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When Dementia is Mean

Angy elderly lady with dementia

Some days caring for someone with Alzheimer’s is harder than others. There are lots of things that can make the day hard, but the thing I dread the most is my mom’s anger over something that didn’t even happen. And it’s worse when she directs that anger and aggression at me. Today was one of those really hard days.

For my mom, these days seem to have no antecedent. She’s just anxious and out of sorts. She’ll wring her hands over and over and perseverate on something that’s upsetting her. And most of the time the thing that’s provoking her anxiety is complete fantasy. Or, which can be even worse, is something that has tiny bits and pieces of truth from various events and decades morphed into some fictitious current event that’s making her sling accusations and hate. It’s pretty awful.

Alzheimer’s Fueled Nastiness

Today she directed her Alzheimer’s fueled anxiety and nastiness at me. It was all over some conversation that never even took place. Yep, pure fiction.

She can get crazy angry. I’m talking downright hateful. And will say the most hurtful things. Because in her mind, whatever she’s upset about really happened. Today was an especially hurtful word filled day.

I have a few go-to caregiver strategies when she gets like this. I do my best to keep my cool, remind myself with each breath that it’s the Alzheimer’s talking, and keep trying to get her off the subject. But today getting her off the topic wasn’t happening quickly. She kept escalating. And the hateful things she was saying to me began to take a toll on this tired, caregiving daughter.

I found myself wishing her brain would hit that all familiar reset button so we could have the conversation about what day it is again for the umpteenth time today.

Please, just ask me what day it is.

The anger and hurtful words filled the room until I lost my cool and uttered, “Mama, stop. You’re confused. That never happened.”

I knew it wouldn’t help. Why did I say it?

She doubled down and got angrier and nastier.

I know when she gets like this to remain calm and detach myself from the hurtful words. I know it’s the Alzheimer’s. But sometimes I fail.

I made the situation today temporarily worse, but then logic finally took over; I think out of desperation. I turned off my emotions and started implementing strategies that have worked with her in the past.

Strategies to Defuse Anger in Alzheimer’s Patients

1. Distract and redirect – Change the subject or start a new activity. You’ll see this recommended over and over when you read about Alzheimer’s. It’s a fantastic strategy… when it works. At my mom’s middle stage Alzheimer’s distracting and redirecting is definitely not a sure thing though.

2. Leave the area – Sometimes I can leave the room, wait about 5 minutes, and re-enter. If Mom has forgotten, it’s like a brand new day. If she hasn’t forgotten, then she’s just had 5 minutes to stew on it.

3. Agree, even if it’s not true – This is another one you’ll see all the experts recommend. I use this strategy for things that don’t really matter. Because arguing never helps. Ask me how I know. But when my mom is falsely accusing me or someone else of something horrible, I just can’t bring myself to agree. Because in my mom’s case I’ve then validated her delusion. And she sure seems to be able to remember when that happens!

4. Stop engaging – Sometimes redirecting and distracting doesn’t work for us, and agreeing isn’t an option. When this happens, I stop responding and start working on cleaning or organizing something. I try to look busy and wait for Mom to forget.

5. Focus on the fact that Mom is upset, rather than the details of why she’s upset – Trying to reason with my mom on the specifics of the situation only makes matters worse. So I avoid the particulars while acknowledging her feelings. “I can see you’re really upset. I love you. What can I do for you right now?” Then I’ll get her something to drink or eat. I carefully avoid the details while acknowledging her frustration. Of course, this one doesn’t work if I’m the target of her anger.

6. Change the atmosphere – I look for ways to give Mom different things to see, hear, and smell. I’ll open (or close) the shades, turn the television on (or off), spray some air freshener, or turn the air up (or down). Sometimes it’s enough to reset her thoughts.

I was finally able to get Mom redirected today, and when I did the anger and aggression disappeared. I had to go through my list of strategies more than a couple of times, but I think changing the sheets on her bed was today’s turning point.

She seems fine now.

I feel like I’ve been hit by a truck.

I’m just hoping nothing reminds her of it tomorrow.

 

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Caregiver tested strategies to deal with the ugly side of Alzheimer's.

Caregiver tested strategies to manage mean behaviors and anger that come with Alzheimer's.    Tips to help caregivers with mean Alzheimer's and dementia behaviors.    Anger senior lady

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Caregiver tested strategies to deal with anger and aggression in Alzheimer's.

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19 Comments

  1. Oh my dear. My mom is not so far yet, but I’ve had that experience with her. Once I just walked out. I just could not take it anymore. I’d looked after my Dad until he passed and never knew the abuse I suffered from him was also senile dementia. I be learnt a lot and some days are harder. You are doing good. Keep it up.

