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He suddenly (for the last week) is more and more uncooperative. Refuses to listen to me and follow my suggestions. Today he refuses to wear the incontinence protection and refuses to get up. After lots of coaxing he finally took his medicine, now tells me I am from hell and to keep my mouth shut. Refused to let the care-givers we have coming in for 2 hrs twice a week touch him or help him with the toileting. How can I get him over this anxiety phase? How long will this last?

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Many dementia patients are occasionally uncooperative. Some more than others. I think that medication can help some, but you will have to discuss it with his doctor to find one that might help him feel better.

You might make sure he's not injured, sick or in pain. Sometimes they aren't able to communicate that and they act out instead. Does he have any rash or sore spots that are sensitive. Is the soap too strong. I'd rule those things out.

If it's not that, then it takes various attempts to get the cooperation. That requires lots of patience, time and effort. It may not ever get better as long as he is verbal and has the strength to protest.

My loved one is on Cymbalta and that helped tremendously with her agitation. She still sometimes needs encouragement to get out of bed and allow her baths, but it's much better with her on Cymbalta.

Sometimes the rapport they have with the person providing the care can sometimes play a part too. I think they sense people who are impatient, nervous or in a hurry. Has that changed lately?
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Alpha, from what I have read on the forums here, if someone has Alzheimer's/Dementia [as per your profile] there will be a time when you cannot reason with them.... sadly that is how this disease works. Hopefully it will be a short-lived phase.

To learn more about Alzheimer's/Dementia go to the blue bar near the top of the page.... click on SENIOR LIVING.... click on ALZHEIMER CARE... now scroll down to the various topics. Lot of good information there.
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Not an expert here, and was asking myself the same question, wondering if it is a change that will last. Someone posted awhile back that she would not take the abuse. The diagnosis is different, but after treating with kindness (not sucking up), posting a notice of briefly what was expected and the consequences, the distrust faded. I was amazed that after being on his side for so long, he would not trust me.
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Did someone recently have a talk with him, visit, like his side of the family? Anyone critical of you there?
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Something may hurt or he may have an infection, even a bladder infection that may otherwise have no outward signs, and he can't reason out that getting up and getting care will make him better, not worse. The instinct to just be still and avoid doing anything when you have pain is pretty strong, and he can't cognitively graps why he should make himself do something he does not feel like doing or fears may be uncomfortable even temporarily. It is not likely anything you did or did not do. But, the person with dementia often blames something external for why they feel bad, and you are the most handy and the most safe for that pupose.
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I am afraid it is all in a day's work for the caregiver to a loved one with dementia. As suggested check for infections. he will not necessarily have a fever but the urine may smell strong like old fish. Try not to fight with him. It won't hurt to accept his decisions for a couple of days as long as you can keep him clean and dry and provide food and more importantly fluids. After that time for a call to the dr's office or a trip to the ER. Do you have plans in place for when he gets too much for you to handle alone?
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sudden behavior changes are common when the person has a UTI.

Understand the possible causes and share them with your contacts at the local police community officer, family and friends.

I aggregate (collect these tidbits on
"Dave Mainwaring's Knowledge Network" )

Sunrise Syndrome,(sun?riz) a condition in which a person with Alzheimer's wakes up rising in the morning and their mind is filled with delusions which include include beliefs about theft, the patient's house not being their home, a spouse is an impostor, belief an intruder is in the house, abandonment, spousal and paranoia, people eavesdropping. Sometimes the person may carry over content of a dream.

One observation is that Sunrise Syndrome is different from Sundowning because the person may wake up in a confabulation mind set. During a Sunrise Syndrome conversation with the content may filled with confabulations; verbal statements and/or actions that inaccurately describe history, background and present situations.

Sundowning in contrast displays as confusion, disorientation, wandering, searching, escape behaviors, tapping or banging, vocalization, combativeness; the demons of anxiety, anger, fear, hallucinations and paranoia come out.


Hallucinations and delusions are symptoms of Alzheimer's disease and other dementias. With hallucinations or delusions, people do not experience things as they really are.

Delusions are false beliefs. Even if you give evidence about something to the person with dementia, she will not change her belief. For example, a person with dementia may have a delusion in which she believes someone else is living in her house when she actually lives alone. Delusions can also be experienced in the form of paranoid beliefs, or accusing others for things that have not happened. For example, the person with dementia may misplace an item and blame others for stealing it. Some people with dementia may have the delusion that others are "out to get them." For example, he may believe that his food is being poisoned.
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Medication, medication, medication!

