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


56 Comments

  • Reply June 28, 2021

    Lucy Hart

    Hi, my mum has vascular dementia but refuses to admit anything is wrong and behaves as if my brother and I are doing things (such as taking her to the doctor etc) purely to hurt or embarress her. We don’t have a close relationship so how can I tell her I’m not trying to hurt her feelings? She constantly hurts mine but being rude and rejecting me. I just want to walk away to be honest but I can’t leave it all on my brother.

  • Reply May 29, 2021

    TERESA D SMITH

    My father recently had a stroke at the age of 89. He’s home and three of us kids are sharing the burden of having to rehab him when we are not experienced in this. My mother has dementia for sometime now. We can’t get her to take a shower. She goes sometimes three weeks or more. Even though she is 88 she is functional in her home. Soon as we try to get her to shower she turns into a crazy person. She went to call 911 to have me arrested last week. She screams at my father to get up and choose between me or her, but he can’t talk so he cries. Seems taking a shower sets her off. So, how do we get her to bath?

  • Reply May 22, 2021

    Pauline

    I need some advice. I believe my father has dementia, and he appears to direct his meanness and verbal abuse at my mom. He does not act this way when I am around. They are both in their early 80’s. In my opinion he has always been a narcissist, and not always the nicest person. He is forgetting how to do things, but tells my mom that ‘she thinks she knows more than him’, as if my mother knows nothing. He has taken some medicine incorrectly (doubling up), couldn’t do the taxes this year because the website was different (so I had to do them), and told my mom he wants a divorce because when she was talking in her sleep, he claims she said she wanted a divorce. I told my mother that I frankly don’t believe he heard her say that because he doesn’t wear a hearing aid at home often. Plus he lies.

    How does my mother get him to go to the doctor to discuss his issues? He won’t go if she makes an appointment. I personally don’t like being around him, and have for a long time done things for him because he is my father, not necessarily because I love him, so it’s difficult for me to be patient/understanding. And I can’t afford to have his condition affect my emotional well-being , which he has in the past. I guess I need advice on how my mom can handle this, as she is bearing the brunt of his meanness. I don’t want this to become physical.

    • Reply May 22, 2021

      DailyCaring

      These are challenging issues and unfortunately there aren’t any easy answers.

      The first thing to do is to make sure your mom is safe. If your father is being aggressive or violent, it may be necessary to move him to assisted living or memory care where he can get the care he needs and your mom won’t be in danger of being harmed.

      It would be ideal to have a doctor evaluate him for any cognitive issues so you can know what is going on. Or, perhaps he has a treatable condition that’s causing dementia-like symptoms.

      If he doesn’t want to go to the doctor, it would be very difficult to force him to do so. You may want to try fibbing to trick him into going. For example, your mother could say that the doctor’s office is requiring him to go for his annual visit, which is now required by the insurance company (or Medicare). Before the appointment, you and your mother should email with or call the doctor to let them know of the concerns about his cognitive health, his refusal to see a doctor, and ask the doctor to discreetly examine him to find out what’s causing these problems. That way, your father only thinks he’s going for a “mandatory” checkup.

      These articles might be helpful:
      – 7 Treatable Health Conditions with Dementia-Like Symptoms https://dailycaring.com/7-treatable-health-conditions-with-symptoms-similar-to-dementia/
      – 8 Treatable Diseases That Mimic Dementia https://dailycaring.com/8-treatable-diseases-that-mimic-dementia/
      – 8 Ways to Deal with False Dementia Accusations https://dailycaring.com/8-ways-to-deal-with-false-dementia-accusations/
      – Dementia and Anger: 9 Calming Strategies https://dailycaring.com/9-ways-to-reduce-anger-in-dementia/
      – Therapeutic Fibbing: Why Experts Recommend Lying to Someone with Dementia https://dailycaring.com/why-experts-recommend-lying-to-someone-with-dementia/

      • Reply November 12, 2021

        Jerome Kern

        How to take of my next door neighbor who has dementual and has no family.
        What should I do?

  • Reply January 19, 2021

    James M Lewis Jr

    My father is 88 he had a stroke 2015 it changed him, hevhas dementia, he has a sepsis infection in the VA hospital for 8 days he get angry for all the pricking and sticking. I figure 1 thats alot,2 just being inside a unfamiliar place isn’t ideal, but he is so angry at times in hospital, but he calms down. Will being back home after a bad infection help.??.he’s a man who likes to be left alone even with dementia, but peaceful

    • Reply January 19, 2021

      DailyCaring

      It makes sense that your father would feel disoriented and angry about various medical procedures while in the hospital, especially if he’s alone and the staff isn’t trained in caring for someone with dementia.

      In terms of where he should go when he’s discharged, it’s best to speak with the doctor to find out what level of care he’ll need after he’s released from the hospital and to evaluate whether or not you’ll be able to provide the needed level of care in your home.

      If he was already living and being cared for in your home, then it might be helpful to be back in a familiar place, assuming his care needs are still manageable. If he was in assisted living and they’re able to provide the needed level of care, it could be helpful for him to go back to that familiar environment.

    • Reply June 9, 2021

      Sandy Simon

      Home can help but trying a day care with other seniors can really help!

