on the phone, she is still able to behave with compassion toward her living mates. The sign that you must stop expecting socially appropriate behavior is when she can never remember anyone around or where she is or even very basic things. You don't sound like you are at this point with mother.

I suggest that you get everything you can read about dementia and read. You are not causing any harm by expecting her to greet you politely when you walk in after a very long day from a new job. It certainly is not abusive to ask her to not be rude. I care for the elderly myself. The worst patients in care are the ones whose families have accepted bad behavior with the excuse that they are ill. Those who are allowed to lapse consistently into mean comments at home, will be even more abusive to their caregiv ers in hospital if support is needed.
With adults there is strength to cause harm when they do deteroriate in those final stages. If this has been the normal in your home, you will find that you have trouble knowing when mom is nearing the end stages.

You sound like a loving dauther. Changing your job, leaving a job that you love for mother is very caring. So I think you are struggling with knowing if you have a right to expect a calm home or if mother is allowed to behave and disrupte everyone's peace in the home. If she is able to be polite to your sister, then she is able to be polite to you. The signal that she can't control is when she acts the same way to everyone. Even then these are spells during which standards for behavior need to be repeated along with repeat explaining the consequence if the behavior continues. Excalations should be calmy given appropriate consequence. Once the episode is over, allow her to rejoin the group. This only reinforces the necessary social requirements for being part of the group.

When mother eventually can not control her behavior, you might need to consider skilled care. There she will be supported by many care givers for episodes of acting out who are able and experienced in handling these to stop the escalation. They generally are willing to allow volunteers and that is one way to see this in action. BUt it sounds like you might be approaching exhaustion yourself. The greatest danger with dementia is for the care givers. Exhaustion and burn out cause serious health issues. If you ever find yourself feeing like suicide is a plesant alternative, feeling like striking mother, feeling so overhwelmed that you simply don't function, then you need to consider skilled care respite or day care so you get a break to refresh your own spirit. You can not be patient from total exhaustion. I am not saying this is you, but I have seen situtaions where the child believes they should never care for themselves, they should give up every pleasure to care for their parent. These people tend to snap and do things they never would if they had simply had enough compassion for others to actually take time to care for themselves. We are not inexhaustable supplies of energy. We are human. We have limits. REcognizing and respecting your own limits and taking time for yourself is the best gift you can offer mother. When you do self care, you renew your spirit and energy so you can offer mother the best that you have. No one can constantly be as patient as needed with dementia patients when they never put themselves first. Even Jesus took time to leave the crowds to refresh and renew. FOrget the christian belief system and just think about the miracles he is reported to have done and yet he had to leave the crowds to spend time resting and refreshing.

" If the dementia is significantly advanced, confrontation, if successful, is likely to be effective for only a short time."

That's my story and I'm sticking to it!

I think I'm talking about one group, and responses indicate belief that I'm talking about another. As long as a person has adequate cerebral function, and expectations can be comprehended, reinforcing them is the kinder thing to do, because it preserves dignity (sometimes temporarily hard on the ego), and a person's ability to find value and meaning in life. They are easier to be around when behaving nicely as well. Isn't this how humans tend to treat each other at any age?

When it really gets interesting is when a person is completely reasonable in the morning, able to cook and pay bills, then on a distant planet in the afternoon. Some make comments or even enter into lengthy dialogue, and do a pretty good job of convincing someone they are mentally fine, then will throw their cat in the dishwasher, or urinate in the refrigerator. Some behaviors persist or become more extreme as cognition declines. If a person liked to say no a lot when younger, may say no to absolutely everything as the condition advances. I remember a woman who played the piano flawlessly, but couldn't find the dining room while she was sitting in it. There are patients who do quite well with small talk, but become agitated and combative at the slightest nuance of condescension or non-congruent body language.

Combine other problems, such as poor thyroid function, COPD (poor oxygenation makes people get weird), chronic depression, anxiety, undiagnosed PTSD, med side effects, and judging what behavior to expect from an individual becomes more complicated. Over stimulation from any cause, even a good time may produce grouchiness.

Sometimes an approach that worked yesterday fails miserably today, but may work again tomorrow. Caregiving for some folks can be awfully damn hard! Ideally, the person receiving care and the caregiver can collaborate in a way that nurtures both. Sometimes that relationship will occur unexpectedly, in the middle of conflict. The likelihood of that happening can be increased if laughter can be introduced to the situation.

Regardless of age or mental status, negative behavior is usually the result of some form of pain or fear. The question is how to respond. Can optimal and lasting results be best accomplished by addressing the behavior or it's cause? In a perfect world, Sis and Mom would figure out how to help each other feel good, then work on ways to help Ms. Peaceful. If the world isn't that perfect, then I agree, Sis needs to be unplugged, and Peaceful needs respite and a way to de-escalate Mom.

If a 5 year old is punished for not having performed some task that was impossible for him, that's abuse. If an older person with dementia is talking on the phone and writing poetry in the morning, then screaming at shadows and cussing at people in the afternoon. What should the expectations be?

My wife's aunt passes the MMSE in the morning, and seems really okay, then forgets who people are in the afternoon. She also forgets to be polite, and uses foul language she's never used before. When she's in that state, I don't think expectations impress her at all.

spirit river well said and eloquently defined

god bless

peacful,

have not heard from you for some time. How are things going with mom?
Have you figured out how to have more peace at home?
Please let us know how things are going!

Praying you are just enjoying theis time with her and there is less hostility at home.

Hey I am back after a tiring weekend. We had an open house to go to. Mom can not mingle by moving. She sits on a couch and makes unusual remarks to people who ignore her.
She was quite shy once. My Dad was at work most of the day so Mom came out of her shell once my brothers became hippies. She heard one time too much that her kids were dirty people who needed haircuts and a bath.
So, in some ways it is her personality to be rude. I ignore the ugly dugs and jabs that come out of her mouth.
You know, even knowing she had her moments of being awful, I see a difference in this way she is now. It comes with COPD , anxiety, and blocked arteries.
So just taking each situation at a time. And avoid telling her things that may upset her. Such as when I go to dinner with friends. She wont go out with me or anyone to eat, Long story. So I ignore and work around.
I really got a lot out of this. The dynamics of discussion are really good.
Thank you so much.

I am still working on her. We all had a long weekend and it is the time that all the bills come in the mail.
Will let you know how it is going. For now I am crawling off to get some shut eye.
P