My friend called me today in tears. Her mother, who has dementia and paranoia, snapped; really, “snapped” is such a useless word to describe what happens when caring for an elderly person with dementia. It does not begin to describe the devastation it causes the caregiver.

One of the least talked about anomalies of elder caregiving is the rage and anger that can suddenly flare up. This anger is totally directed at the home caregiver who has probably been doing everything possible to make her parent feel safe, comfortable and loved. Everything was fine until something set Mom off. It could be something from the past she has been dwelling on for some time; maybe an old incident regarding money, a lost friendship, a cheating husband. Whatever, the train of thought, Mom has now zeroed in on you, caregiver.

Most likely the tirade will begin by the caregiven telling the home caregiver how much they are hated. “Do you know how much I hate you?” “You think you are really something and you are nothing.” “I want to go home.” Today, it just all boiled over and in an instant Mom became another person. Her tone of voice changed, her facial expressions changed, her language became a barrage of swearing; words you had never heard her use before. She grabbed your arm with a strength you did not think she had. It seemed that the tirade of venomous words would never stop. You are in total shock; your mouth hanging open.

Actually, it is probably best, your mouth hanging open, because you cannot reason with a person who has dementia. Why, because they have lost the capacity to reason. If the person is paranoid, too, you really just have to wait for the caregiven to run out of anger.

As a caregiver, I was often shocked at the vehement energy projected during one of these episodes and the only comeback that I ever used that worked was, “I love you, too, Mom”. This simple statement seemed to deflate the situation.

You, dear caregiver, need to understand that your parent will not remember this episode.

This is the time when you have to dig deep within your soul; stop the tears, grow a spine of steel and move forward with grace, compassion and understanding. Just know that most every elder caregiver will experience this. Do not internalize these hurtful words; just learn and be prepared.