How to Manage Your Anger When Caring for Someone with Dementia

July 19, 2017

Caring for someone who has Alzheimer’s or another type of dementia can be challenging and can sometimes lead to anger in both the person who has dementia and the caregiver. Today, I’m going to focus on caregiver anger that may arise and how to deal with it.

Dementia caregivers get impatient, annoyed, frustrated, and even angry for a variety of reasons, some of which include:

  • Things may not be happening as you’d like or are out of your control
  • You’re feeling overwhelmed in your role of caregiver, or feel like you do not have enough time for other aspects of your life
  • Others aren’t helping out and/or are criticizing your efforts as a caregiver
  • Unrealistic expectations of others, including the person who has dementia, and of yourself
  • The care receiver may be doing things that are irritating or scary to you (such as the inability to do “easy” tasks that are no longer easy for them, wandering and getting lost, asking the same question over again, wanting to continue driving when it’s no longer safe for them to do so, paranoia)
  • The care receiver may be angry about something, which can trigger an angry response from you, and the anger of both parties escalates from there
  • Resentment of having to care for someone you may not have gotten along with in the past
  • Role reversal resentment (such as having to do things that your spouse used to be in charge of, like managing the finances; or having to make sure your parent is safe and cared for if you’re an adult child)
  • Inaccurate thinking (such as telling yourself “The person with dementia is doing it on purpose to make me angry” or “The person with dementia should do everything I tell her to do the way I want it done”)

It’s natural to get angry, but it’s important to mindfully manage what you do with it. One reason is that people who have dementia are sensitive to your moods.  If they feel afraid of you, for instance, that could have a negative impact on the caregiving and care-receiving relationship that is ideally rooted in trust.

Another reason to mindfully manage your anger is that if left unchecked it can sometimes result in emotionally or physically harmful interactions with the person who has dementia or others — and you want to avoid that at all costs.

The following tips aren’t a guarantee you won’t get angry, but hopefully they’ll help you respond in an effective and healthy way.

First, it’s good to be aware of the signs of anger, such as:

  • Shortness of breath
  • Tense muscles, a tingly sensation in your body
  • Clenching your fists and/or jaw
  • Sweating, getting red in the face
  • Speaking in a louder voice
  • Maybe even wanting to hit the other person

If you notice some or all these arising in you, tell yourself, “I’m getting angry and I need to be careful about how I respond,” take several slow, deep breaths before responding, and even take a time out (see below for more tips).

Second, it’s good to be aware of the way(s) you usually express your anger:

  • Aggressively — such as yelling, talking over the other person, arguing, bossing, criticizing, shoving, hitting
  • Passive aggressively — such as taking longer to do things, abruptly hanging up the phone (though some may consider this aggressive behavior)
  • Passively — such as not responding, withdrawing
  • Assertively — stating your opinion, needs, or wishes while being respectful of the other person (this is considered the best way to respond)

When a caregiver loses their temper and becomes aggressive toward the person who has dementia or others, this is a warning sign that they have lost control, need help, and may need to take time off from caregiving responsibilities. And if the behavior becomes abusive or neglectful, then Adult Protective Services will need to get involved. On the other end of the spectrum, unexpressed anger can sometimes result in caregiver depression, which can also be dangerous and affect the health and wellbeing of the caregiver.

Again, you want to avoid these extremes. To do so, here are some healthy ways to deal with anger:

