Caregiver asks – What can I do about my abusive dad?

What can I do about my abusive dad?

Inquiry (edited): My dad has been diagnosed with Pick’s and Parkinson’s disease, which affects his speech and movement. My mother is in the early stages of dementia with a shaky hand also caused by Parkinson’s. My parents live by themselves in New York and are able to dress and feed themselves. I live thirty minutes away and care for them daily from nine to five. Dad gets mad when Mom loses things and Mom gets mad because Dad is confused and demanding. Dad has hit Mom four times. Although, he controls his behavior while I’m there, I’m afraid he will hurt her. They do not want another caregiver and Mom will not leave her home to come to my house. At times I look at Dad and feel so sorry for him because he looks so lost; so does my mom. Do you have any suggestions?

Thank you for writing to Ask the Caregiver’s Voice.

I can only try to imagine what you and your mother are going through trying to help your dad.

First, if your father is already striking your mother, his abusive behavior has already gone too far.

Observe and record behaviors.
Maggie McNamara, Family Consultant for the [Updated 1/20/2018: Passages Caregiver Resource Center formerly,] Mountain Caregiver Resource Center, in Northern California  recommends that you and your mother observe and document each time your father exhibits these abusive behaviors.

• Does he try to strike your mother when she doesn’t respond fast enough?
• Does he raise his hand to strike her when she cannot help him take his medications due to her own shaking hand?
• Does he try to strike her when she can’t find something quickly enough that he needs?
• Does he strike her after you leave for the evening?

“With enough observation you may see a pattern emerge,” according to McNamara. However, she advises contacting Adult Protective Services if he continues to strike your mother. For example, after watching your dad for a week, you and your mom may discover: Dad grows flustered when Mom doesn’t respond quickly enough to his requests (demands) and raises his hand trying to strike her when she gets close enough to help him take his medications.

“All behavior has a reason,” McNamara writes. “It may be harder to identify when someone has dementia, but it is all the more important to do so, because the person with dementia is unable to communicate what s/he needs, wants, or feels.”

“In addition to observing what happens before or after the behavior (time of day, who is present, sounds, sights, smells), it is also important to observe emotional content,” McNamara elaborates in her response via eMail. “When people have dementia, their intellectual capacities are diminished or destroyed, but they still remain emotional beings. Understanding if someone is afraid or angry will make a difference in how we communicate with our loved one.”

Behaviors can be caused by multiple reasons.
Your father’s behavior toward your mother can be caused by any number of reasons, including:

• an imbalance in his medications or a reaction to the medications. (The meds may have worked well earlier, but as your father’s body gets used to them, the dosing or medication may need to be adjusted.)
• his frustration and feeling of helplessness living with these two diseases.
• characteristic behaviors associated with Pick’s (also called Frontotemporal Lobe Dementia – FTD).

The Frontotemportal lobe controls our manners.
McNamara adds “The frontotemporal lobe is the place in our brains that acts as a ‘filter’ between what we think and what we actually say or do. This area is almost like the part of our brains that controls our manners. [Your] father may have very little control over his behavior because of the changes occurring in this part of his brain.”

Learn more about your loved one’s disease or illness to know what to expect.
To better help you to observe his behaviors, I recommend that if you haven’t already; try to read as much as you can about Parkinson’s and Pick’s disease in order to understand more about both.

Since there is more information readily available about Parkinson’s, here is a resource to get you started on Pick’s or FTD: National Institute of Neurological Disorders and Stroke – Information page on Frontotemporal Dementia

Your understanding will enable you to know what to expect in order to better manage your parents’ care.

Most important—get abusive behavior under control
Of foremost importance is to get your father’s behavioral outbursts under control. If he should seriously injure your mom, the consequences may move out of your family’s hands and into an agency’s. I’m assuming you’re trying to avoid this given your comment that your mother won’t even come to your home. You and your mother need to work together to observe and record your father’s behaviors with as much detail as possible and then present these to your father’s doctor as soon as possible.

I also recommend that you connect with other caregivers. Attend a support group if there are groups that meet near where you live. The National Family Caregiver Support Program offers programs in your area. There are times you will learn more from fellow family caregivers like yourself than you may from professionals.

My heart goes out to you.
My heart goes out to you as I read your second last sentence. I know what this is like having cared for my father with Alzheimer’s.

To cope with my father’s stubbornness, paranoia, and accusations while living with Alzheimer’s I imagined how I would like to be cared for if I had his disease. You might find taking this perspective to be a revitalizing way to help your parents. Consider that your father is likely feeling a sense of significant loss while your mother struggles with the uncertainty of her husband unraveling before her eyes as she stresses over coping with his demands. The more you can learn about their diseases the better you’ll cope with and help your parents to understand what they’re experiencing.

Brenda Avadian, MA
TheCaregiversVoice.com
with advice from
Maggie McNamara, Family Consultant
Passages Caregiver Resource Center
(formerly Mountain Caregiver Resource Center)
[Updated 1/20/2018]