I learned the hard way that memory loss/dementia causes anxiety and that anxiety eventually can lead to paranoia with a capital P. Things go along, go along, go along--and then they don't. That is the point at which you need the right medications. You have arrived.

My mom's family doctor it turns out, was not giving enough of the right stuff to have any impact. After about 18 months of her distrust and surliness, we sent her to a Senior Behavioral Center; there are many all over. She was there for ten days and they fine-tuned her medications. The result? She is a different person!!!!!!!!!!!!!! Calm, pleasant, and happy to see me whenever I arrive. I am so grateful to the scientists and doctors who made this possible. The bill? After insurance, only $1,000. Well worth the money!
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Alpha3, I agree with Salisbury. The distrust comes from a progression of the disease. There is no more logic or reasoniing available to him. The anxiety comes from not knowing whom to trust or what to do. He pushes that feeling away by blaming you. Only medication in sufficient dosage will help. Keep complaining to the physician until you are heard and he gets enough medicine to keep him calm.
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Good advice to check with doctor. My experience: after my sister and I both suffered for months with her paranoia, the doc prescribed a tiny dose of an antipsychotic. Almost immediately, my sister was happy, content, cheerful and not paranoid. And there have been no side effects! I hope. You are as lucky as my sister and I. It must be really miserable to feel as paranoid as she did.
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Thanks, Putthatknifeaway.

SisterLisa,

Thank you for sharing that story. It really helps to have such confirmation. Some people believe that it is not right to "drug" elders into a correct frame of mind. But how can one argue that happiness is not better than misery?
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Thanks, everyone, for your sympathy and helpful suggestions. He does not have a UTI but I think the Sunrise syndrome matches his behavior. He has developed an ever increasing stubbornness and I spend endless time trying to coax, explain 'why' and cajole him into cooperation. I have to remind myself he doesn't understand the reasons because he can no longer reason. Our new doctor at the senior's clinic (the old one left town) has reduced his blood pressure meds and is cutting his Reminyl medication down from 24 mg to 16. I am afraid that will make him deteriorate even faster. Perhaps the higher blood pressure is responsible for his new instability. This new doctor thinks blood pressure up to 160 is ok. The old one always insisted to keep my husband's blood pressure at around 120. His diabetes pills have also been reduced.
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My husband started dementia with a bang. He quickly made a change intro a Dr. Jekyll/ Mr. Hyde personality which could flip in a few seconds without a noticeable initiating factor. He became very paranoid and suspicious of me, the obvious "safe" person in his life. He was verbally, mentally and emotionally abusive. I had him leave our home or I left before I knew what was wrong with him. He was very oppositional and sabotaged my efforts at good things for our family. I refused to take abuse from him when I saw him as a healthy person with problems.

Once I knew he had dementia I determined to stay with him in sickness or in health. It took 6 years for him to move mostly out of this phase and become more calm and reasonable. Thank God! He still pulls some of the negative behaviors, but I've had counseling on how to react and cope and he's much, much better now for a year. I still have some PTSD from the 6 years. I had to set boundaries of places he couldn't enter to startle or disturb me.

There's hope that a person whose behavior is harmful to the caregiver can improve! Naturally my husband no longer believes he has dementia and chooses to forget he was diagnosed with it. He stopped his medication and would refuse to do anything about caring for himself in terms of his dementia.
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I am quoting Colorsue:

"Istill hav eosme PTSD Fromt he six year."

I also find I need to recoover from the worst years with my mom. It was about five years of going from bad, to worse, to worst. And I have had thirteen months to "recover." I am noticing that it is easier to be around her and to not feel guilty when I am not, and also to see her as a "patient" and not a p.i.t.a.

"Recovery" didn't happen the minute she went into AL. Not by a long shot.