  • Be mindful of situations that typically make you angry
  • Educate yourself about the type of dementia the person has and caregiver tips. The Alzheimer’s Association website is an excellent resource
  • Learn techniques for how to communicate with someone who has dementia. The Alzheimer’s Association has a helpful brochure about this, and the Alzheimer’s Association Colorado Chapter has a tips sheet that includes examples of what to say and what not to say in various situations
  • Imagine what it must be like to have Alzheimer’s or another type of dementia and how you’d like to be treated
  • Remember that what will happen during your interaction with the person who has dementia is not always predictable, so it’s best to limit your expectations
  • Remind yourself that you can’t argue with a person who has dementia—you’ll never win; so pick your battles and maybe even agree with the person even if you disagree with what they’re saying
  • Take a time out—brief (such as leaving the situation for 5-10 minutes if possible to let yourself and the person you’re caring for calm down) or longer (such as respite time of several hours, days, or weeks)
  • Change the subject or activity if the current one is agitating
  • Strike while the iron is cool; try to avoid talking about potentially upsetting topics (such as stopping driving) or doing something stressful (like taking a shower) when you and/or the person who has dementia is already upset
  • Respond in an assertive way when appropriate (though not responding is sometimes the better response)
  • Practice relaxation techniques (such as deep breathing, spiritual practices, closing your eyes and visualizing being in a calm place)
  • Change your inaccurate thoughts; for example, “The person with dementia is doing it on purpose to make me angry” becomes “His brain is sick and he doesn’t realize what he’s doing; it hurts when he does that, but he’s not doing it on purpose;” or “The person with dementia should do everything I tell her to do the way I want it done” becomes “She’s sick and may not be able to do even ‘simple’ things the way she used to so I need to be patient”
  • Know your limits and that it’s OK — and healthy — to ask for help from family, friends, and/or professionals
  • Join a caregiver support group like those offered by Iona and the Alzheimer’s Association, and get individual counseling if needed
  • And last, but certainly not least, remember to take care of yourself by doing such things as eating right, getting enough sleep, exercising regularly, keeping up with hobbies, getting together with or calling family and friends, and keeping a journal.

What are some healthy ways you deal with anger? Let us know in the comments. 

By Bill Amt, LICSW

Bill Amt, LICSW, is a licensed clinical social worker and is the Mental Health Program Manager at Iona Senior Services. As a psychotherapist he works with older adults and caregivers who are coping with the emotional challenges of aging, and he also leads support groups for caregivers and people diagnosed with early-stage dementia. He has a Master of Social Work degree from The Catholic University of America.

23 thoughts on “How to Manage Your Anger When Caring for Someone with Dementia”

  1. AM a caregiver. .My husband is battling dementia. …having difficulty learning to live and cope with the issues this disease presents. Never thought this would be an issue in our lives. The anger,frustration and uncertainties keep me from feeling I am coping properly and am concerned about my well being as I travel this unknown scary path.

    1. Dennie, thank you for your comment and sharing your fears and frustrations. You are absolutely correct that it is a scary and difficult path. But, do know that you are not alone. Iona’s Information & Referral Helpline specialists can give you information about support groups and other programs and services in the DC area, or refer you to good online resources to find other services if you live outside DC. You can speak with a specialist M-F from 9 AM – 5 PM by calling (202) 895-9448.

        1. Thanks for your question, Lisa. We’re a local nonprofit in Washington, DC and serve the DC metropolitan region. However, I’ve shared your question with our Helpline staff in case they can direct you to resources in the Queens area.

  2. I have been taking care of my elderly mil. She was diagnosed with LBD 7 months ago. No one in the family really gets involved. What makes it worse is she speaks only 10% English. Her nationality prevents her from going to assisted living. I feel the type of treatment that she needs to help her is Massage Therapy. Her country offers free medical care. They can help her to adjust. To me to take a life just to extend the life of a person who has lived a full life is wrong. There is no good out of this situation. It has affected me mentally. We are to have 20% ruminating thoughts(bad thoughts) well mine is 90%. I will never forgive my husbands family what they have done to me!

    1. Thank you for your comment. Your anger is certainly a natural response given the difficult situation you are in. We hope that some of these tips help you manage those feelings in a healthy way. You might also consider joining a support group for caregivers or get individual counseling. You can contact Iona’s Helpline at 202-895-9448 or info@iona.org to speak with a specialist, ask questions, and learn more about services or programs that might assist you.

  3. Thank you for your tips. Although my 94 yr old grandfather doesn’t have dementia, he’s got cancer and many of the behavioral patterns you described apply to him. My mom is his primary caregiver and I can see it all wearing her down. The whole family dynamics have changed, it’s affected everyone in one way or the other and today we went through a situation where anger arose and although I KNOW it is not my grandfather’s fault, I was blaming him for everything. The way you put it about rewiring our brains to think about their behavior in a different way helped me calm myself. I will definitely keep it in mind.

