Husband with dementia has become violent and aggressive.

Husband with dementia has become violent and aggressive.

My husband has FTD (frontotemporal dementia) and can be recalcitrant, argumentative, stubborn, angry, paranoid and worse. Until now, I’ve written it all off to the disease and tried to adjust his care and environment so he can stay at home with me as long as possible.

Last week, things went downhill. When our daughter brought her child to visit, my husband, who didn’t recognize his own daughter, claimed that some strange woman was stealing his children. He got very angry, hit me, and threatened her with a gun! I had to call the police. Thank God they put him in psychiatric care instead of jail.

Now my husband’s psychiatrist is saying it’s not safe for him to come home, and I’m finding it almost impossible to locate a dementia care facility that will take a resident with a history of violent or aggressive behavior.

A window of opportunity to help your husband

You mentioned that you had to call the police. But does everyone, from the police to the psychiatric facility, know your husband has dementia? If not, they may be inclined to treat his situation in ways that do more harm than good. So first, make sure that everyone concerned knows his situation.

The police may be obliged to file criminal charges against your husband because the situation you described is basically aggravated assault (a threat of harm involving a deadly weapon) and battery (harmful physical contact), which is a felony in most states.

The police did you a favor by detailing your husband on what is sometimes called a “5150” hold. While that term applies to a section of California law, most other states have similar laws for involuntary psychiatric detainment. During such holds, it’s typical for the police to confiscate any weapon involved, though they may be obliged to return it to the owner if the detainee is determined to no longer be a danger to himself or others. In such situations, when the psychiatric hold is terminated, the patient is returned to their home, and sadly, the situation may repeat itself until someone ends up killed.

While your husband is in 5010 hold, you have opportunities that won’t last forever:

• Talk to an eldercare attorney…yesterday. Since you mentioned that your husband’s behavior was part of a pattern, hopefully you’ve been thinking about this. Now’s the time to take action.

• Get your own attorney. The assault your husband committed may be considered a “tort”, which means that not only criminal but civil penalties may apply. Since criminal charges may be involved whether or not you decide to press charges on the civil aspects, you’ll need someone who can represent your interests independently of any effort to ensure your husband’s safety. It may be that certain lines need to be drawn to separate those interests in order to get the right outcome for your husband.

• Have your attorney talk to your husband’s “regular” attorney. Make it clear that your primary concern is safety for both you and your husband. Make sure your attorney understands that you’re looking for your husband to be taken care of, not locked up and put through the criminal justice system. If and when there are hearings on the case, the judge may be inclined towards a certain degree of flexibility in sentencing, given the particulars of your husband’s dementia.

• Talk to a geriatric psychiatrist. Not all doctors, even psychiatrists, are familiar with situations like your husband’s. Explain the situation to the geri-psych and get help formulating a plan to deal with your husband’s mental health going forward.

• Have your husband sign guardianship and power of attorney papers, possibly as a condition for his release. If and when he’s released, you will then have more legal authority to get him into a dementia care facility, especially if he pushes back on it.

• If your husband’s not cooperative about guardianship or POA, have him declared incompetent, meaning he is mentally, legally unable to handle his affairs on his own.

• Ask the police to hold onto the weapon as long as they can. They should be able to do so as long as the case is under investigation. But they may be legally limited in what they can do per the law once the case is resolved, especially if your husband’s no longer considered a danger to himself or others, but once you’re his guardian and he’s in a dementia care facility, the point will be moot.

• Locate a dementia facility capable of handling combative, aggressive patients. You mentioned you were having difficulty with this. Unfortunately, that means some of the calmer, more residential-feeling homes are probably off limits. However, there are some nursing homes that are fully staffed to handle patients like your husband. Look for 24×7, “full service” nursing homes.

• Talk to your husband’s doctor about his behavior and get medications prescribed to calm his symptoms. Keep in mind, however, that in your husband’s current condition, he’s likely to hide, refuse, or not take his medications.

• Talk with the doctors at the psychiatric facility about keeping your husband long enough for you to get these things done. If they insist on releasing him, tell them that you are not currently capable of handling his care. If they still insist on releasing him, tell them that it must be to a facility that can handle patients like him. Remember, you’re not leaving him there; you’re buying time to get a solution in place.

• As a last resort, consider a restraining order. if your husband IS released and you know he’s a danger, you may have no other choice. Since you know he has dementia, he’s probably only going to end up in worse situations. That’s why it’s important that it doesn’t come to this.

Your safety comes first.

Chances are you’re pretty wrapped up in the relationship you and your husband once enjoyed. Sadly, that began to come apart when dementia set in. You’ve held onto the threads of it as it’s worn out, and your heart’s in the right place to want for him what he can no longer provide on his own.

But don’t let that get confused with what might actually happen if you don’t act now to ensure and preserve your own safety. Not to be a Debbie Downer here, but if the psychiatric facility decides your husband just had an “episode” and is no longer a danger, the worst case scenario is that he’s returned home and the police are obliged to return the weapon, EVEN THOUGH it was used in an assault that was part of a criminal investigation. I know that sounds crazy, but you have to consider the outcomes that could lead to.

I am so, SO sorry you’re having to go through this, but in some ways, your situation is like that of a battered spouse. You MUST make yourself safe while you can. Then, and ONLY then, can you look after your husband’s needs.

Either way, it’s going to be a long, long road.