When your parent with dementia becomes hostile. Causes and tips.

Elaine Pereira January 31, 2018

Brain & Memory > Dementia

When Your Parent with Dementia Becomes Hostile. Why It Happens and How to Respond.

Growing up we are raised to be respectful to our parents. Don't talk back. Don't interrupt. Except for the ugly teenage years when our parents can't do anything right, we probably adhere to the boundaries more or less.

Steadily, however, the pendulum of life swings, bringing about a reversal of roles. Instead of being tucked in at night by your mom, you're watching out for her safety. It's a daunting responsibility being a "parent to your parent". I know; I've been there. Many sons and daughters walk in the shoes of being a caregiver or advocate for their aging mom or grandfather.

The thin line between acknowledging their autonomy and making sure they don't self–destruct is fluid. Dad needs to take his medications on time, but balks when you remind him. Mom needs to eat better but resents your interference. My mother flat out called my "bossy!"

Regardless of what medical or aging issue your parent is dealing with, your involvement might be unwelcomed. Dad has a significant hearing loss but refuses to wear his hearing aids. Despite great advances in technology, he thinks email is "cold" and efforts to explain texting to him have literally fallen on his stubborn deaf ears.

Or Mom has already had one hip surgery and a second broken hip might be her demise. Despite that, she refuses to use her cane/walker in public and won't let you pick up the hazardous rugs that she tripped over resulting in her first broken hip.

Alzheimer's and dementia compound already tenuous dialogue. Your parent with physical limitations may ignore your sound advice and express disfavor. Your parent with dementia/Alzheimer's, however, may become agitated and hostile!

Alzheimer's Assaults
My mother's journey through dementia was tantamount to falling off a cliff. She was a kind, accomplished woman until Alzheimer's took hold leaving an agitated, angry and compromised person in its wake.

Alzheimer's is not a personality quirk or just obstinacy run amuck. It's a real, debilitating neurological disease. All brain centers are impacted by Alzheimer's advances, engulfing and consuming gray matter like Pac–Man. Piece by piece, the individual experiences deterioration as their mind is chipped and chiseled away.

One of the first indications of Alzheimer's in addition to the intermittent confusion is the ugly personality changes. My mother was patient, poised and understanding; a genuine lady until Alzheimer's steadily destroyed her very essence.

Mom became more judgmental and irritated, traits she had never exhibited. Her voice often took on a sinister tone, punctuated with a slight hiss. She accused someone of stealing her brown wool pants and snapped at me when I suggested she had donated them.

Known for her organizational skills and meticulous attention to detail, her apartment started to look like an episode of Hoarders! When I offered to pack and pitch she had a "hissy fit" and growled at me to leave her stuff alone. It was so not her but becoming more her with deteriorating dementia.

Eventually, I wove together my professional experience as an Occupational Therapist with my daughter duties and orchestrated a blend of dialogue that was more effective than using rationalization. Logical thought wanes as Alzheimer's continues its assault on the brain. The decline is sporadic initially, however, which contributes to the bewildering oscillation between lucid and bizarre behaviors. Even with my credentials as an OT and decades of experience with neurological disorders, I missed and dismissed the indications of Mom's genuine dementia disease at first.

Silence is Golden
It's hard not to correct the ridiculous remarks people with dementia say. My mother was almost giddy when she professed she had discovered there were "multiple solutions for Sudoku puzzles". The irony is that Mom had a Master's in Education and had taught high school math!

Language compression, processing and execution (ie listening, understanding and talking) are also negatively impacted by Alzheimer's. What someone with dementia "says", what they hear themselves say and what they probably meant, are all scrambled and unreliable. They no longer can self–correct; meaning that if they call a white sweater red, they may have lost the color word association or their auditory processing skills are, as my German mother would have said, "kaput!".

Quiet deference and validation are far more effective than confrontation. Don't let your eyes get stuck as you roll them upward in amazement when you parent says or does something bizarre. It's only bizarre to you. Although their reality may be anything but real, again it is their reality. And while you're trying to instill some common sense, you're also instilling frustration.

Hostility is an unfortunate outcome of Alzheimer's. Be patient. Try to remember it's not your mom or dad snapping at you but the disease. Whatever they insist on, offer vague agreement. Change the subject. Head nod. Use non–inflammatory phrases like, I'll look into it. That's a good idea. Or don't say anything.