  4. Me and my wife take care of my 90 year grandfather who has LBD with sundowners. I mostly put it on my shoulders since he is my Grandfather. He is also mostly blind with macular degeneration. The type that cannot be fixed. He is very fall prone and constantly forgets to use his walker. We have been caring for him for the last 9 years. For the past 6 years his Dementia has continued to worsen. I have had a hell of a time coming to terms with his mind state. I kept trying to reach my grandfather somewhere in there and this made the situation worse. I have problems not always being able to care for myself due to having Rheumatoid Arthritis for past 19 years. So with his care on top of my RA makes it very tough at times. I finally got to a breaking point where I no longer care nor love my shell of a grandfather. It’s not that I no longer take care of him it’s I just feel my grandfather is gone and this shell of craziness is what’s left. I get very upset and angry quickly. I would never be physical or mean to him but I Express my anger by cursing to myself not at him. My wife is constantly reminding me to not do this and deal with this away from him. My wife is amazing when it comes to caring for others. Very patient and compassionate. I on the other hand have no patience. He wants the care from me though. Like helping him to the bathroom. I have to constantly prompt him to sit and pee otherwise it’s all over the floor and a big mess to clean. He can feel like he needs to use the restroom up to 20 times a day. I am the one who deals with this through the day and nite. Waking up every 2 hours through the nite some nights. It changes constantly. We are going to be looking for a long term home for him but he is with us till then. My wife tells me I need to deal with this better but in the moment I get so angry at him. Like 10 minutes later I feel horrible for not dealing with my emotions and him in a better way. I was really close with him when I was growing up. I want to be as great as my wife is with dealing with him but I just end up angry with him. I guess my question is how do I stop getting so angry in the moment? I don’t want to be like this with him but it just happens. Thank you much for any info that might help my situation.

    1. Thank you for your question and for sharing your experience as a caregiver. I shared your question with our Information & Referral Helpline Specialists, who will respond via email. You can also contact our Helpline at (202) 895-9448, or by emailing info@iona.org. In the meantime, one good reminder for ALL caregivers is to recognize your own limits and ask for help. As they say on the airplane, you need to put the oxygen mask on yourself (in other words, take care of yourself) before assisting others.

  5. My husband has severe dementia and acts aggressively. As the prime caregiver and responsible for us both in our retirement, it is depressing to come this far in life and then have health issues. I have recently been diagnosed as borderline diabetic so I am finding it difficult to deal with both our health problems. He does his own laundry and makes soup but he smells and has to be reminded to do his toilette. I am weary of wiping poop smears off the toilet before I use it and am so deeply embarrassed that I don’t want people to come over although I used to be very social. I need help with managing him and can’t do what I thought I could.

    1. Thank you for sharing your experience. Know that you are not alone in your feelings of frustration. In fact, a shrinking social calendar is often a “side effect” of a dementia diagnosis, and we hear from many caregivers who face the same challenges as you. You might consider contacting our Helpline at (202) 895-9448 or info@iona.org. You’ll be able to speak with a social worker who can answer your questions and refer you to services or programs. Asking for help is the very first step in managing your difficult role as caregiver!

  6. Every time an issue arrises that require my wife to become aware of the fact that she is suffering from dementia she becomes despondent and goes away to sit and dwell on the problem with total dread. She is inconsolable and may stop eating and stay in bed. When I remind her that her actions are because of her condition, she becomes angry and blames me for reminding her of the fact that she has an incurable condition and there is no hope. I don’t know how to get her to see how important that we take advantage of our good times together while we have the chance and not to become so morose about her life. She cries for long periods and doesn’t want consolation. What should I do?

  7. Hi folks my mom has dementia and my dad has roughly 6 months to live in his fatal battle with cancer. They’ve been married 55 years and he doesn’t want to tell her how bad his disease is( he doesn’t want to frighten her) sadly her paranoia has taken over and every time to phone rings she insists that ” dad is talking about her”. I’ve moved back to the family home to watch both my parents fade away. Any advice?? I stopped working in August to be here with both of them. We all have our family story’s but, anybody out there with a similar one? They are both 79 years old and I’m the oldest child 53yr male divorced with children of my own but these are my parents. They come first

  8. I get really angry at my 89 year old mom not because I don’t love her but because I take care of the house and I know she gets tired but I have a disability and no one understands how hard it is to try and do the little things.
    My one sister never comes around and I feel if I went away she would visit.
    I blame myself for not doing anything right.
    No one comes over to visit my mom. Is this my fault?

    1. No, one thing that happens is when people seeing you do the job, they stay away so that they can’t be roped in. Many of my siblings do not visit out of fear and avoidance. People run into a fight or run away, often running away.