I am wondering if others have noticed a recovery period and how long it lasts/ed.
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you have been given some good advice, first look for a cause, and its usually physical.. check toenails cut and other little things, my Ma started to put on weight with good food, and so no longer fitted her shoes .. UTI, rashes, dehydration, all add to the problem. sometimes a short course of sedation.
THEN most importantly get some cans and cut some more shoulder epaulettes, so that you are not taking the abuse personally, and can deflect it.
I know a lot of elderly get so sensitive that they cant wear their undies the usual way and have to have the seam out [ modern clothing, has improved] but it can be something that simple.
For daily things like getting out of bed.. don't give a choice, but say "I have your breakfast ready, so get up now and go to the bathroom and I shall see you in the dining room." or whatever, he might have forgotten what to do, so resists all.Then when their day triggers off the by rote memory they can improve.
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Sounds like you might be dealing with a urinary tract infection. It makes the elderly very ornery, oppositional and downright nasty to deal with. This kind of infection causes encephalitis (fluid on and swelling of the brain). My mother, usually a very sweet lady (doesn't have Alzheimer's but slight vascular dementia) hit me and cursed me when she had a UTI. Get him to his urologist. If he doesn't have a urologist, then to his primary doctor for a referral.
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T l am with mood med when my husband got home he would not put on disposable at night while he had a little bladder infection I had a talk with him told him if he did not listen to me or pushed me I would have no choose he would go to home I said if you love it here you will stop this as no nurse will put up w
with this he had all his marbles and stopped he also took mood meds he's not doppey he's just relaxed but don't let him abuse you if he doesn't under stand you will. Need new ways to deal with it as well if no let him know he can't get away with bad behavior I'll or not get him to a concellor he may need to get some fun happiness out that he's been trying to deal with that he can't express to you
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It's not clear, but does the change in mood correlate to the change in Rx dosages. If so, request meds back to prior dosages. Every MD has an opinion, and small changes can wreak havoc or save the day. Also, you said no UTI? If not already, have that verified with a culture. A "renowned" MD told me "no way" was it a UTI. Thankfully I insisted. Sure enough, despite no outward symptoms it was a UTI. Two days of antibiotics brought my Dad from a tie-down patient back to himself. UTIs in elderly aren't like in youth at all, and often don't have an odor or any outward symptoms except mood, yet can be dangerous if untreated.
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what is the name of the antipsychotic medicine mentioned? marymember
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Alpha 3: I have a dear friend who dealt with a similar situation. Her husband had numerous serious health issues. Had to take lots of medication. And when having to deal with the situation of gradually getting worse, finding it necessary for rest home care, he would become angry with his wife, and accuse her of seeing another man, or wanting to. He passed away not to many weeks after that. Which was a number of years ago, and she still, to this day, lives a single life, reflecting on the good times they had together. She would never have been unfaithful like that. They were close and loving people when he was well. Sickness does lots of things in varied ways to individuals. Personalities vary, and individuals cope or some fail to cope with their own ailments. So.....some become argumentative and difficult for caregiver to work with, other become quiet, won't talk and are complacent with their situation. One has to decide how to deal with it, to the best interests of all, for that particular situation. Usually the family doctor, or community services may offer helpful suggestions, especially if your family doctor knew the individual before the sickness and poor health entered the picture. Also the doctor might know if a certain medication could be the culprit. My mother when alive, had to take away an anxiety pill that had been prescribed for my dad, for he became mean and very hurtful verbally. (which was completely against his nature, for he was one of the nicer guys you would ever want to have for a friend, and basically he cared deeply about other people, when he was well). He could hardly stand to see, hear or read about anyone being abused or hurt by someone else. Checking with family members, the doctor and maybe a long time good friend might offer some helpful suggestions. Do not give up looking for the light at the end of the tunnel. Hoping for a peaceful solution to come you way soon, I encourage you to ask for a near by friend or relative who knows your situation to be available for a few hours to visit with or sit with your charge, while you take a breather away for a few hours. No doubt, I'm thinking, you are deserving of that. May relief , balance and a measure of peace come your way soon. joylee
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Thank you, Joylee. It is so difficult for me to overcome my anger and frustration when I am confronted with rejection and verbal abuse. I can turn away but inside I hurt. And then, perhaps the next night at the nocturnal potty trips, he is a small child again who needs to be led back to bed because he forgot where it is. And then there is a day where he is perfectly contented and calls me sweetheart again. And I haven't steeled myself against any of it and keep falling apart.
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Have him checked for urinary tract infections. They make older men loopy.
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If he can understand simple tell him like I told my husband if you can do it do it but if you can't she is there to help if you get pushy or mean I will have no choose but remove you from here to a place where they can sick or not they want to stay home they will be good and get some mood altering meds chill him out most of it is independence
But don't let him get away with pushing you put him in his place
my husband CA.nt talk but he did a little of those bad thing you just have to be the boss no one likes being sick just give him some space when he yells walk out and don't come back till he calls you nice and hugs you and shows he was wrong
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