Does your loved one have a passive—or aggressive--demeanor?

This is the tenth in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

Over the years of speaking with caregivers who take care of an Alzheimer’s patient I have found that the patients seem to fit into two categories. They are either passive or aggressive. What does this really mean?

One of the meanings by which Webster’s Dictionary describes the word “passive” is “offering no opposition or resistance, submissive, yielding, patient.” This type of Alzheimer’s patient offers all of those characteristics. Each one of those descriptive words has applied to Barbara over the years. During early on-set of the disease she would sometime get angry with herself because she did not understand what was happening to her memory, nor did I. We would get angry with each other, but not to the point of any violence or physical contact. Throughout our married life Barbara was always the calm and collected one when difficult situations arose.

When Barbara first started to go to Day Care she was hesitant to get on the van. (At that time in 2006 she was able to walk and get on the van by herself.) When she was hesitant I would give her a push on the “backside” and tell her the driver was going to take her for a ride up the mountains. (To Barbara a hill was a mountain and she enjoyed riding anywhere and with anyone.) It wasn’t too long before Barbara gave no “resistance” when it was time to go to Day Care.

For about the past year Barbara has not been able to walk. She adjusted immediately to using a transport chair in the house to go to bed, use the toilet, or go out for a walk. As each new challenge arose she made adjustments to the equipment we had to use for her. She gave us no “resistance” to the use of the Sera-lift when we first used it on Thanksgiving Day 2011. And to this day we use it an average of eight times a day to toilet her and get her in and out of bed. To our family, Barbara has been the ideal patient, under the conditions she has to live with on a daily basis, and she has the best of personal care that we can give her at home. It would be most difficult for a person in good health to emulate what she goes through each day by spending her entire day sitting in a recliner chair and her nights flat on her back for ten to twelve hours. She is most cooperative in all we do with and for her.

I’ve heard it said many times that most Alzheimer’s patients who were calm and collected prior to contracting this disease are more likely to be passive with the disease. There may be caregivers who would take exception with this theory, but we must also remember as we’ve stated in an earlier article, that no two patients will have all the same traits and characteristics of this disease. It is my intent in these articles to highlight our journey with Barbara.

One of the meanings by which Webster’s Dictionary describes the word “aggressive” is “starting fights or quarrels, bold, pushing, a desire to dominate.” This type of Alzheimer’s patient may or may not have all of the characteristics, but certainly some of them prior to or after the on-set of the disease. Caregivers I have spoken to with this type of patient will experience far more difficulty in managing their loved one than I do. Many of these patients will be combative, tend to destroy items in or out of the house, and continually argue with the caregiver. I’ve been told stories of patients who have struck and pushed the caregiver and become violent within the house. A frail caregiver, be it man or woman, could not withstand this sort of treatment from a person of size. The life of the caregiver could be in jeopardy in an instant. At this point it is important for the caregiver to discuss this situation with the patient’s neurologist or physician to see if an anxiety medication would be helpful. Medication must be adjusted properly to suit the patient. Giving some medications during the day may make the patient drowsy and they will sleep for long periods of time. Then they won’t sleep at night.

An aggressive patient may have an influence on whether the caregiver chooses to keep him or her at home or if the caregiver is unable to handle the situation and must place the patient in a Long Term Care Facility. (Making this decision was discussed in our previous article.) This is not an easy decision and to keep an aggressive patient at home will add many more challenges to the caregiver. And as we’ve said in another previous article, the caregiver should try not to feel any guilt in doing this. The change from home care may prove beneficial to both in the long run. It’s a personal decision that the caregiver will agonize in their mind over and over again. Another thing to remember is that all caregivers have different levels of tolerance when it comes to this disease, where some can go the distance, but others may struggle with their own health or the welfare of other members of their family. This is not a “one shoe fits all” when it comes to caregivers. So if you are a caregiver, pat yourself on the back for what you are doing, because I know firsthand how difficult it is and what you are going through. I commend all the caregivers who may be reading this article and thank you for the care you give your loved one at home or in the Long Term Care Facility, if it was necessary to place him or her. Remember that caregivers are a select group of people and not all people can be caregivers.

(Previous articles are available online at www.patriotnewspaper.com, click on Features.)