      You must never get angry, either at yourself or your mom. If you do, time to change to a facility, sell the house, and take a good portion for yourself.

      You must enforce some sort of pattern of support. If it means taking loans on the house to hire professional services, do it. If you do not have the money, you must use all resources you can.

      But creating a miserable situation for your mother at home is not helping anyone. She isn’t dead, she needs stimulation.

      Organize visits with any friends she has and family, and don’t ask, tell. They don’t have dementia, its time to be an adult and take a load off your shoulders. And if they don’t, turn to people who will…there are organizations that have people who will visit, and there are day centers for seniors in almost every city that is state funded.

  9. Several years ago, my now 94 year old friend made me her Power of Attorney. Last year, because she had lost the ability to manage her finances, had invited strangers into her home, and had two serious falls, I enforced the PoA.

    Over the past year, her cognitive state has steadily declined. After much tweaking, a dedicated care team is finally in place.

    The other day, she told me that she was angry at one of her helpers because she refused to do anything for her. I know this helper is dedicated and caring. My friend Sally (not her real name) said that she left lights on all the time, and she finds it necessary to shout at the helper. She wants to fire the helper. The helper states that Sally has never yelled at her, nor does she leave unnecessary lights on.

    Sally has insisted the woman be fired, but I have stood my ground. Sally accused me of not caring for her, and she is angry because I told her that the helper will remain. The helper is scheduled for Sunday/Monday evenings, and the rest of the week other helpers are with Sally.

    Unfortunately, I had an angry outburst directed at Sally yesterday. I did not strike out, but I was very assertive, yelling that the helper will NOT be fired. I feel bad, I apologized to Sally, and I will never do this again.

    I know I handled the situation badly. What should I have done?

    1. I dont think there is a should be done. If Sally is accepting other caregivers, but not Sally, I would have a talk with Sally and say “Hey I know you are doing a great job, I know it. Its just not a fit, do you have any solutions or can you recommend someone else.”

      If Sally has problems with all caregivers, it is more about the transition that must happen. When Sally gets upset, you have to deflect, not respond.

      You’re doing a great thing, how many friends would do this? You’re making a difference, thats all that matters.

      None of the people afflicted by this disease are accepting of the inevitable changes that must occur so that they can stay at home, but it all must happen. The one thing they hate losing is their independence, but feeling like a burden is the thing they hate more. They are not capable of seeing the big picture, that is why we are there, and we make tough choices…dont ever beat yourself up for it, walk away from an argument…

  10. Thanks, everyone, for sharing your comments and concerns. It’s wonderful to see that this article has resonated with so many people. If you would like to speak with a professional about your concerns, you are welcome to contact Iona’s Helpline at (202) 895-9448 or info@iona.org. Iona’s Helpline is available M-F, 9 am-5 pm. Other supports for dementia caregiving challenges are the Alzheimer’s Association (https://www.alz.org/ or the 24-hour hotline (800) 272-3900), and the elder care locator (https://eldercare.acl.gov/Public/Index.aspx).

  11. For those of you coping, or just experiencing it, it does get better.

    The entire reason for caregiving at home is to give them a better life than they would have in a home, because that is their wishes. If you feel you can not cope, than a caregiving facility might be the answer.

    My father recently died, caregiving illness at home, and my mother was in early stages dementia at the time. She has progressed (and thankfully memory meds do help), and simple tasks become harder and harder, and her windows of memory are shortening.

    However, she does have a quality of life she enjoys. She gets the comfort of her home and her comfort activities, I try to get her involved in activities outside the house (this will help you too) at least twice a week (cant afford one, a book store is great, so is a museum, often free one day a week). You will need complete time off, preferably once a week, but if not possible once a month.

    My entire point is that she does experience happy moments, and that’s the point. I’m of the firm belief that the memory doesn’t matter as much as the feeling (although I always take pictures to show her regularly and she loves it).

    I am in a luxurious position to have the time to do it all myself however if you are working, and can not afford professionals or have a great support to cover off the times, choose a facility. If you are getting angry all the time, choose a facility. It is a lot harder to nurse your family than it is a stranger, oddly enough. But if they are having an awful time (and believe me they absorb the negative feelings), and you are, there is no point in keeping them at home.

