Verbal abuse stemming from dementia needs to be managed with determination, patience

Dear Carol: My dad’s in the middle to late stages of Alzheimer’s disease. It’s been rough on both my mom and me in many ways, but right now I can say that the worst is my dad’s verbal abuse. He was always a gentle, wonderful man, so this uncharacteristic behavior is extra baffling and hurtful. He calls us ugly names and swears at us because he thinks that we’re stealing from him or even poisoning him. Mom is so ashamed that this is happening that she can’t tell anyone about it but I need an outlet, which is why I’m writing. How do we handle living with Dad’s verbal abuse without breaking down or acting ugly ourselves? — KC.

Dear KC: I’m glad that you wrote. Enduring verbal abuse from your wonderful dad has to be wrenching for you both and you have my heartfelt sympathy.

Even though you know that his behavior is caused by his disease, understanding with your head doesn’t prevent hurt in your heart. For your mom, it’s worse because spouses have a deep emotional investment in how their mate is perceived by others. Some of this embarrassment is due to the stigma that still clings to dementia.

Additionally, your dad’s behavior flies in the face of years of a great marriage so it’s terribly painful for her. I recall that there were times when my dad’s disinhibited behavior, even happy behavior, would upset Mom because this didn’t seem like the man that she knew as her husband.

You both might find it helpful to try to determine what lies behind your dad’s abusive episodes. Could your dad be especially stressed because of too much activity surrounding him? Is he confused by something unusual in his environment? Is he experiencing pain? Could he be afraid?

Try maintaining a journal detailing all elements surrounding these times to help you pinpoint what could trigger this behavior. This written record will also make it much easier for his doctor to evaluate what is happening. The physician might read your notes and have other observations, as well.

As far as coping with an episode, remember that only if you stay calm can you calm your dad. Keep your face and voice friendly and ask him to tell you about what’s bothering him. “Tell me about it” is generally a good phrase to use rather than trying to defend yourself or even saying, “What’s wrong?” The reason for this is that your dad has lost the ability to reason using language, but everyone likes to be heard and your dad is no different.

Once he starts calming down, try to distract him with something that he enjoys. The goal is to make your dad more comfortable, which will help you all. While your dad needs understanding, so do you, so work with his doctor to learn how to better manage these episodes.

In addition, attend in-person or online support groups. This phase typically passes, but support along the way can do wonders.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com.