When Ellen Smith's husband Irwin, affectionately called "Smitty," was diagnosed with Alzheimer's nine years ago, she knew there would be changes coming. But nothing she had learned about dementia prepared her for the behavior she began to witness.
First came the agitation and aggression. Her beautiful home in Holbrook became a disaster: drawers pulled from dressers, stereos and televisions thrown down, blinds torn from windows. Smitty would often stare into mirrors and threaten his reflection before ripping the mirror off the walls. Ellen could no longer take her husband out. Sometimes he would have hallucinations that people were trying to kill him. Other times he would refuse to get back in the car with her and she'd have to chase him around a parking lot. Neighbors often called the police.
Then came the violence, directed almost solely at Ellen.
She had watched him run outside and was concerned for his safety. But when she went to the door, she saw him turn around and flash a malicious grin. "I'm going to kill you," Smitty bellowed at her, charging at her as she quickly retreated into the house. Her husband pounded relentlessly on the door of the Holbrook house they had shared for 36 years. "I knew if he got in, he would do it, he would kill me," she said. She called her son who came over and calmed his father down.
But there have been other times when she has not been able to escape unscathed. Her husband of 49 years has punched her, slammed her against the wall and pulled out clumps of her hair, all while threatening to kill her. She began sleeping in another room and for a time, her son and daughter took turns sleeping at the house in order to keep their mother safe. A gentle man who had never raised a hand to his wife, Smitty was now unpredictable: no one knew when he might have an outburst or how far he would take it.
"How someone you've been with so many years can have the ability to do this," she said. "I said, 'This is not Smitty anymore. This is someone else in his body.'"
For Smith, who's in her mid-60s, the fear of living with a violent husband has subsided. Doctors were finally able to get the correct medications and dosage to control his aggression and he is much more calm, she said. Once in a while, the old Smitty, 71, will pop out. He'll come over to Ellen and give her a big kiss and a hug. Then the next day he pushes her away.
"To know this is someone you spent your whole life with and they've done such wonderful things, you're so saddened by it," she said. "Because you know who the person was and you don't know who this new person is."
The behavioral changes that come with Alzheimer's and related dementias can be startling and frustrating for caregivers. In some cases, the behavior can also be dangerous. The following offers information and resources on some of the more common changes experienced by those with dementia.