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Change of behaviour

Clovellely
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Hello - my dad passed away a couple of months ago. He was on some heavy class A drugs. During his last weeks at home he was aggressive toward me and my mum but not towards others like carers where he was actually over friendly in some ways.  We thought we were doing a good thing fulfilling his wish to stay home but it’s torn us all apart. My mum keeps going over his behaviour and what I’m asking is how would / would the drugs he was taking have an effect on his personality and behaviour? Thank you 

  • Hello Clovellely and thank you for your post,

    I am sorry to read the sad news about your dad, this must be a difficult time for you and your family.

    I was unsure of your dad's exact situation and unclear about your dad having 'class A drugs'. This term refers to illegal drugs such as heroin or cocaine. Drugs such as morphine are used legally as pain relief and are known as controlled drugs.  

    It sounds like the last weeks with your dad were difficult with his behaviour changing towards both you and your mum. As a cancer information nurse not involved with your dad's care, I am unable to say what caused this change, whether or not it was caused by the medication that he was on. Sometimes the cancer itself can cause behaviour changes for example if it has spread to the brain.

    When someone has cancer and is possibly dying, this can affect them emotionally in different ways. A person may go through several different emotions such as fear, anxiety and depression which in turn can cause anger.  It may be possible that your dad did not realise the impact his behaviour was having on your family. We have further information on our website which you may find helpful to read here.

    You can go through many feelings after a relative has died and they can often be quite complex, especially when someone's behaviour has changed. It might be worth seeing if you can talk to your dad's specialist or someone from the palliative care team, (if they were involved in his care), about his last few weeks and any concerns you may have with his medication and his behaviour. As they know what his situation was, they may be able to give you more of an idea why his behaviour had changed.

    You may also want to think about having bereavement counselling, which may be helpful for both you and your mum to come to terms with what you have been through. The organisation Cruse can help with this. Their details can be found here.

    On our website, we have information on the different stages of grief after someone dies which can be found here.

    I do hope this reply helps in some way. Please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care,

    Jemma

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    Hi,

    I’m sorry to read about your loss and in particular that his end of life experience wasn’t quite as he and your family would have hoped. I can only relate my own experience as the son and grandson of people who died of cancer at home and as a patient who came close. These are my thoughts, for what they’re worth.

    He would probably have been scared, in pain and frustrated towards the end. However much Oramorph or Diamorphine he was given, he probably needed more but the doctor felt unable to oblige. This is frequent cause of friction between patients/family and clinicians who are obliged to stick to prescribing guidance. My normally deferential Dad shouted at the doctor “what’s the worst that could happen? It’s not as if she has time to become addicted to the heroin is it? FFS!” All opioids have side effects which can trigger behavioural changes. Someone close to me had horrendously vivid terrifying nightmares which she couldn’t distinguish from reality for several hours. Without the drugs she was in severe pain - achieving a balance is difficult. 

    Older generations were brought up to be deferential and respectful towards doctors and nurses. That inhibition runs deep, building up frustration within a dying patient who might feel the need to let off steam. Family members are the only other available target, so we often feel the brunt of this frustration. Social inhibitions start to break down and someone who has never sworn in front of their children or grandchildren may start to swear like a trooper all the time. This isn’t personal, the family have done nothing wrong, it couldn’t have been prevented - it just happens … a lot! 

    Finally one of the stages of grieving involves guilt. However rationally we try to think, we find it hard to accept that death was inevitable and we blame ourselves. “If only I’d made him/her visit the GP sooner”, “if only I’d insisted he was seen sooner by the consultant”, “if only I’d insisted he stayed on chemo for another month”, “if only I’d etc. etc.”. 

    Like the rest of us, you and your Mum are only human and I’m sure you both did everything you could to make his end of life journey as smooth as possible. It’s over now, you need to give yourselves time to recover. He wanted to die at home and you gave him that. Imagine how guilty you’d both have felt if he’d died alone and scared on a busy hospital ward because he couldn’t go home and all the hospices were full. 

    I hope you and your Mum are able to come to terms with your loss and eventually accept that you did all you possibly could have done.

    Best wishes
    Dave

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