What do we do about brother becoming violent with his wife during the night?

She needs to call 911 and have him admitted for a psychiatric evaluation...now.

Sounds like he's having delusions, which is common with Parkinson's, and his wife is no longer safe with him at home, which means she needs to place him in the appropriate facility sooner than later.
And the next time he so much as raises a hand to her, she needs to call 911 and have him brought to ER. Once there, she MUST tell the hospital social worker that she can no longer care for him at home and then it will be up to the social worker to find placement for him.
Safety for both your brother and his wife must now be top priority.

Parkinson's psychosis is well-recognized but it isn't what you'd call actually common, so it is just possible their medics need a light bulb to go on.

This is an emergency: your sister in law needs to give them a really clear account, ideally with visual recordings, of what is happening.

She mustn't stand in his way. If something else like that happens and she is afraid for his or anyone else's safety, she must call the emergency services.

If they have not already done so, I would consider evaluations by four specialists. Depending on where you live, you may not have them locally and need to travel some distance.

1. Movement Disorder Specialist. A neurologist with more training and experience caring for PD patients.
2. Sleep Disorder Specialist. Often also internist and/or pulmonologist.
3. Neuro-Psychologist. Neuro-psych testing can help differentiate between Parkinson’s Psychosis/Dementia, REM Sleep Disorder, Lewy Body Dementia, Alzheimer’s, Vascular Dementia. Each one has different tendencies. Several here have thrown these terms around but only a professional can make those diagnoses.
5. Certified Geriatric Pharmacy Consultant. As we age, our bodies have a different tolerance level for certain meds. A change in medication sometimes can change everything… for good or bad!

My husband has been through so many ups and downs over the last 34+ years diagnosed with young onset PD at age 40. Each of these specialists have given me so much clarity as to what we were dealing with as the PD progressed. When it comes to PD, there is so much misinformation even among health professionals. PD is such a misunderstood disease because it can affect each person differently so the treatment has to be customized for the best results.

Medicine management and limiting what my husband is exposed to in the daytime really helps us. He loves military history so he enjoys reading and watching tv programs/movies that included wars etc. So at night when he acted out his dreams, he was fighting wars and he saw me as the enemy. His eyes were wide open but he rarely remembered anything.

If they do not have one, have them order the Aware in Care kit from The Parkinson’s Foundation. Should he go to any facility, (even ER) he needs someone to advocate for him to try and keep his meds straight and on time. This kit can be a huge help.

https://secure3.convio.net/prkorg/site/Ecommerce?store_id=4003&PAGENUM=1

My friend's father, suffering from Parkinson's, was removed from the home after a series of unpredictable attacks that put his mother in a hospital. The behaviors you are describing can happen with progressing Parkinson's and related dementia. Unfortunately, your brother needs to be placed in a facility which can handle neuro disorders with violent tendencies. With his wife, call his physician immediately and demand evaluations be done where they can handle his unstable, and potentially dangerous psychosis. His understandable frustration with his declining health is being demonstrated with the only means he has, toward his available wife. He's shown what he's capable to do. Everyone thinks they can handle it until the next time. Please take the situation seriously and don't hesitate to act. Otherwise, there's going to be a very tragic end to the situation. A candlestick could have easily been a knife from the kitchen drawer. He's okay tonight, but what about tomorrow? She has to sleep sometime, and her family must protect her.

1. Call police immediately if and when that happens. They can get him to the hospital for a psych evaluation. If she can't get him there. He IS A DANGER TO OTHERS. Why weren't the cops called the 2 other times??? She could have gotten help then. Now it's just a waiting game. She better hope she has a phone handy when he attacks her again, and can dial 911 during an attack.

2. Get a new doc. There are brain/personality changes going on. He needs his meds changed immediately. If the other doc won't do anything, get another doc. He/she is not the one being attacked.
He might have to go to a psych ward until they can find the right med combination. Do not come up with excuses why this shouldn't happen. He could kill her since he has beaten her 2x. Do not wait for a 3rd time.
3. Find a geriatric and Parkinson's psychiatrist who can help prescribe meds. I'd get on this immediately. If I have to get a phone book and go down the list and it took me 5 hours.
Tare him immediately to the hospital and tell them he is a danger to others and get him help. I don't know if she can get him in the car. She could call the non emergency police number and ask for help getting him there.

VegasLady, given that where I live, it takes a month or more to get an appointment with a neurologist, I think this gentleman needs to be in a placement immediately, for his wife's safety.

Regardless of what anyone thinks the man was asleep or whatever, he still beat her with a brass candlestick.

Call the cops and have him Baker Acted, or 5150 in California. Do not take him back at discharge. It’s beyond happiness now. The whole idea is to keep everyone safe and him not ending his days locked up for homicide.

Regardless of the dx involved (and there could be many reasons for his behavior), his wife's life if at risk. This is an emergency that needs to be dealt with on a short term basis while causes, dxs and other options are investigated and explored. Next time he does something violent or extreme... call 911 and have wife tell them she is in fear of her life and can not control him. Hopefully he will still be raging when they arrive and that should give him a short stay in a psych ward for a full work up - with any luck they will start to play with meds that will help calm him. I'd also change MDs and explain his violent behavior and see what new eyes say. Dying in the name of love in this case is not a good thing.

I really don't think at this point a Neurologist can do much. And I would not feel safe stay in the same place with him. Like said LB is part of Parkinsons and its a violent Dementia. He could have killed her with a candle stick. He needs to be in a psychic unit and experiment with meds. When stabilized he should be placed.