My client suffers from mild dementia. He is usually kind to me, but when company is present, he is often mean and bossy. He is at time abusive and unreasonable, but I understand clearly that this is part the initial stages of dementia. The thing is that I do enjoy working for him most of the time, but sometimes I think I might need a second opinion. (Incidentally, I am paid by the State of California to provide 37 hours of care per week for this man.)

His endurance with his failing health often astounds me as he is so stubbornly strong as he faithfully follows every doctor order and makes every appointment. He has several serious and life-threatening conditions, yet he is ambulatory (now) and wants to get as much accomplished either through his own efforts, or through me.

He is usually nice to me, though he does ask me to do certain manual labor tasks at times, but I almost always do them in stride. It's as if I am fulfilling the tasks that he once could have completed without any problem. He is frustrated and angry at times but manages to keep those emotions hidden from acquaintances, doctors, nurses, etc., but not so nice to his caregiver, which is hurtful...because I do genuinely care and know how to provide it.

The problem is at its worse when company is visiting him at his apartment. Often he will single me out and make disrespectful comments for the company to hear. Or he'll say things to imply that I'm not doing a good job for him, which is not at all true.

I realize the problem is mine and that his verbal abuse only brings up within me issues that bring to mind previous experiences as a child.

I'm writing to ask for advice from caregivers who have encountered similar situation.


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By the way, Steve, your profile says that your client has general age-related decline, but if he has dementia, even in its mild early stage, that is probably the most significant part of why he needs care and why he behaves the way he does. Caring for someone with general age-related decline and someone who has dementia are really two different experiences (with a lot of overlap, of course).
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I think that blannie has pegged it -- his desire to appear in charge is what is behind the barbs in front of company. Staying out of site (if possible) and/or being especially respectful MIGHT help. (With dementia results are never predictable.)

You are right that this is your problem, not his, but you are entitled to solutions, too! Maybe it would help to think through his probable reasons and compare them to your childhood situation. Also think of your status then and now. You are a competent independent adult now. You can walk out at any time and ask for a different assignment. You don't have to take his abuse, and if you chose to do so it is out of compassion and an understanding of his impairment, not out of helplessness and weakness. Perhaps keeping that in mind will help you deal with it.
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He's probably angry that he needs your help and when others are around to see it, his helplessness is magnified (in his mind), so he lashes out at you. Is it possible for you to make yourself scarce during visits from others, so that he appears more independent to them and he doesn't have you in his line of sight to react to?

I'm sure it's hard to take his barbs, but as long as your employer is OK with your performance, I'd just try to tune him out.

I'm sure you'll get lots of good answers from others with parents with dementia. Luckily my mom is always nice, so I don't have the specific problem you do. You sound like a wonderful caring person and your client is lucky to have you.
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