When Your Loved One Isn't Very Loveable: Part I

Caregiving is never easy, and it can become even more complicated and emotially trying if your loved one becomes "difficult." Part I of this step-by-step guide helps you understand the underlying causes of changes in your loved one's behavior.

Soon after Virginia Hoffman's husband was diagnosed with Lou Gehrig's disease, he began a spiraling descent into anger. during the ive years she cared for him until his death in 1990, he never let go of that anger. "He wanted me with him all the time, and he lashed out at me because he was angry," she recalls. "When I was caring for him, I felt like I was the only one in the world who was going through something like this. It was very difficult," she remembers.

The family of Gene Cannon also understands the frustration of caring for a difficult care recipient. His wife, Edie, and their seven grown children cannot rely on friends to help care for the 79-year-old Alzheimer's sufferer, because he is too violent and distrustful to allow even his closest friends near. In fact, his family had to hide the kitchen knives to ensure that he cannot carry out his threats to kill them.

For the parents of 14-year old Valerie Smith, caring is a constant battle between the teenager's need for autonomy and her parents' fears about their HIV-positive child.

While all caregivers face adversity, families caring for family members who, due to personality, temperament, or disease, are angry, violent, or uncooperative face an almost impossible task. Is it even possible to provide loving, quality care to a person who tries to hit, refuses medication or food, tells you he hates you, or acts as if you aren't even there? Yes, say the experts, but it takes a lot of patience and practice, as well as recognition of your own frustration and anger.

The root of the problem

There are myriad reasons why a care recipient may be classified as "difficult," says Dr. Vicente Figueroa, assistant director of the Medical Illness Counseling Center in Chevy Chase, Md. It may be the disease, as is the case with Alzheimer's, which can turn kind, gentle, cautious people into swearing, violent, and paranoid strangers. It can be the prognosis, leading the care recipient to feelings of anger, resentment, guilt, depression, or frustration, which they unwittingly take out on the caregiver. Or it can be personality, which loss of control magnifies. So your overbearing, stubborn, or independent mother becomes more so under your care, or your uncommunicative husband becomes snappish and sarcastic at your every comment.

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