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Vascular Dementia- Aggression - Carers UK Forum

Vascular Dementia- Aggression

For issues specific to caring for someone with dementia.
My Husband (recently diagnosed with Vascular Dementia) went to punch me in the face today, luckily his reach was not enough to make contact properly. I know to expect aggression, and I know it's not him, but how are you supposed to deal with it. Husband has always had a temper, as do I, and we have had many arguements in 38 years together, but never violence. I would like advice on how to handle this. The doctors say Husband is frail, but he weighs 14.5 stone and has a lot of upper body strength although in a wheelchair. Thanks for reading
You MUST NOT put yourself at risk. If he was always aggressive, he may now be a bigger threat as the part of his brain which controls behaviour is flawed.
Make sure you have a room with a locked door, and a phone with you, so you can dial 999.
A number of people have taken videos of their relatives outbursts, this gives clear evidence to the doctors of what the situation is like at home.
Definitely film him. Another forum member did this of her mum laying into her with the most vile verbal abuse, a total tirade that no 'outsiders' had witnessed. She showed the video to her mum's GP and he was deeply shocked, and took action.

Also, when the mum was in hospital, she let rip at the daughter, and the nurses, so there were more witnesses as well.

I'm afraid your husband is now dangerous. Even in a wheelchair, as you say, a heavy man, at close range, could break your jaw/nose, blind you, potentially even kill you if you fell backwards badly and hit your head on furniture etc.

Would you prefer him in a home now? No shame in saying yes.

Only other option might be for him to be on something like diazepam to 'calm him down'.

What triggered the attack do you think?
Can I ask how old you are? Do you own your own home? have over £46,000 savings between you? (Just Yes/No). If you are worried about the cost of residential care, we can point you in the right direction, your answers affect how the charging system works.
Presumably your husband is receiving Attendance Allowance and claiming exemption from Council Tax due to Severe Mental Impairment?
Hello Linda
My neighbour really tried hard to keep hubby at home but he became so violent that a Home was the only option to keep them both safe. It might be worth starting to look at homes in case that becomes your only safe option too.
Yes it was a very sad time, but it is the nature of the disease for some.

I don't have nothing practical to suggest for now as my experience is only second hand, but I do feel for you, keep safe
Thank you for your replies, my Husband is 84 & I'm 55. I asked Husband why he was trying to punch me & he said he'd shouted for me & I hadn't gone to him. Carer was with him, have carers twice a day now to wash him. I was outside watering baskets. I will ask doctor if can have any medication, but so far this is a one off. I know he might have to go into residential care but we aren't at that stage yet, as for paying for care, have saving above limit, Husband can afford to pay and I with youngest stepson have just got POA for finance/health (just in time luckily) I am finacialy independent. Husband does receive Attendance Allowance and I have applied for Council Tax disregard, council phoned re Council Tax today & said as well as disregard we will have band put back into next lowest as Husband in a wheelchair (double discount!) I will take on board your concerns but I don't feel in danger at all, just wondered how others dealt with aggression.
All this is happening so fast and haven't yet come to terms with it all.
Thanks again for replies and reading post.
I'm glad you are yourself financially secure, even if your elderly husband needs to go into residential care at some point - that is SO essential. (The WORST is to be 'trapped' caring for someone who really needs to go into residential care, but the caree can't risk the cost which would result in them becoming homeless eventually, or, at least, with a vastly reduced quality of life -eg, to sell up and massively downsize to pay care home fees - as their bitter 'reward' for the years of caring they have devoted to their caree)

Even just knowing you 'have an escape route' can take vital pressure off you.

It's reassuring the 'punch' has only happened once, but now you must be aware that it is 'on the dementia menu' so to speak, as the horrible disease 'progresses' and so this might become an increasingly frequent pattern (and then it may disappear again - my MIL was very 'escape-prone' - ie, she kept trying to get out of the care home, very very determined, and then, as the dementia progressed, the fight simply went out of her - in a way, horrible and sad, but the 'upside' is that she is far less 'distressed' in being in a place she has to be in anyway.....)

It's interesting that he could understand your question, and give what to him was a 'reasonable' (!) answer.

I guess you could try saying something along the lines of 'I do come when you call me if you are on your own, and if I am in earshot. But please don't try and punch me ever again - I am the one looking after you. I am not a slave, I am your wife! I am doing my best for you.' In a calm, but clear voice?

It's quite tricky when someone shows 'aggression' towards us, as our instinct is either to fight or flee - ie, be as 'pugnacious' back, or simply 'collapse and cow'. Being calm and reasonable is the best response, but it's not instinctive!
As the carers were present, what did they do to help the situation?
I'm so glad that whatever happens to him, you are financially secure, that is a huge advantage over many others.
Whilst you want to care for him as long as possible, this would be a good time to look at what EMI (Elderly Mentally Infirm) care homes are in your area. Good homes have long waiting lists, as vacancies only become available when someone dies. Sad but true.
Some homes offer day care, some respite care and I know that the home where my mum was liked to get to know someone in advance, by offering respite, so that they could get to know the patient, and vice versa, in advance. Some residents enjoyed respite so much that they didn't want to go home!!
Start by looking at the Care Quality Commission website, you can search for your area and the type of services offered.
Thanks Jenny & Bowlingbun. The carer present just said you might get that!! I actually have a pager and Husband usually remembers to press that when he needs me. pager is useful when I'm in the garden. I was going to look into Husband going to Day Centre, but He has been even more sleepy than normal, so wouldn't be much use at present, even falls asleep eating & drinking. We have palliative care nurse tomorrow so hopefully can see what support is available. Sometimes Husband is still as he was before, but changes very fast to quite different person.
I think it is harder to decide when your Spouse/Partner needs residential care than it is when it is your Parent, slightly less emotionally involved? We aren't there yet though.
MUCH harder when it is a spouse - much, much harder, no doubt about that.

I do think that 'sleep' is OUR best friend as a carer as well - because when they are asleep, we can go 'off duty', yet we know they are 'all right' (such a strange thought - but what does the mind with dementia dream about? Dreams are strange enough even to the able-minded!), and 'at peace' and so on.

I think, too, that as Sleep is the sister to Death, that the more they sleep, the easier it does become to accept they are 'slipping away from us'.

My husband 'slept to death' as the cancer spread in his brain - it was a gentle way to pass from this life to whatever we must hope 'comes after'.

Wishing you as well as can be on this slow and so difficult and distressing a journey....KR, Jenny