    There are lots of resources out there, most cities have day programs for the elderly (a lot like a day care) at very minimal costs. There are free caregivers and support groups (worried? Install a $25 camera you can connect to your phone)? Alexa is a fantastic tool for alzheimers, I can load it up with routines and just say Alexa, life history, or Alexa Banking, and it will tell all the things that comfort my mother instead of me saying it 20 times a day, and because alexa is a firm female voice, my mother considers her an authority. Alexa is also great for reminders, routines, music and other things. Notes and white boards are great things to wake up, I always leave a positive message with love to my mother and she attitude is always better. Exercise and fresh air do help for both of you. Healthy eating does help. Doing activities together does help (puzzles, books, drawing, anything away from television). And comfort things (photos, music, some television) does help. Friendly animals do help, nothing shows more unconditional love than an animal.

    Try to think of it this way: end of life is going to get us all. It can be a happy ending. Think of this as an opportunity to show love and respect for the person who gave you (or your husband or your parents) a happy life. It is not waiting to die, it is celebrating life, and there are still happy moments to share and enjoy.

    Is it hard? Yes. Will you get mad/upset/depressed? Yes. But it does get better (your approach, not the person) and when you break through that, you will feel better. Get the support, involve anyone who will be involved, reach out to the community. But again, if every day is yelling at them or showing frustration, choose a facility.

  12. My husband has been diagnosed with Alzheimer’s. He has been for the test which included driving he failed. Every morning Wego though the same thing that he is capable of driving he gets very angry and goes on for quite some time. He has bipolar which has been under control for a very long time but sometimes it is like he is having Manic episode. I talk it through with him and eventually calms down I then go and have five to ten minutes by myself. How long does it take for him to stop wanting to drive?. I love my husband do dearly and o want to make his life as easy and happy as I can for him

  13. I wrote a few months ago. I have been doing a lot of studying. For Dementia I had mentioned Massage Therapy. Of course there is no cure. This is a treatment. The physical pain that a person can feel, is the same pain they feel inside that they are letting out. The Massage Therapy on the Hands, Back nd feet, can increase the average living by 4-5 yrs. they will start to be comfortable. To possibly extend their lives why not!

  14. Been dealing with memory issues with my mom for about five years. The last 2-3 it’s become more obvious and the past 6-9 months have been pure hell. Tried for 2 years to get doctors to listen to me. Finally, after having her in a locked senior unit at the hospital twice in three weeks, she’s been diagnosed with nonspecific dementia. She can no longer be left on her own and the steps I’ve taken to deal with that are being met with out and out violence. I’m waiting now after getting a doctor referral to hear from a highly regarded memory center to get her there for a full exam and official diagnosis.

    Sometimes she realizes she’s at home. Other times, not. Anytime I hear “I want to go home” I know I’m in for one hell of an adventure. Sometimes she acknowledges who I am. Other times, even while referring to me by name, she denies vehemently that I’m her daughter. That was a truly hard blow, but I’ve learned to just let that go.

    We’re at the point where one day might be pretty good and the next is a nightmare. It’s been going on this way since I last brought her home from the hospital. In the interim, I’ve been trying to arrange a combo of in-home care and adult daycare. I’m an only child, as is she, so family help is pretty limited. She also doesn’t have many resources and mine aren’t massive but reduced last year when I took on a mortgage for a house I planned to move us to. IT was a good distraction for her for a while and she was active in changing up some interior designs. Had to postpone remodeling when reality began to severely crumble after the holidays. I’m beginning to think neither of us are ever going to live there.

    She’s on lowdose antipsychotics at night which mostly get her to sleep through the night. She had a UTI a few weeks ago which touched off one of the hospitalizations and possibly the first in a series of wanderings.
    She is very resentful of being kept in the house and not staying on her own which she insists she can do. This leads to violent outbursts and escape attempts.

    I think I’m going to lose my mind. I want to get to the care facility and see what options they can offer me but not sure I’m going to survive to get to the appointment. Someone told me that an anti-depressant might help improve her mood and limit if not eliminate these clashes. Hoping that’s the case because I want to feel good about leaving her in the care of others and I know that I have to go to work.

    These techniques are helpful because I know that as the abuse has escalated, my ability to try to maintain a calm composure has gone over a cliff. I love her so much and I know it’s not her making this happen but still …hours upon hours of verbal abuse, culminating with arm and hand twisting when you try to safely redirect is really taking its toll. Other terminal illnesses are cruel and all come with grief, but it’s unbelievably hard to grieve a “living” person.

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