Understanding and Handling Emotional Outbursts

When it happens

Some individuals go through most of dementia with few uncharacteristic emotional outbursts. Among those who have them, they tend to increase over time.

Why it happens

When outbursts happen infrequently, they're most likely to be caused by some unexpected frustration, such as trying to remember how to do something once easily mastered, especially if the person is already under some other emotional or physical stress, such as a move or an illness.

What you can do

• Help the person feel secure. This is the number-one way you can ward off unpredictable emotional states.
• Know that transitions of all kinds can be difficult: a new caregiving aide, a move, a change in routine, a shift from one activity to another. Provide extra time and reassurance.
• Be empathetic without talking down to the person: "This is a hard day, isn't it?"
• Keep to a routine schedule; predictability is very soothing.
• If you sense agitation mounting, try stepping back. Count to 10 or 15 from another room or somewhere apart where you can keep an eye on things, and then try again.
• Try distracting an upset person with tried-and-true favorites: a tape of preferred music, a cherished blanket or other comfort object, a sweet snack such as ice cream.

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How to Get Help for Critical or Abusive Parents

If your situation is truly intolerable, Social Services may have to step in. The main thing is, don't waver. If you tell your abusive elder you are setting boundaries and you will call for help and then leave them for a time, do it. It may only take one or two times before the cycle is broken, though if the dynamics are life-long, it could take much longer.

You may need regular respite care to get away from this behavior often enough to take care of your own needs. One thing to be aware of is that many abused children become abusers themselves. This can carry over into elder abuse. Putting an end to this problem by setting clear boundaries, calling in reinforcements, and carrying through by letting others take over the caregiving role when you need respite, could be vital to you and your elder. You don't want to be a person who "loses it" after being pushed too far by a life-long abuse situation. You don't want to return abuse. If you recognize abusive feelings surfacing in yourself while you are caring for someone, get help. Stop the cycle as soon as you can by having someone else take over.

Occasionally, the situation is so severe that you, the caregiver, may need to turn your parents over to a guardianship organization. In that way, a non-family member is in charge. You can visit and see to as much care as you can without letting yourself become a victim of more abuse. This is a difficult step, but in some cases it's the only way out of the abuse cycle.

Counseling can help enormously if you find yourself in this situation. Turning your parents over to the care of others and then feeling guilty about it won't help you. Discovering the roots of the problem may. Caring for elders is hard enough when they are just cranky or demanding because of aging, loss, and health issues. When they are truly abusive, and the situation is long-standing, caregivers really do need help.

Detaching with love doesn't have to be this dramatic, but it can be. Either way, following through with detachment and setting personal boundaries could help you weather caregiving in a safe and sane manner.

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Dementia Outburst Damage Control

This morning, you decided that a quick trip to the grocery store would be the perfect thing to get you and your elderly loved one out of the house and active.

The two of you are walking down aisle five of your newly-renovated neighborhood grocery store, when, without warning, your shopping companion releases a profanity-laced tirade foul enough to make you want to crawl underneath the shopping cart and pretend to be invisible.

Since that's not an option, what do you do?

Here are a few tips:

1. Keep your cool. Remaining calm is the key to handling this type of situation properly. A level-headed approach will allow you to think more rationally and, oftentimes, your serene attitude can rub off on the person with dementia.
2. "Move along, there's nothing to see here." If you're in a public place, try to draw onlooker's attention away from the person who is making a scene—explaining, if you can, that the person has dementia.
3. Perform a search and rescue. Try and figure out what may have ignited the outburst. If you are able to isolate the root cause of an outburst it will help you prevent another episode. Also, try to distract the person with dementia, drawing them away from the source of their frustration, giving them a simpler task that will engage them and bestow a sense of accomplishment once they complete it.
4. Remember, it's not them, it's the disease. A person with dementia faces a crippling amount of confusion and frustration that can manifest in unseemly outbursts. At times it may be difficult, but trying to maintain this perspective will help you cope with inappropriate behavior.

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