7 Ways to Reduce and Manage Mean Dementia Behavior

Mean dementia behavior is upsetting and challenging for caregivers to manage

People with dementia might say hurtful things

When you’re caring for an older adult with Alzheimer’s disease or dementia, they might make mean comments, use hurtful words, or accuse you of terrible (but untrue) things. 

It’s devastating to hear, but the most important thing to remember is that their disease is causing the behavior. 

Your older adult isn’t purposely saying these things to hurt you. The damage in their brain is causing it.

However, while they’re yelling or making false accusations, it’s tough to try to keep that in mind and ignore the hurtful words.

We share 7 effective tips to help you manage this mean dementia behavior and reduce the stress and resentment it causes.

 

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Understand why someone with dementia says mean things

First, it’s important to understand why this hurtful behavior is happening. 

Dementia is a brain disease that causes parts of the brain to shrink and lose their function, resulting in cognitive impairment. 

These different parts control functions like memory, personality, behavior, and speech. Dementia also damages the ability to control impulses, which means actions aren’t intentional.

Even though it’s difficult, do your best to remember that they truly don’t intend the mean things they say.

These mean comments and hurtful accusations often happen because the person is unable to express what’s actually bothering them.

It could be triggered by something in their environment that causes discomfort, pain, fear, anxiety, helplessness, confusion, or frustration.

Working to accept the fact that they’re not doing this on purpose helps reduce stress and makes their behavior easier to manage.

The overall strategy is to take a deep breath, remind yourself that it’s not personal, take care of  immediate discomfort or fear, and try to find the cause behind the behavior.

Next, look for long-term solutions that will help you get the support and rest you need to keep your cool in challenging situations like these.

 

7 ways to reduce and manage mean dementia behavior

1. Calm the situation down
The first thing to do is reduce the tension in the room.

Start by limiting the distractions in the room, like turning off the TV or asking others to leave.

And if you stay calm, they’re also more likely to calm down. 

It might help you to count to 10 or even leave the room for a short time to cool down. Repeat to yourself “it’s the disease” as a reminder that they’re not intentionally doing this.

If the current activity seemed to cause the agitation, try shifting to a more pleasant, calming activity. Or, try soft music or a gentle massage.

 

2. Comfort and reassure while checking for causes of discomfort or fear
Take a deep breath, don’t argue, and use a calm, soothing voice to reassure and comfort your older adult. 

It also helps to speak slowly and use short, direct sentences.

Then, check for possible causes of agitation or fear, like:

  • Pain or discomfort
  • Signs of overstimulation
  • Feeling disturbed by strange surroundings
  • Being overwhelmed by complicated tasks
  • Frustration because of the inability to communicate

It also helps to focus on their emotions rather than their specific words or actions. Look for the feelings behind what they’re doing as a way to identify the cause.

 

3. Keep track of and avoid possible triggers
Whenever difficult behavior comes up, write down what happened, the time, and the date in a dedicated notebook

Also think about what was going on just before the behavior started and write that down as a possible trigger. 

Having everything in one notebook helps you find possible causes for the behavior.

For example, if your notes show that your older adult gets angry and starts calling you names around 4pm on most days, it could be because they haven’t eaten since noon and they’re hungry. They may not realize it or don’t know how to ask for food. 

To test your theory, try giving them a snack around 3:30pm to see if that helps prevent the outbursts.

 

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4. Check for a urinary tract infection
A urinary tract infection (UTI) can put a lot of stress on your older adult’s immune system. 

That can cause sudden, unexplained behavior changes like difficult behaviors, more agitation, or being less responsive than usual.

 

5. Consider an adult day program
You might also consider enrolling your older adult in an adult day program. 

These are places where your older adult would go for a half or full day of activities and socialization. 

Interacting with other people and participating in a variety of enjoyable activities can reduce stress and help them sleep better. 

That can improve their overall behavior and reduce their need to act out.

Find a local adult day center through the Eldercare Locator (also at 1-800-677-1116) or through your local Area Agency on Aging.

 

6. Attend a caregiver support group
Caregiver support groups are filled with people who really understand what you’re going through. 

Talking with other caregivers gives you an important outlet for stress. You can vent your frustrations so it will be easier to stay calm when your older adult is being hurtful.

Fellow caregivers may also have helpful advice or perspective that can help you get through a difficult episode.

 

7. Lean on family, friends, and other help to get a break
Always being around the same person can make anyone annoyed and short-tempered. This goes for both you and your older adult.

Taking some time away can help both of you. 

Ask family and friends to take over for a few hours or hire caregiving help

Taking regular breaks gives you a chance to take care of yourself and gives you both a little time away from each other.

 

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By DailyCaring Editorial Team
Image: Bing Butt
Sources: Alzheimer’s Association, NHS, New York Times


25 Comments

  • Reply November 20, 2019

    Shakela Strawberry

    I feel like I can see this from a mile away. However my family member is in denial. How do you get someone tested for this if they are refusing help and treatment? And if it just gets worse, how does one help? I have kids and this has been hurtful to them as well.

  • Reply November 18, 2019

    Jeri Anderson

    My Mom is blind, in a wheelchair, no feeling in her hands, and has dementia.
    How can we help her? There is almost nothing on caring for Blind, dementia patients. If we put her in a nursing home, we would have to be there til she went to bed. Are there any suggestions? She is 92 years old and healthy. I am a long distance care giver. I travel by bus 300 miles for 7-14 days each month to help my sister (primary caregiver).