  • Reply October 6, 2020

    Cool for cats

    My mum has always been a horrible, vindictive nasty piece of work and this just makes it worse. She is a complete narcissist and does not even acknowledge its her with the problem. Me and my dad have suffered years of emotional and physical abuse, and although it sounds really horrible i am just waiting for her to die.

    • Reply October 6, 2020

      DailyCaring

      We’re so sorry to hear about your mom’s long history of mean behavior 🙁

      • Reply August 24, 2021

        Velma V

        I 100% feel your pain but not for much longer. The parents will be in control and on their own, just the way they like it.

    • Reply December 9, 2020

      Diane Duran

      I feel the same about my husband he is mean and physical. He scratches me, grabs my arm and twists it, pulls my hair and chokes me. Then an hour later he comes to me and says he is sorry. I am all alone no family or friends within two hours of us. It sure makes me laugh when people say “join a support group”. How? I can’t even take a shower without him getting angry for leaving him. He is mean and hateful. I do not believe any doctor or professional should give advice until they live with someone confused and angry 24/7. It is nothing like caring for a patient a few hours a day. It is like living in hell everyday. DD

      • Reply December 10, 2020

        DailyCaring

        We are so sorry to hear about this abusive behavior. You might consider discussing this behavior with his doctor to find out if there are any interventions you could try to reduce it.

        In case it’s helpful, we also have an article with some other things to try – 6 Things to Try Before Using Antipsychotic Medications for Dementia Behaviors https://dailycaring.com/how-to-handle-dementia-behaviors-without-antipsychotic-drugs/

        Or, you could call the Alzheimer’s Association at their 24/7 Helpline at 800-272-3900 to find out if their family specialists may have recommendations or ideas on how to manage or reduce this aggressive behavior.

      • Reply January 2, 2021

        Betty Wilmoth

        My mom is 86. We figured out magnesium helps with her anger. If she doesn’t take it, she’s mean and vulgar. That has never been my mom. Figure when he gets like this and 30 minutes before that time give him magnesium. Yes my mom’s Drs know about us giving her magnesium. I hope this helps in your situation.

        • Reply January 4, 2021

          DailyCaring

          It’s great that you found something that helps reduce your mom’s anger. And it’s even better that her doctor has approved of her taking this supplement.

          It’s always recommended to check with the doctor before adding any supplements or over-the-counter medications. For some people, supplements can interact negatively with existing medications or with chronic health conditions.

      • Reply January 10, 2021

        Anonymous

        Yes Diane… I am living the same experience with my mother. And no one understands until they experience it 1st hand! Praying for you; praying for me.

      • Reply February 6, 2021

        MC

        Diane Duran, I Know What You Are Going
        Through Because I Go Through The Same Thing With My Husband . HE has PTSD And Dementia . He Doesn’t Hurt Me Physicaly But He Does Abuse Me Verbally And Screams At Me And Acts Like A Narcessist . If I Didn’t Have Jesus In My Life I Couldn’t Make It . God Bless You And Pray For Jesus To Help Him And Give You Some Peace . I Don’t Baby Him And I Let Him Know That I Don’t Appreciate His Behavior , And I Stop Doing The Little Pleasures That He Might Like , When He Treats Me Badly . I Sleep In The Guest Bedroom Most Of The Time So I Can Have Quiet Time To My Self , SoBasically I Distance My Self Away From Him And Ignore Him Whe He Gets In His Ugly Moods . This Works For Me Because It Gives Him Time To Cool Off AndThink About His Behavior , And Then He Seems To Appreciate Me More And What iDo For Him , Because In My Situation I Have To Handle Everything There Needs To Be Done In Running The Home , Driving , Dr Appts , Checking Acct , Shopping , Giving Him His Medication Etc , I Am The Caregiver .

  • Reply July 15, 2020

    Anon

    We have finally had enough and made the decision to place my awful, hateful grandmother in a nursing home. We have spent the last seven years caring for her in our home while she rented her home out and gave the money to her addict son (my uncle) and got nothing but venom and false accusations in return. We do realise that her dementia is in part to blame, but she was always a very negative, toxic woman before the dementia. We have chosen a facility close to my uncle so he can visit her (he claimed the distance of 25 minutes was to blame for not seeing her) but I doubt he will once he realizes that her home will have to be sold in order to pay the RAD and there will no longer be $400 a week in rent coming his way. Dementia is a horrible disease, but when someone was always a **** it really doesn’t make a lot of difference.

    • Reply July 16, 2020

      DailyCaring

      We’re so sorry to hear that your grandmother has treated you and your family so horribly 🙁 It sounds like her behavior was a consistent part of her personality and adding dementia to that mix only made the situation worse.

      It sounds like the decision to move her to a nursing home was necessary. She’ll get the care that she needs and we’re glad that you won’t be exposed to that abuse any longer.

  • Reply June 26, 2020

    Dee Mari

    Never leave a dependent person alone with a narcissist claiming to be caring.

  • 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 May 10, 2021

      A RODRIGUEZ-RICH

      Thanks A Million 2 whomever called ME Right Back when I Called the local Chapter & was subsequently 4warded 2 The NATIONAL ALZHEIMERS ASSOCIATION……Again your prompt response Remains ever Appreciated!

  • 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.

          • May 10, 2021

            A RODRIGUEZ-RICH

            INSIGHTFUL.

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