Most of us have seen evidence of people being harder on those they love than they are on strangers, or even people they don’t like. We tend to show our family members every side of ourselves, including the least flattering one because we feel safe enough with them to just “let it all hang out.”

This typically holds true for our care recipients as well. Age and illness bring a host of difficult emotions to the surface for seniors, and caregivers are subject to their anger, fear, frustration and sadness regarding their circumstances. For some, though, there are deeper problems lurking behind an elder’s moodiness and outbursts. These feelings may turn into abusive behavior or exacerbate an already abusive personality.

Why Do Elders Turn on the Caregiver?

I believe that care recipients target the person doing most of the care because they feel safe enough to do so. They are frustrated and need to vent about getting old, having chronic pain, losing friends, forgetting things, being incontinent—all of the undignified things that can happen to us as we age. They turn on the person who shows their love by trying to take care of them because, on a gut level, they trust that this caring person won’t leave them.

In other cases, a caregiver may have been a target of criticism and negativity in the past. If a relationship has been historically abusive, it is likely that this toxic behavior will carry over into caregiving. Mental illness or a personality disorder may be to blame. If other family members have decided that they do not wish to participate in the elder’s care, it complicates things further. There is a great deal of pressure on one primary caregiver to shoulder the burden of care and bad behavior, and coping is an ongoing challenge.

How to Cope with an Abusive Elder

When it comes to handling a loved one’s abuse, clearly, the best option is to remove yourself from the situation. But for many caregivers, that is not an option. Other family members may not be willing or able to assist. The family may lack the financial resources to hire a third party to take over the elder’s care, or the elder may vehemently oppose the idea. A mix of hope, love, fear, obligation and guilt typically compel the primary caregiver to continue seeing to their loved one’s needs. In order to make this arrangement work and minimize its detrimental impact, caregivers must learn to set boundaries, detach from their care receiver, and prioritize their own wellbeing.

A Caregiver’s Experience

I think it helps if the caregiver can do their best to not take every insult or outburst personally. Detaching with love is the best approach for interacting with a bad-tempered elder. My experiences with difficult family members don’t compare to many of the stories I read on the Caregiver Forum, but I was subjected to some pretty nasty treatment by my mother a few times.

She was a wonderful, loving person at heart, but her escalating physical frailty and frustrating memory issues would cause her to lash out at me. There were times when I was nearly in tears by the time I left her after my daily visit to the nursing home. Several of my family members had lived in this facility over the years, and the staff knew me and my family very well.

One day, a nurse overheard Mom’s particularly foul behavior and suggested that I just skip the next day’s visit. I couldn’t imagine carrying out her advice, so I ignored it. Things smoothed over, but eventually the same scenario transpired again. It was a Sunday and the nurse said once more, with added emphasis, “Carol, just skip a day.”

On Monday morning, I found I just could not make myself go to the nursing home. I didn’t do this to be stubborn or make a statement. I was just hurt and exhausted. I knew Mom was in good hands, so I gave myself a well-deserved day off. I didn’t even call her on the phone that day.

When I resumed my daily visits on Tuesday, Mom was sweet as pie. I couldn’t believe the difference. The nurse was right—I needed to stand up for and take care of myself. It also showed me that even people with dementia are sometimes able to sense when they have crossed the line. If the caregiver shows that they won’t be treated in an abusive manner, the elder will often behave—at least temporarily. Use this to your advantage.

Keep your boundaries firmly in place. If abusive or disrespectful behavior continues, remove yourself from the situation and take some time for both of you to cool down separately. This is harder if you and your loved one live together, but there are ways to protect yourself while providing adequate care.

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Find Backup and Take a Break

Bringing in professional help can be beneficial for everyone involved. Seeking respite may help your loved one gain a new appreciation for all you do, while still letting them see a new face. Best of all, you will get a breather. Regardless of the type of respite care you choose, making preparations ahead of time is key.

Research home care agencies, adult day care centers, and other care options before they are needed. If you have everything set up when your loved one acts out, you can calmly say you won’t tolerate such treatment and promptly arrange for an alternative care provider. If you can’t follow through quickly, the consequence is less likely to have an impact on your loved one’s behavior.

Acknowledge their pain and frustration, but stand up for yourself and make it clear that you are doing your best. Remind them that if that isn’t good enough, then someone else will have to take over. You may be able to explain this change by saying that you are bringing in a professional, since your company seems to be so displeasing to them. Follow through unless you see an immediate change in behavior.

Know When to Walk Away

Unfortunately for some families, no amount of counseling, boundary-setting, detachment or respite care will change an elder’s abusive behavior. Continuing to provide hands-on care for someone who refuses to show you respect and cooperate with the care plan will ultimately jeopardize your physical and mental health. Whether you feel you have been roped into this scenario or have voluntarily taken on this role out of love, it is crucial to know when enough is enough. Permanently handing off your loved one’s care to in-home caregivers, an assisted living facility or a nursing home will ensure they receive the assistance they need and allow you to limit your interactions as much as you see fit. It is a difficult decision to make, but sometimes the best option for both parties is separation.

Be strong and resolute. My flawed goal of trying to please everyone, no matter the cost, taught me many lessons that I hope I will never forget. I learned that I have feelings and I count. You count in the caregiving equation, too, so make your wellbeing a factor in your loved one’s plan of care.