    Thank you, Jeri

  • Reply July 13, 2019

    Rose Rodriguez

    Good morning my dad is in a nursing home right now he does not want to come out of bed . Seeing my dad how he was it’s a different person . My father is a wonderful dad he took care of me now it’s my turn to take care of him. My mom pass away 20 year ago and my dad mention her all the time we have picture of my mom in his room . Right now i’am taking care of my friend mother and it’s hard . Please help me understand

  • Reply July 7, 2019

    RAM

    If one more person says, “It’s the disease,” I’m going to have to slap them!! That does absolutely nothing to help with the abuse that can occur.

  • Reply July 1, 2019

    Angelina Brown

    Awesome article! We often fail to consider how difficult it is for a caregiver to tackle patients with Alzheimer’s and associated dementia. Sometimes it gets difficult to remember that the patient is suffering, and this is not the real him/her. It is necessary that there are available support groups and psychological help for people dealing with such crisis.

    • Reply July 24, 2019

      jeanette

      I take care of a woman who is great for telling people to shut up very rudely when they are trying to give them assistance also go to strike them in the gut with their elbow or yell at you to get out which you can’t because they are a fall risk. I will tell them that I will not shut up and I am there to help them. I am not mean about it but tell them to be nice. They will act in ways that are harmful or have the potential to be harmful and don’t appreciate being told about doing it for their own safety. I have been a caregiver for 10 years. There are times you have to open your mouth – you just don’t want to be angry or yelling when you do. i have noticed this has caused the behavior to stop.

  • Reply May 12, 2019

    Ann

    At what point should a person with dementia be placed in a memory care home?

    Have been trying to handle the situation at home for the past 6 months but the anger and bullying is getting worse.

    He has always been a bully and it has gotten to the point I want to just walk out.

    My health is not great either. Have had 2 strokes and do not want another one. No family live close by.

  • Reply May 10, 2019

    Jimmy

    Anybody out there have a father that’s dying of bone cancer AND a mother with moderate dementia? I moved home and quit my job 9 months ago to care for both parents. Mom tells me at least 3 times a day ” dad isn’t sick he’s only LOOKING for attention ” ( my father has 6 months to live ) I’m watching my mothers mind slip away ( the brain scan showed 65 percent memory loss) so dealing with this from 430am to 6 pm everyday is taking its toll. Any ADVICE OUT THERE??

  • Reply April 27, 2019

    stephana

    My mother is almost 92 and lived in a lovely senior apartment building. She did very well and was sharp mentally until a year and a half ago. First small memory changes then big ones with behavioral changes as well.(paranoia, anger not being able to remember when to take meds…not able to handle day to day tasks without being overwhelmed.
    2 months ago my family and I had to make the decision to put Mom in a nursing home due to numerous falls and breaks , and in the past year and half Dementia.
    She was no longer safe at home because she refused all the forms of helps to keep her safe.
    She is now at a lovely place where the staff takes very good care of her and keeps her involved in various therapies and art classes and music presentations.
    The sad part my mother has completely turned on me.She calls me every day saying terrible things .The first time she called me I just said “Mom, I have to go and I’ll talk to you later” I felt gut punched-Though I understand the disease it still breaks my heart.She doesn’t do this to any other family members….and yet I have been the daughter who has traveled very far to care for her for all her surgeries and broken bones and loved her with all my heart….I won’t call her because I know I will be yelled and screamed at.Yet the nursing home staff says shes doing really well…I just need to vent …I know this is a common thing but it breaks my heart that now I have become the bad one…I hope this will pass.

    • Reply July 17, 2019

      DailyCaring

      I’m so sorry that this has happened 🙁 You’ve taken wonderful care of your mom and it’s helpful to know that she’s currently getting great care from her nursing home.

      With dementia, behaviors often have phases and will pass in time. Hang in there and know that you’re doing the best for her and that the disease is what’s causing her to lash out at you. For now, getting off the phone when the mean behavior starts may be the best way to protect yourself.

  • Reply April 19, 2019

    Judy Hollocher

    my mothers demented ugly selfish behavior has been happening for many years before the dementia. the dementia has made it worse some, yes.

    • Reply July 17, 2019

      DailyCaring

      I’m so sorry you’ve been dealing with this type of behavior for so long. Hopefully the suggestions in the above article can help to reduce and manage it.

  • Reply December 26, 2018

    Rachel R.

    Nothing is mentioned about how helpful medications can be for controlling impulsive mean behavior.

  • Reply May 17, 2017

    Jami

    This article doesn’t really help to tell you what to do. I need practical application.
    For example, dad was really angry at mom because he wanted her to hurry and get dressed so we could go on our errand. He was in her face, shaking his finger and I thought he was about to hit her.
    So I told him to “Stop acting mean, dad. You need to be nice. We are all trying to get cleaned up so you need to relax.” I told him to go take a walk by himself and to leave her alone. He turned on me and then got angry with me. What else can you do in this situation?

    • Reply May 19, 2017

      DailyCaring

      Does your dad have dementia? Or was he just angry and being abusive? Those are two very different reasons for his behavior. If he does have dementia, maybe the stress of everyone getting ready was making him agitated and angry. It might be better in these situations to keep him separate from the group and engaged in a favorite activity until everyone is ready to go. Or, maybe don’t tell him that you’re all going out until the last minute and have everyone ready first before asking him to get ready.

      • Reply May 19, 2018

        Anonymous

        You do know that ” angry and abusive” people get dementia too, right? Just because they are ill doesn’t mean that behavior goes away. It most likely amplifies it.

        • Reply May 22, 2018

          DailyCaring

          That’s absolutely true. Dementia’s effect on personality can be very unpredictable. Sometimes, the person’s original personality becomes magnified whether they’re angry or kind. In other cases, their personality can change to the complete opposite — a very kind person becomes mean or a very mean person becomes sweet. And in some cases, their personality doesn’t change at all.

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