Behaviour changes and paranoia

(For context, my dad had a stroke in July and has been home for three weeks).
Hello all, I’m just wondering if anyone else has experienced this when caring for a loved one who has had a stroke. Since Friday, my dad has refused to take his blood thinning and blood pressure medication. He says he “doesn’t need it” (his aphasia is quite bad but this is the jist of what my mum and I could get) and is incredibly paranoid of anything we give him. I’ve offered to show him his prescription, explain what each tablet does, tell him about why he needs to take it, but nothing works. He also stopped engaging with an physio, occupational, and speech therapy. He hides in rooms that you can’t see through the windows when they come and just shouts for them to leave.

Today, things are worse. He is doing everything I already mentioned, but went out alone while I was asleep (his mobility, vision, and sense of risk are not sufficient enough for him to safely go out alone yet). I’m so grateful that he didn’t fall as he has had a craniectomy, so I bang to the head could cause serious damage, let alone any other injuries he could have gotten. He hasn’t spoke to me properly all day, won’t look at me, won’t engage in anything. When my mum returned from work he was a bit better, so we tried to go out for a coffee as a family. When we didn’t park where he wanted - it was too far, my mum also has a mobility impairment and neither of them would be able to walk from there to the coffee shop - he absolutely erupted and would not stop shouting at my mum. We took him home, went out together, and came back a few hours later. He is not engaging with either of us, and only shouts at my mum whenever she goes near him. Now, he is trying to cook and just shouts when we try to help.

I’m so incredibly worried and don’t know what to do. I’m scared this behaviour is going to escalate further and I won’t be able to keep him safe. I can’t drive, and my mum works over an hour away Monday to Friday, so if I needed help with him I don’t know what I’d do. I’m not entirely sure what advice I’m looking for here, but just wanted to know if anyone has had any similar experiences.

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Hmm, yes, Scarlett,

he’s 56 yrs old ; plenty of energy left in him. He’s obviously cross. His team aren’t helping (he thinks) and his bubble / world is shrinking, while perhaps he tries to expand it. Has he met other stroke survivors? Does he even want to be helped… probably not (yet). He needs to understand his limitations and acknowledge them, then he can start asking / seeking help. He hasn’t started grieving yet, and is angrily trying to regain control… which isn’t happening… or is!! Let him struggle a bit, so he can understand how helpless he really is. This struggle is natural. You care, but I feel you must allow him to act like a monkey before things settle and his rational mind can see he needs to settle. Tame the monkey !! In Chinese Qigong we call the emotional brain Xin, and the rational intent Yi. His yi must tame his xin.

Good luck, Roland

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@Scarlett-W so sorry to read of your current struggles. Behaviour changes can occur post stroke. Some of it may be him being angry at the situation he finds himself in. You almost have to go through a grief process before you can start to accept what has happened and be able to move forward.

It may also be worth talking to his GP or the stroke team for advice on how to handle it & maybe they can look for reasons he is like this. Talk to your GP about extra support too. It’s a lot for you to cope with.

I hope he settles again soon.

Best wishes

Ann

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