You’re a family caregiver and your loved one is yelling at you. At the end of a long day, it’s tough not to feel hurt or yell back.

Dementia, Alzheimer’s disease and other illnesses that interfere with normal brain function can trigger anger, abuse or delusions in the person you’re caring for. While medications may help reduce the number and intensity of episodes, there are also techniques you can use to help both of you. Here are three suggestions:

1. Keep it simple

It’s important to remember that your loved one’s anger may be a reaction to fear, confusion or pain. Keep daily routines simple – one step at a time if possible – and consistent. Keep choices to a minimum. These are progressive illnesses and your loved one may no longer be able to handle life skills that were feasible a month ago, or even a week ago. Also, it’s not always possible for a person with dementia to notice or tell you when they are ill or in pain, but they may be responding to it with anger.

If your loved one is simply angry it’s best not to confront. Try changing the subject or removing yourself from the situation.

2. Take a time-out

Time-outs for adults are different than those for children.  Instead of telling your angry husband or mother to “go to your room,” you take yourself out of the situation. You might say, with no other explanation, “I need to go outside. I’ll be back in 10 minutes.” Then leave for a brief period. Be sure to tell them when you will return. If you don’t feel it is safe to leave your loved one alone in the house, you may simply say, “I’m going to the bathroom now.” Keep a good magazine in the bathroom and lock the door. Return in a few minutes to see how things are going.

3. Enter their reality

Entering the other person’s reality can be very effective for defusing a difficult situation.  For example, Jane has taken her dad to the doctor in his wheelchair. He becomes agitated and angry while waiting for the doctor. He keeps getting out of his chair, saying, “I have to catch my plane.” At first Jane reminds him he’s in the doctor’s office. He remains agitated.  Jane takes a deep breath and “enters his reality.” She points out that the captain of the airplane has put the seat belt sign on, so he must remain in his seat.  Dad, relieved, settles back in his chair to wait quietly. Use your imagination.

While there are many great books and Web sites, an essential resource for anyone dealing with the difficulties of Alzheimer’s or dementia is a book titled “The 36-Hour Day,” by Nancy L. Mace and Dr. Peter Rabins. It’s available at local bookstores or online at amazon.com

Joan Jackson is a partner with Peter Carrillo in Practical Dreamer, providing clinical health education and other services, including caregiver support groups sponsored by the Area 12 Agency on Aging. Contact her at (209) 588-1835.

© 2008, Friends and Neighbors Magazine