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Dementia And Being Mean To Family: What Helps, What Doesn’t

Whether you’re a family caregiver for a loved one with frontotemporal dementia, mixed dementia, vascular dementia, Lewy body dementia, or Alzheimer’s disease, you have likely been on the receiving end of hurtful comments or even aggressive behavior. 

Behavior changes in dementia can be hard to see and manage in the moment. At Trualta, we’re here to help caregivers get the dementia support they need. Check if you have free access to our platform, where you can access educational resources, share experiences in a dementia support group, and learn about resources to help you on the dementia journey.

In this article, we’ll review:

  • Why dementia and being mean to family can happen during the disease process.
  • What behaviors you might see.
  • Helpful strategies for managing and responding to these behaviors. 

Why Does “Mean” Behavior Happen In Dementia?

Your care recipient with dementia might show behaviors like:

  • Agitation. They might worry, pace around, have trouble settling down or sleeping, and appear restless.
  • Aggression. They might hit, hurt, yell, or say hurtful things.
  • Sundowning. This involves becoming aggressive and agitated in the early evening or late afternoon. They might seem worried, confused, and irritable.

While it may seem like your loved one is being “mean” to you or another family member, it usually isn’t intentional at all. 

There are several possible explanations for why your loved one is engaging in challenging dementia behaviors like aggression or agitation:

  • Brain health and cognitive decline. As dementia progresses, your loved one gradually loses cells, called neurons, in their brain. Changes in cognitive function in areas like the frontal lobe may result in loss of impulse control, so they may say rude or insensitive things to others. 
  • Health or medical issues. Your care recipient may no longer be able to understand or describe how they’re feeling. If they’re in pain, uncomfortable, unwell, or tired, they might show anger or withdraw. 
  • Memory loss. They may experience anger or confusion if they can’t understand what is going on.
  • Adjusting to change. For example, a change in routine happening very suddenly.
  • Experiencing loss or loneliness. For example, no longer being able to drive or not spending as much time with others.
  • Feeling pushed to do something they don’t want to do. For example, eating more food or bathing. 
  • Overstimulation. Brain changes might make it harder for your loved one to process lots of sensory input at once, like bright lights or loud noises. This can be overwhelming and stressful.
  • Seeing someone become upset. People with dementia may depend on others for emotional cues–so if they see you or someone else show anger, they might, too.
  • Medications. In some cases, medications (or interactions) may contribute to behavior changes. 
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Helpful Tips For Responding & Managing

Challenging behaviors and personality changes are common as dementia progresses. You may feel like your loved one isn’t acting like themselves, which can be distressing to see. 

When responding to a challenging behavior from your loved one, remind yourself:

  • Safety comes first. Take action right away if you’re worried your loved one’s behavior could hurt themselves or others. 
  • Behavior is communication. Be a detective and figure out what needs your loved one is communicating. For example, are they hungry? In pain? Cold? 
  • They’re not being “mean” on purpose. This behavior might be the only way your loved one’s body knows how to react to their feelings. 

Here are some tips for responding to agitation and aggressive behaviors from your loved one. 

  • Consider the environment or events that happened just before. Could their behavior be the result of feeling overwhelmed by crowds or noise? Did an unexpected change happen?
  • Investigate health or medical causes. Could they be constipated? Did they sleep well the night before? Are they experiencing any other symptoms, like a fever or low appetite?
  • Avoid arguing, correcting, or criticizing them (even when they’re wrong). Using logic, reasoning, or asking them to remember something won’t help them feel less confused or frustrated. 
  • Give them space. If they’re upset or aggressive, they might need a few minutes to calm down and let the anger pass. Stay close by to monitor, but give them some physical distance.
  • Avoid pressuring them when they refuse something. Take a break, come back, and try again later.
  • Be mindful of your facial expressions, tone, body language, and behaviors. Try to stay calm and relaxed, smile when you can, and use a gentle tone of voice.
  • Use comforting distractions. For example, watching a favorite TV show, having a snack they enjoy, or asking about a favorite keepsake.
  • Create a routine. Your loved one with dementia might be very sensitive to change. Routines can help support comfort and familiarity. 

Don’t forget to check if you have free access to Trualta for more information and guidance on managing difficult dementia behaviors. 

References

  1. UCSF Weill Institute for Neurosciences Memory and Aging Center. (n.d.). Behavior & personality changes. University of California San Francisco. 
  2. National Institute on Aging (2024, July 11). Alzheimer’s caregiving: Managing personality and behavior changes. 
  3. National Institute on Aging (2024, July 17). Coping with agitation, aggression, and sundowning in Alzheimer’s disease. 

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