My Dad's Dementia Turned Him Into an Angry Man

Photo by Tim Doerfler on Unsplash

My dad was a laugher, so the anger of his dementia came as a surprise.

His whole family has laughed their way through almost everything in life. Put my dad and his sisters in the room together and you’d hear the howls of laughter from half a block away.

My dad's older brother Daniel passed away years ago, but I can still hear his distinct laughter. It's one of my fondest memories of my dad's family. In contrast, my grandparents were quiet people.

They survived the Great Depression with five offspring and the seriousness of that life forever creased their faces. They always smiled at the uproar around their kitchen fireplace or as their extended family squeezed into the front room of their tiny house. (It qualified as a tiny home before those were chic.) But they weren't laughers like their adult children.

My dad could joke about anything and even when he wasn't joking, he had a tendency to tell you he was "only kidding" if you became upset. His sense of humor got him into trouble on more than one occasion and cost him at least one good friend that I know about.

He still laughs now with his remaining sister from time to time on the phone. It's almost like instinct when he hears her voice. I generally get the opposite reaction to my voice.

Here's what I learned the hard way about dementia anger:

• It's real. No matter how much you want to believe that the anger will go away tomorrow, you must accept that for some people, it is a manifestation of the diseases that cause dementia. My dad has dementia with Lewy bodies, which is known to cause delusions. In his case, those delusions are what lead to the most anger.
• You can't reason with a mental disorder. A friend who went through the dementia of her father before me taught me this. In the early stages, I kept trying to reason with my dad-- explaining the things he didn't understand. He is not a toddler learning to do things for the first time. He is an adult in the final years of his life, losing his abilities. There's little that he is capable of learning or understanding.
• There are triggers. Figuring them out is hard. But if you can eliminate things that trigger anger, you will achieve at least a bit of peace sooner. In my case, I am one of my dad's triggers. My husband (you know the one who does all the grocery shopping and pharmacy runs for my dad?) is the biggest trigger. We found that my dad has far greater peace if we both stay away as much as is possible. Luckily, my dad has his own apartment on our property and a daily caregiver provided by the state. Another thing that triggers his anger is not following his instructions. He needs to feel in control. If he says he wants Peter Pan peanut butter, you'd better not come home with Jiff.
• Medication helps, but it takes time. It takes time both to determine the best combination of medications, and to give them time to work. My dad's meds were changed several times before the dosages began to resolve at least a bit of the anger.
• It can lead to self-abuse. My dad hits himself. The madder he gets, the crazier he gets about hitting his head. He cries and screams and slaps his head. It's a horrible thing to watch. We removed all unnecessary medications and weapons from his apartment. (Which of course, made him quite angry.)
• It can lead to abuse of others. My dad yells at me. He yells at his caregivers. He once threatened to blow my husband's head off. So far, he has not actually hit or hurt anyone, but it is a concern we watch for. He is verbally sexually abusive to his caregivers, something that may or may not stem from the anger.
• You must report the anger to someone. Thank heaven my dad has a good primary care doctor. I make sure she stays abreast of his anger issues so that she can help with medications and document the situation. During the pandemic, she has been available for electronic visits. (Which of course, makes my dad angry.) I would not hesitate to call law enforcement if I felt he was going to cause bodily harm to himself or someone else.
• Hired caregivers need to be warned. You simply cannot hire anyone to take care of an angry dementia patient without proper warning. They must understand the ramifications of everything they say or do. They must be able to report new triggers as they crop up. And most importantly, they must be tough enough to tolerate outbursts and understand it is the disease talking.
• Family caregivers need emotional support. This is by far one of the hardest things I have ever done in my life. I cannot tell you how many times I have wished for an end to the torture. My dad was a laugher, but now it feels like that was a coping mechanism he no longer has. And when he quit laughing, I did too.

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