    1. Hi Lynette,
      Sorry you are dealing with this, too. Sometimes walking out for a bit is the best choice for sure. I had to do it today! Caregiving is a lot harder than I thought it would be. Thanks so much for stopping by and sharing your experience. 🙂

  2. I to understand the effects of the care giver of a loved one wit Alzheimer’s. My dear husband has those very bad days describe also. Those days I can keep myself positive with cheerfulness makes a difference for him. I have learned over the 8 years since the family realized something was wrong how to deal. I have a great support system. There are those days though. I describe them as my train wreck days. Those days leave you in mental exhaustion. I cherish the better days. There are no really good days with this disease. Bless you all. Today is a good day to have a good day.

  3. Thank you so much for sharing. I’ve read all these strategies, but having them in one conscise list is so helpful to me. I’m sure I’ll refer to it often in the increasingly difficult days. Also, your honest sharing of what often does or doesn’t work is very encouraging. Thank you.

    1. Hi Susan,
      So glad you found my post helpful! I think it’s important for caregivers to hear real examples of how other caregivers are handling their difficult days. Thanks so much for stopping by!

  4. I have trouble getting someone to sit with mom. Can’t afford to pay someone. Feel like a prisoner in my home but I feel terrible for thinking that way. Do anyone else ever feel this way?

    1. Hi Deb,

      I think your situation and feelings are very normal. We were able to find an “Alzheimer’s senior activity day” sponsored by a local non-profit organization. Mom went once a week from 9-3. It was free, but they did accept donations. Check your local agency or office on aging. See if they have a list of adult day services in your area. If none of them are free, contact the ones that charge and ask them if they offer financial aid. Also, https://www.alz.org/ has a search feature that allows you to look for local resources. Give that a try, too. Would love to have you join our caregiver FB group. ❤️ We are all caregivers there and understand where you are in this. The link is the sidebar.

      Anne

  5. My Mom went through this stage too. Unfortunately, this was at a time when my Dad was going through the last few months of his life. She was horrible to him. We had to understand that she was not enjoying being mean. She was as miserable as we were. Her doctor finally prescribed Lorazepam. This made all the difference in the world! My Mom was a lot more pleasant to be around, she was in a much better mood, and she was able to enjoy herself and others around her. This was a 2 X daily dose, and if she was overdue for her medication it was extremely apparent. I can’t imagine how we could have survived without it. Good luck.

  6. My what makes the loved one spew such meaness. Are they in pain or is it that they are confused or scared? Family thinks you are complaining so I don’t share the difficult days any more. Thank God for my Peer groups and boards like this.
    Terry

  7. Excellent information…..I have been there also with my younger onset husband and this is great info!

  8. I know I’m late to the party but I wanted to tell my experience in case it might help someone reading the comments. One of the ladies I take care of had become mean and unreasonable toward me one day. For a couple of hours she was yelling at me, yelling for her husband (he was at work) to get me out of their house, yelling for her mom (who had died decades ago) to get me out, yelling for the police…I kept trying to get her to take her meds so she’d calm down and she refused. At one point she picked up the remote control to the TV thinking it was a phone and said, “Police? You need to get this woman out of my house! Hello? HELLO???” I saw my opportunity and said, “Do they have you I hold again???? Oh my gosh! I can’t believe it!! They’re supposed to be there to serve and protect! This is outrageous!!… …Oh, here’s the pill you wanted.” She took it and was fine after that.

  9. It’s year 2020 and your list and your sharing of your personal experience is still applicable and helpful.. this is what I’ve been looking for sooo thank you and bless all family caregivers.

  10. My Aunt with Alzheimer’s won’t allow any caregivers to help for more than a couple days. After that point she becomes agitated and aggressive but unfortunately she’s not to the point where she will forget after a few minutes, hours, days etc. She’ll refuse to engage in any activities even if it’s something she loves like hanging out with the grand kids. Any suggestions would be greatly appreciated on getting past the angries!

    1. Hi Keri,

      I’ve been where you are now. I found that sometimes I could get Mom to “help” me when I couldn’t get her to do other “for fun” activities. For example, I could tell her one of the kids needed 24 cupcakes for some event, and she was on it! Clipping coupons, folding laundry, and watering our small vegetable garden were also things she would happily do. As Mom’s Alzheimer’s has progressed, she is more receptive to games, crafts, and puzzles. I know the interest in these will fade, but for now, they are working. Hope this helps! Anne

  11. Hi
    You did good and gave me inspiration as well. Thank you.
    My mother has Alzeihmer and my dad vascular dementia. It is hard to care for them. But we are reminded to show ourselves grace (also).
    My prayers goes to you. Continue to do good.
    R

  12. No matter how many people said my mom didn’t know or mean the hateful things she said to me it didn’t take the sting out of it. No one can continue to live with that level of stress and anger 24/7. We had to place her in a memory care unit where she continued to rage for 7 years before she died. It’s a nightmare for anyone who has had to experience this long and painful loss of a loved one. Keep praying.

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