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Steps can be taken to avoid violent Alzheimer’s behaviour

Q: I have known for about a year that my father has Alzheimer’s disease, but recently he has become a problem. He wants to try and find his childhood home, and he thinks our family home is not the right place. He tries to leave, and as he is no longer allowed to drive, this could be dangerous to the general public. He gets nasty and violent if anyone tries to physically restrain him. We have so far been able to talk him out of leaving. What should we do? He is 72.

A: Despite the fact that your father was only diagnosed a year ago, it appears that he is suffering from quite a late stage of Alzheimer’s already. Perhaps he had the illness for a while before you recognized it.

It might not be classic Alzheimer’s because mini-strokes may have led to a vascular type of dementia. I assume he has had a brain scan, CT scan, to rule out any potentially treatable condition such as a brain tumour.

It’s important to remember that he is not exhibiting hostile behaviour on purpose, and there are things you can do to keep outbursts from happening.

Sometimes aggressive behaviour is due to pain, discomfort or a lack of sleep. A loud and noisy environment or too much activity surrounding him may also be a trigger.

In your father’s case, he seems to be suffering from disorientation or confusion regarding where his home is. He thinks he is a child so thinks he is in the wrong house.

As this situation is potentially dangerous both to him and others, you should not hesitate in calling the police and have him sent to hospital in an ambulance the next time he tries to leave.

He will be assessed to see how bad the situation is and will probably be kept there or sent to a long term-care facility, where he will most likely be given sedating medications.

Sad as it is, it sounds to me that he can no longer be looked after in his own home. At one time, patients like your father would be cared for in a dementia ward of a psychiatric hospital, but these no longer exist in most provinces.

Many care homes have a locked floor where Alzheimer’s patients with a tendency to wander are kept.

When you visit your father, do not argue with him. If he says he wants to go home, make an excuse such as maybe next week. He will soon forget. As Alzheimer’s affects recent memory first, focus on the past and let him tell stories from his early life.

Finally, be sure to take care of yourself. It is not unusual for the caregiver to feel depressed and isolated. Keep in touch with your friends and continue your activities.

Try not to feel guilty if you do not visit as often as he would like.

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