Mar 12, 2012

The Contentious Alzheimer’s Patient: You Can Be Right or You Can Have Peace

So the next time you find yourself ready to argue with your loved one with Alzheimer’s disease, ask yourself, “Do I want to be right or do I want to have peace?”

By Marie Marley
Alzheimer's Reading Room

The Contentious Alzheimer’s Patient
Marie Marley
Alzheimer’s disease patients sometimes have personality changes that can be extremely negative. Formerly sweet loved ones can become argumentative and even verbally, emotionally or physically abusive.

Things had gotten so bad I wanted to end my relationship with Ed, my soul mate of 25 years.

He had become impossible to be around. He was incredibly irritable, angry, mean and emotionally abusive. What’s more he was making scenes in public on a regular basis, which was immensely embarrassing.

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Plus, although he always liked his beer, wine and hard liquor, he had begun drinking prodigious quantities of it. Even more worrisome, he began drinking before noon, and he drank into the wee hours of the morning while waiting for his New York Times, which arrived around midnight.

Then he started falling frequently. I had to take him to the emergency room more than once. I suspected his drinking was not only causing these falls, it was also contributing to his depression and belligerence. But I couldn’t convince him to drink less.

I loved Ed, but I just didn’t think I could tolerate it anymore. Yet I couldn’t possibly end our relationship, either. First because I loved him so much. Second, it would have been morally reprehensible. He couldn’t have gotten along on his own for even one day.

And he was often really confused. One Saturday evening he actually called the New York Times and yelled at them because he hadn’t his ‘Sunday paper r-r-received yet.’” When I reminded him it was Saturday he got angry.

He got angry over the smallest things. Before that we had been able to discuss things we disagreed about, but if I expressed a contrary opinion then, he became hostile.

In a last ditch effort to save the relationship I called a friend of mine who was a geriatric social worker and asked her for advice on what to do with this angry, aggressive, antagonistic Romanian.

The first thing she told me was that she thought he might have dementia.

“Dementia?” I repeated, immediately dismissing the notion. “Well, I don’t care what it is. I just don’t know how much longer I can take it.”

I didn’t want to hear about or think about dementia.

She then told me a shocking thing.

“You have the option of ending the relationship. You know that, right?”

That made me snap to attention.

“I can’t do that,” I said, as though it was the stupidest thing I’d ever heard. “I love him. Besides, I told you, he couldn’t survive without me. How could I ever abandon him?”

She told me she knew women who were married for as long as fifty years who, in similar situations, divorced their husbands.

For an instant I fantasized about how wonderful it would be not to have to endure his abusive outbursts, but I immediately dismissed the thought of leaving him. I would never leave him. Never.

She then said that if I was going to stay with him she could give me some advice. Here’s what she told me:
  1. Don’t bring up topics you think may upset him or lead to a disagreement.
  2. If he starts to get agitated, abruptly change the subject.
  3. Don’t argue with him. Agree with everything he says, no matter how absurd.

I was speechless. That would change our relationship completely.

If I followed her advice we couldn’t discuss politics. Our views differed so much that would violate rule number one.

And I couldn’t talk about my job or personal problems because he’d get upset if I didn’t take his advice. That would violate rule number two.

And quite seriously, I couldn’t imagine myself agreeing with everything he said because he was so often wrong. I couldn’t imagine bowing my head and going along with whatever nonsense came out of his mouth. And a lot of nonsense was coming out of his mouth those days.

She said she couldn’t promise following those rules would stop all the fights, but she said it would help. She advised me to try it for a while and see what happened.

I protested, saying I couldn’t agree with him when he said stupid things.

“When that happens’ she said, just ask yourself, ‘Do I want to be right or do I want to have peace?’”

That was a difficult question. If I followed her advice it meant my relationship with Ed would change dramatically. We’d no longer be able to talk about whatever we wanted, or whatever topics naturally arose.

And – what I dreaded the most – I wouldn’t be able to be honest. No matter how much I disagreed with him I’d have to pretend to concur. Our relationship would become superficial, dishonest and unreal.

I resisted at first, especially with item number two. I was stubborn and didn’t want to agree with some of the nonsensical things Ed said – such as that I’d promised to do an errand for him when I hadn’t. (I ended up apologizing for not having done the errand, then told him I’d do it right away.)

In addition, not only did I find some of these approaches very difficult, I kept forgetting them.

Nonetheless, when I finally mastered all three strategies, the results were dramatic. The number of nasty arguments decreased significantly and our closeness returned to its former state, which was a blessing after so many months of constant unbearable bickering.

And that’s how it came to be that as Ed became more demented I agreed with him about more and more. Important things, unimportant things; political issues and mundane day-to-day issues; silly things and serious things.

As many people with dementia do, he soon began mixing up day and night. One afternoon, when he woke up disoriented after a nap, I agreed with him that it was the middle of the night. And late one evening a few weeks later, I agreed with him that it was noon.

Although this whole plan seemed ridiculous at first, I found that it did stop most of our nasty fights. It was definitely worth the effort and sacrifice to have the warmth, peace and tranquility between us restored.

During the same time period I observed some of his other loved ones interacting with him, and they did not use these techniques. The result was that he became as angry with them as he had previously been with me. I tried explaining the ‘new rules’ to these people but they refused to follow them. They paid a high price.

So the next time you find yourself ready to argue with your loved one with Alzheimer’s disease, ask yourself,

“Do I want to be right or do I want to have peace?”

Author of a book on her own caregiving experiences, Marie Marley is a medical grant writer who, over the years, acquired a keen understanding of many geriatric topics, including dementia. She tells her story in Come Back Early Today: A Memoir of Love, Alzheimer’s and Joy. The book, a Santa Fe Writer’s Project Literary Awards finalist, offers information, advice and hope for caregivers of people with Alzheimer’s. Marie is currently the Senior Manager for Grant Development at the American Academy of Family Physicians and lives in Olathe, KS.

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