Question: How do I handle the change, the anger, the words? It hurts.
Dr. Amy: It’s stressful, hurtful and depressing to be attacked with angry words. And it’s especially stressful if the attacks are coming from someone who was not like that before, or from someone you love. I am not sure from your letter, but it sounds like you are either a new caregiver or that something has changed with the person you have been caring for. My advice to you is to check the medical facts, set boundaries if possible, and get support.
Dementia can change people’s personality over time. And new medications can sometimes cause shifts in personality, too. On the medical side of things, I encourage you to make sure you have a clear diagnosis and are also confident that there is no depression or other underlying illness. The doctor is the best person to help you with this.
Once you fully understand the medical picture, it’s important to set boundaries. Start by getting clear in your own mind what behaviors are OK and what behaviors aren't. Then have a conversation in which you explain how you feel, and what you’d like to see in your relationship. Try to avoid accusing or blaming. Stick to talking about your feelings and what you’d like. If the person continues to say rude and hurtful things, you do not have to respond. Sometimes, people who are unhappy say nasty things to get a reaction. You might try silence. If the person continues to say unkind things, walk away. Stay away for a short period of time, to gently show that you are not willing to put up with abuse.
If you are caring for someone with dementia, setting boundaries will not work, and it’s really not appropriate to try. Alzheimer’s and other types of dementia take away people’s ability to function properly. If this is the case, I encourage you to check out resources developed by Home Instead Senior Care at homeinstead.com. Just click on the Alzheimer's disease tab at the top of the page. They have also developed helpforalzheimersfamilies.com. Both are excellent resources. You can listen to other people in your situation and learn more about dementia from the experts.
At the same time, you really need a buddy to talk to. Someone who can listen, be supportive, and provide perspective. Do you have a close friend you can count on? I also encourage you to consider joining a support group. Talking with people who are living through the same challenges can ease your stress. Sharing how you are feeling—with someone you trust—can bring you a lot of relief.
Lastly, try to arrange for time away on your own. Put together a team of people who can help out so that you can take a break, get some exercise, and do things that are fun. This is not selfish. You need to take care of yourself so you can carry on and continue to care for this person.
You are being challenged now and I am sure you must feel terrible sometimes. I encourage you to focus on the things you can control, to make yourself feel better. I send you strength and peace.
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