When you’re caring for an elderly with dementia, they might make mean comments, use hurtful words, or accuse you of terrible (and untrue) things. It’s devastating to hear!

The most important thing to remember is that the disease is causing the behavior. Your senior isn’t saying these things to purposely hurt you.

But trying to keep that in mind while they’re yelling isn’t helpful enough. We’ve got 7 effective tips to help you manage this difficult behavior and reduce the stress and resentment it causes.

Understand why someone with dementia is saying mean things

First, it’s important to understand why this hurtful behavior is happening. Mean comments or hurtful accusations could be triggered by something in their environment that causes discomfort, pain, fear, anxiety, helplessness, confusion, or frustration.

Dementia is a brain disease that causes parts of the brain to shrink and lose their function. Different parts control different 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 mean the mean things they say. This behavior often happens because they’re unable to express what’s actually bothering them. Accepting that they’re not doing this on purpose reduces your stress and makes the behavior easier to manage.

7 ways to manage mean dementia behavior

1. Calm the situation down
The first thing to do is bring the tension level down. You can do this by limiting the distractions in the room, like turning off the TV or asking others to leave.

If you stay calm, they’re more likely to calm down. It might help 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.

4. Check for a UTI
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 senior 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.

6. Join a caregiver support group

Caregiver support groups are filled with people who really understand what you’re going through. It gives you an important outlet for stress — you can vent your frustrations so it will be easier to stay calm when your senior is being hurtful.

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 a caregiver. Taking regular breaks gives you a chance to take care of yourself and gives you both a little time away from each other.