Handling dementia tirades when you’re the only caregiver

Dear Mary:

My husband has dementia, and he is so hateful towards me. He is a retired army officer and has always expected our home life to run a certain way but now he is constantly yelling at me and telling me I’m stupid or lazy. I find myself crying a lot and it’s getting more and more difficult to provide care for him while picking up the extra responsibilities around the house that he can no longer do. I am his only caregiver as our son and his family live out-ofstate.

Dear Reader:

For many of the progressive dementias, personality remains the same even after dementia enters the picture so if the person was always a strong-willed individual, he will continue to exhibit those traits. Your husband spent his entire career setting expectations and giving orders; that is what he knows how to do, and he will most probably continue doing that as long as he is able to speak.

Keep in mind that an individual living with dementia has loss control and will continue to lose control over just about everything to the progression of the disease. Because of what is going on in the brain, they lose the ability to both understand what is happening and to express themselves in ways we might expect, so behavior becomes their way to communicate. And, just like the saying goes, “You always hurt the one you love,” the person who is close by is usually going to take the brunt of their emotions.

That does not mean you need to tolerate the situation without taking care of yourself. In fact, you need to make caring for your health (physical, emotional, and spiritual) the priority. If you fail to do that, you will not be in the position to oversee your husband’s future care.

So, you need to speak with your physician and letr them know what is going on. Also speak to your husband’s general practitioner or neurologist and let them know about the tirades; it is possible that a simple medication adjustment might decrease his anxiety and, therefore, his outbursts.

Next, develop your support system. It does not need to be a large number of people but know who you can call if you just need to vent or a shoulder to cry on, or if you need someone to take over a few tasks few you, or — even better — someone who can sit

with your husband for an hour or two so you can get a break.

Make sure you keep your son in the loop; ask him to spend a weekend or longer with your husband, again, so you can have some quiet time to recharge. And, if you have not already done so, join a support group. The Department of Aging and Disabilities offers two support groups each month, one in the north part of the county and one in the south. These groups will continue to provide both virtual and in-person opportunities to share.

Contact the Department’s Respite Care Referral Program or one of the county’s many home care agencies and hire staff to help with your husband’s care and allow you to get routine breaks. You do not have to do this alone. If you are unsure of what veterans’ benefits might cover, you can call the Department of Aging and Disabilities Information and Assistance Program staff (410-222-4257) for assistance.

Educate yourself about dementia, particularly about which kind of dementia your husband has. Attend the caregiver workshops presented by the Department of Aging and Disabilities. I strongly encourage you to participate in the Dementia Live workshops; this will give you an idea of what to expect as you continue on this journey and will give you tools to improve communication between the two of you.

Most importantly, if you ever feel threatened by your husband’s words or actions, back out of the room. Go to another room or outside to see if he is able to calm down. Please do not hesitate to call ‘911 if you ever feel in danger. Anne Arundel County police officers receive dementia training and are well prepared to diffuse tense situations; the County’s Crisis Intervention Team can also be both a calming influence as well as a support.

Do take care of yourself. While he may not understand it, your husband depends on you.