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My my 82 year old mother lives at home. I live next door. I have a caregiver that comes in for a couple hours during the week days. She's become aggressive, hitting throwing things and locking the door. How can I watch her and keep her safe if she won't let me in. She had a UTI and was in the hospital for a week. The doctor recommends 24-hour care. I have a security system with a camera in the house. She was good for 2 weeks and very accepting of the help. But the last four days have been angry and combative. My siblings won't help. I don't want to have to put her in a home because it's inconvenient for me to take care of her. I need some ideas on how to deal with the anger, to have her accept my help or the help of others.

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As you know, people with dementia have good days and bad days. It might help to discover something that will lessen the stress on the bad days. One suggestion is to have a key made to her home so when she locks you out you can get in. That's a simple solution.

Are your mom's outbursts related to anything? Does she become aggressive when you try to assist her in any way or does she just wake up having a bad day? When she's having a bad day, stay away from her range physically so if she strikes out at you she won't make contact. When I worked in hospice I had several patients who were combative. I'd place things within their reach that they could throw (because I knew they were going to throw things). I would place spiral notebooks, a wooden spoon, a bread basket, things that wouldn't cause any damage or injure someone who would get in their way. Also, things like these couldn't be lobbed very far because my patients were not strong enough to send them sailing too far. I would make the suggestion, "Cecelia, here, take this bread basket and throw it if you want to throw something." She'd throw the bread basket and as long as I had other items right there for her to throw she'd occupy herself (and exhaust herself) throwing these things. It was a release for her.

I also found music could be helpful. I downloaded dozens of songs from big band to old standards. I'd turn on the music and just waited to see if it took and most of the time it did. A patient would hear the music and after 2 or 3 songs the music would evoke memories in my patient which defused her combativeness.

Then there were times when not a damn thing worked and we'd just have to ride it out. For an elderly person, being angry and combative to the point of striking out is exhausting and as long as I stayed out of the line of fire I would wait for the mood to exhaust itself and it would eventually.

And if worse comes to worse, you can always leave your mom's side and let her rage alone. That is, if she can be left alone. Leave her at the kitchen table while she's having an outburst. Put a deck of cards on the table or a newspaper or something else that might serve to catch her attention thus lessening the outburst. Let her sit there until she's worn herself out. Or she could be situated in a recliner or in her room--wherever. As long as she's safe in a room alone.

I've found that hovering and trying to placate someone who has dementia and is striking out and otherwise combative is useless and only agitates the person more and causes over-stimulation. They're angry, they're frustrated, they don't understand why. Those kinds of feelings are unpleasant in and of themselves so having someone else buzzing around trying to calm the person down just adds to the overall anxiety of the situation.
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Just wanted to add that you would not be putting her in a facility because it’s inconvenient for you to take care of her. Anyone who would accuse you of that is clueless about what it takes to be a caregiver. You would be putting her in a facility to keep her safe. There are staff there who have the training to deal with people in your mom’s condition, and they are there 24/7/365.

I’m sure this is not the mom you grew up with. It’s really difficult to accept who she is now. I know you’ll make the right decision for her.
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Let me just add that the UTI could be back.
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That is why you should put her in a home, so you do not have to run yourself to a frazzle trying to take care of her. They take care of her day to day needs you oversee. She will continue to get worse, you are not that powerful to keep this from happening. I would rethink this entire situation.
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Great answers here!

Yes, get a key cut for yourself.

Agree she needs to be checked out for UTI hanging on or recurring --- make sure they do a culture, too! Especially if she was not like this before the UTI. I speak from experience.

If the cause is not a UTI, but entering an anger phase of her dementia (some types have an anger phase that is really hard to deal with, and some caregivers put their loved one in a facility until it passes, while others use other strategies), then you won't have such a quick and easy fix.

You did not say what type of dementia your mother has, so .... Anyway, with my Dad certain supplements and strategies have really helped. They might not help your mother at all. For strategies for re-directing the patient and diffusing anger, check out Teepa Snow's videos on You Tube. She is amazing! I have learned so much from her and so grateful.

I know this is hard and wish you and your mother the best!

Edited to add: Sometimes, a UTI can leave irritation in the urinary tract after it has been cleared up (as a top urologist assured me when I asked). It might be possible she has discomfort she does not express due to her dementia, but simply acts out in angry gestures. You might want to question her about discomfort in her pelvic region and "down there" when she is having a good moment. Just an idea. This can usually be cleared up with medication.
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Why do you not have keys to her house?

Your mother's needs are only going to increase and she will no longer be safe to leave alone. UTIs can be recurrent and especially difficult to treat in frail elderly. UTI or not, her dementia will only get worse and her needs will only increase.

Start investigating memory care homes now before it's an emergency. Starting to plan now for her future and long-term care needs is the prudent thing to do.

Accept that your siblings will not help. Even if they did offer help, it's not going to be enough because she has dementia. What will happen to your mother if something happens to you? And something happening doesn't have to be tragic. It can be something as simple as getting stuck in a massive traffic jam that prevents you from getting home. What then?
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