JOAN’S BLOG –TUESDAY/WEDNESDAY, APRIL 15/16, 2008 – ALZHEIMER RAGE

I discussed in one of my Blogs, and on my radio segment on Jacqueline Marcell’s “Coping with Caregiving” show, my utter shock at my AD husband’s unexpected rages and temper tantrums. They were over insignificant (to me) incidents, such as late dinners or a hand held shower that was left out of its holder, especially in the very early stage, when we did not even have a diagnosis. I was completely bewildered at this personality change, and the accompanying irrationality. There was no way to make him understand that his sudden rages were a gross over reaction to whatever incident set him off. That inability to reason frightened me more than the outbursts. That is when I began asking, “Who is this person,  and where is my husband?”

Because the Message Boards and my e-mails have been filled with disturbing tales of the Alzheimer spouse’s rage – both verbal and physical, which is a frightening and dangerous phenomenon, I would like to assure everyone who is experiencing this that it is PART OF THE DISEASE.  “Rage is the result of neurological impairment”, according to A New York Times article, “When Rage Explodes, Brain Damage May Be the Cause” by Daniel Goleman.

For the spouse of an AD patient, understanding that you are not at fault, that the rage is not directed at you “personally”, and that it is part of the disease, is the first step in coping with and managing it. How ironic that I am dispensing this advice – I’m the one who had such a severe anxiety attack the last time my AD husband went into a rage, I couldn’t catch my breath. However, I have learned since then ( I think; I hope) to walk away and let the storm pass, imagining in my mind that the AD devil has possessed my husband for a time, and there is nothing I can do until he decides to finish up his business and leave Sid’s body alone again. That advice stands only when the rages are verbal, short, and not occurring on a regular basis. No one can or should be subjected to relentless verbal abuse and persistent anxiety over when and where it will occur. That is when it is time to call your spouse’s doctor, get them evaluated again, and perhaps put on medications to control the outbursts. That will benefit the well being of both of you.

When the rages are accompanied by physical violence, the first time should be the when the doctor is called. One of my friends was given this advice (paraphrased) by her husband’s doctor- “When you have been knocked out of bed, and find yourself on the floor, don’t think it is going to be the last time it happens.” Brain disease or no brain disease, you cannot allow yourself to be in physical danger. Alert the doctor immediately.

According to the New York Times article referenced above, “Studies have found that about a third of Alzheimer's patients have uncontrollable rages. Inability to handle the patients' outbursts of rage is the single most common reason given by families of Alzheimer's patients for sending them to nursing homes or hospitals.”

When Sid first started acting irrationally and flying into tantrums, he was unable to recognize that he was doing anything wrong. As time progressed, however, even he started to feel that his behavior was odd. Since that time, he has told me that he could feel anger building and a rage coming on that he was unable to control. Afterwards, he wondered why he reacted in that manner, and he was as frightened and upset as I was. It was when we joined the Alzheimer’s Support Group, and he talked with other AD patients who were experiencing the same outbursts, that he started to calm down. Knowing that he was not the only one, helped him to put forth extreme efforts of control when he felt the anger building. As you are aware, he has not always been successful; the control comes and goes; but he is far better than he was, and he is doing the best he can. I know how hard he is trying - he has told me that he is holding on to control with every ounce of his strength because of his love for me. He does not want to cause me any more emotional pain.

I am sharing Sid’s words with you in the hope that they may offer a glimpse into your own spouse’s thoughts and feelings – maybe he can speak for the spouses that are not able to express themselves.

Whether physical or verbal, anger and tantrums are part of the damage Alzheimer’s Disease does to the brain. Try not to take it as an offense against you personally, but do get help immediately if the rages are persistent or accompanied by violence.

Feedback to joan@thealzheimerspouse.com

©Copyright 2008 Joan Gershman         

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