How to Calm an Angry Dementia Care Provider

You may have read our recent post How to Calm Angry Outbursts of People Living with Dementia, where we discussed strategies to bring back calm and comfort for you both. Since we all know that it takes two to tango and anger can occur on both sides of the care relationship, we also wanted to share some things that a person living with dementia may try if their care partner is angry.

In dementia care, there will be moments when a caregiver (or care partner, as we prefer to them here at Positive Approach to Care®), will lose their temper and have an angry outburst. After trying and trying, they will have hit a point where they feel they just can’t take it anymore.

This may occur in a variety of situations, such as when you (the person who is living with dementia) indicate repeatedly that you do not want or need the help they are trying to offer. Whether it is  help with bathing, bathroom matters, money handling, driving, or navigating safety issues, you have told the helper that you are fine or don’t want or need their help. So for you, this anger comes out of nowhere and feels unjustified.

If you are a person living with a changing brain who is not expecting this reaction from someone who is supposed to be helpful or friendly, it is important to recognize signals that things are not as they should be. Something different is required.

So, what can you, a person living with dementia who is still able to notice this and use some of your retained skills, do in these moments?

1. Pause what you are doing

If your care partner is angry, you may want to stop talking, moving, or resisting. If you were yelling in response, stop and take a deep breath to help calm the situation.

Why? Because yelling creates a stress response in the other person’s prefrontal cortex, the part of the brain that is responsible for decision making and planning and causes it to shut down. The person’s limbic system, the emotion center of the brain, then takes over and disables their ability to process thoughts rationally.

So, by you pausing, taking a deep breath, and being quiet, you give the other person and their brain a chance to calm down and view things more rationally again.

2. Breathe Out

While taking a deep breath and exhaling, try saying “Wow!” with as much force as you can. This will help you release some of your stress, and signal to the other person that you are aware that they’re upset. By acknowledging their anger but not fighting it, you help calm the situation.

3. Relax

Did you know that human communication is thought to be predominately non-verbal? What that means is that our body language is critically important, and if our verbal and non-verbal communication don’t align, it can create distraction and distrust.

So if your care partner is angry, try to get your body and your face to relax – turn down the tension in your muscles. This will communicate to the other person that you are in a relaxed state, and will help their limbic system calm as well.

4. Step back

Take a step back to give your care partner some space. If you were face to face in your prior interaction, see if you can turn your body to the side into supportive stance. By doing this, you give your care partner some additional visual space and come across as less confrontational.

5. Offer an apology

No matter who you feel may be at fault, offering an apology can help you both find a common ground again.

And while it may be difficult to say I’m sorry if you don’t feel you were in the wrong, sometimes it’s what’s needed to help protect your relationship. As author Mark Matthews stated: “Apologizing does not always mean you're wrong and the other person is right. It just means you value your relationship more than your ego.”

You may want to try using one of Teepa’s five I’m sorrys:

1. I’m sorry I made you angry.
2. I’m sorry that happened.
3. I’m sorry I was acting like I was.
4. I’m sorry, I didn’t mean to hurt us (our relationship).
5. I’m sorry, this is HARD!

Notice something about these phrases? None of them assign the cause of the situation to the other person. For a genuine apology, try to remember not to blame, and drop the word but from your vocabulary, as that will likely just make the situation worse.

Then it’s time to pause. Pay attention to the person you are now supporting. Notice what your care partner is doing, looking at, or saying. If they have calmed down and seem more approachable again, you two may possibly come back together and figure out what set each of you off, so you can try something different moving forward.

A message from Teepa:

“Hey All – I am sure for many of you reading this post, the perspective in this message seems totally off the wall. Impossible, even. Let me just let you know from my experiences, you are mistaken.

There are actually thousands of people living in the early states of various dementias who are quite capable of doing what I have proposed. In fact, many of these individuals use these steps and skills each and every day as they care for their friends, parents, or spouses with a more advanced dementia. Still, many more people living with dementia use these skills as they live in situations where those who try to support their care are not trained or skilled in how they address intimate or personal issues.

I posted this on April Fool’s Day, not as a prank or a joke, but as a way of seeing it from the other side of the mirror. This is actually an invitation to truly imagine people living with dementia as people first and foremost. Each person living with dementia will display multiple abilities, disabilities, and variabilities – just the same as any other population.

As someone who does not have a diagnosis of dementia, allowing ourselves to see that we might be the one needing some support, a pause, or some time to think in a moment of high distress is critical for all of us.“