Blog 39: Anger Management

Before dementia, Bill was never an angry man.  Words to describe him that come to mind are: kind, tolerant, concerned, reasonable, responsible.  Look at him here in this photo with his ninety-year-old aunt in October 2005:

Blog 039 Image 1

That’s how Bill was.  He was all of those words above and more.  Then, when dementia came along, nibbling at first, but chomping as we moved into 2010, it stole from his personality most of his mental abilities, so that he could no longer think in a reasonable way or imagine the future or use language to make his point. Though dementia was never able to turn him into an angry man per se, when it robbed him of those mental abilities, it gave him no other recourse but to use anger as a means of bringing about change. He could not reason or imagine, his language skills were all but gone so, if he needed to exert some control over his own life, what could he do? He could only resort to bouts of anger to let us know that he wanted things to go differently.

We’ve seen, in previous BLOGS, how unco-operative Bill could be when the nurses and I tried to clean him up and change his clothes.

“What’s wrong with these clothes?” he’d shout.

“You’ve had them on for four days!” I’d answer.

“There’s nothing wrong with them!” he’d yell.  “Get away from me!”

And he’d send us scurrying, an odd toilet roll or a sandal following us in our wake.

But, as I have explained before, this performance went on, not because he wanted to hurt us, but because he didn’t have sufficient powers of imagination to help him understand that we only wanted to exchange his soiled clothes for clean ones.

It was the same with those bouts of Sundowners, which he would have at times at sunset.  When Bill clipped me over the head because dinner was not ready at night-fall, he didn’t want to hurt me.  He just wanted to let me know that it was dark outside and that dinner should be on the table.  He couldn’t imagine it being there five minutes into the future. He only knew that it wasn’t there then. Along with that loss of mental powers, Bill had lost, not only the ability to tell time, but also most of his sense of time (c.f., BLOG 17).  As a result, there was nothing in his head to help him understand that, though it was dark outside, the night was still young and there was yet plenty of time to eat before we went to bed. He did not have the language to explain what he was feeling and clipped me over the head to try to get me to understand.

And when he ranted and raged for those hours before he would fall into coma-like sleeps (c.f., BLOG 14), those rants occurred because of a similar frustration.  In those earlier days, Bill knew that something was going wrong with his brain.  He wanted to find help, but he didn’t know where or how to find it.

“We’ve got to go!  We’ve got to go!” he’d yell.

But he couldn’t think where he wanted to go or verbalise why.  He was trying to imagine a future, trying to plan something out, but he couldn’t get passed:

“We’ve got to go!”

Is it any wonder that he became angry?

Rants could start, too, when I would try to get Bill to take his medication. By mid 2010, he was taking quite a few tablets and capsules.  He took them for blood thinning, blood pressure, cholesterol, internal ulcers and constipation.  What a shame there wasn’t a tablet to decalcify arteries and capillaries!  But, by June of 2010, Bill wasn’t taking his medication voluntarily at all.  What prompted this refusal, I do not know.  Did he think I was trying to poison him?  Did he just not recognise what the tablets and capsules were?  Or, could it be that, because he could not imagine the future, he did not realise that these things might make him feel better later on?  Whatever unreasonable reasoning went on in Bill’s brain, the fact was, come Hell or high water, he was not going to take those tablets.  They’d move as a bundle around the table, be hidden under papers, go into his pocket, or even down the drain or out into the garden.  And, when I would coerce him to take them one more time, the rant would start.  Eventually, of course, I had to start crushing what I could and hiding the powder in Bill’s food in the hope that he would ingest the medication while eating.

Other bouts of anger could be short and sharp, but they all occurred for the same reasons. Because he could not imagine what might happen, even a short time ahead, Bill could not comprehend why we were doing things and, as a result, felt the need to lash out to stop us.  Consequently, he slapped the OzCare worker, who took his walker from him and put it in the boot of the car.  Because he could not think into the future, Bill did not realise that she was taking him to the park so that he could use it there.  And, when he punched the Medical Centre nurse, who was taking the stitches out from a wound beside his temple, it was because, lying on his side, unable to see the action, he could not imagine what she was doing.  He only knew that she was hurting him ….  so he thumped her to stop her.  And, when I went up yet another Supermarket aisle instead of going through the checkout, Bill thumped me.  He couldn’t understand why I wasn’t checking out.  I had goods in the basket. Why was I going up another aisle?

But, the time that I get goose bumps of fear, remembering Bill’s anger, is a time when we were both in the bathroom, Bill and I, with a very caring, lovely nurse who visited quite often.  She was physically very tiny and she and I, together, were trying to get an unco-operative Bill washed, me at the backside and she in the front.

And, as she washed his chest, he grabbed her around the neck with both hands and squeezed her throat. I can still hear the horror, the anguish, in my voice as I yelled:

“No, Bill! No!”

And, still glowering at her, he let her go.

“It’s all right,” she said. “It’s all right.  I’m all right. Don’t you worry.”

She might have been a little lady, but her heart was enormous.

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