How can I keep from keeping my patience and not yelling at Dad, who has dementia?

A fellow caregiver asked...

As primary caregiver for the past three years for my Dad, who is in the second stage dementia, I find myself sometimes losing patience with him. Sometimes I'm accused of "snooping" in his personal things (which is not the case), and I lose my patience and end up shouting at him. Is this considered being verbally abusive?? How can I learn more about verbal abuse so I prevent this from becoming a problem??

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Keeping patience while caring for someone with dementia can be a herculean effort. This is a wonderful question because the writer easily admits her fraility; so many caregivers are experienceing these same feelings without the ability to articulate their humanness. Your intuition is also pretty healthy regarding shouting at your dad and questioning verbal abuse. I would not be concerned if #1 this doesn't happen often and #2 it is symbolic of your personality that he is already familiar with. If your loss of patience is happening frequently and may be escalating, then this does indeed border on verbal abuse. There are several things you can do to help change this scenario. You cannot change your dad but you can change your approach. A philosophy of care titled Habilitation suggests always trying to be in the patient's world. That is, attempt to see through his eyes and be in his reality - it is NOT the same as yours! Try this: When dad accuses you of snooping - quickly apologize and say "I was just looking for the list, I'm sorry I didn't ask you first". This is referred to as a fiblet or therapeutic lie and works extremely well - almost always. I know it may be counter-intuitive to fib to your parent but by doing so you have avoided any confrontation and most important have preserved his dignity. You cannot reason with someone who has lost the ability to do so and attempting to reason or rationalize most always ends up in anger and accusations. I suspect also that losing your patience may be a classic case of caregiver burnout. You are becoming emotionally fatigued from the act of caring. This is a common phenomenon with dementia caregivers. Try to take care of yourself by doing special things just for you, taking breaks, and getting help. Have you considered Adult Day Program for your dad? It is a good way for him to have meaningful use of his leisure time and provides you with some necessary respite. If he doesn't seem interested in attending, try a fiblet such as he "only needs to try it for a week", and let the staff at the ADP handle the situation - they have been trained to deal with this special population, are wonderful at getting folks involved, they have no history with him, and they can go home at the end of the day! Please take care of you.