Here are some ideas for alleviating this dilemma:
Keep yourself out of harm’s way: If a care-receiver is physically threatening, the best way to protect yourself and defuse the situation is by leaving the room. If he is attacking you verbally, explain calmly but firmly that you will not abide it and that the conversation is at an end until the care-receiver changes his tone. At no point should your words or actions suggest that you will tolerate abusive behavior. At the same time, it is important not to respond angrily in kind because that will only add fuel to the fire, causing an escalation of the altercation.
Spare yourself the blame: Sometimes caregivers hold themselves responsible for a care-receiver’s abuse. They tell themselves things like, “If only I talked with him the right way, he’d treat me better.” But by not holding the care-receivers responsible, they give tacit approval for their bad behavior. It’s important to be clear to yourself and your loved ones that you don’t deserve to be treated poorly. Nobody does—ever.
Confer with the care-receiver’s physician: Some of the causes of care-receiver abuse may be amenable to medical treatment. If the patient, because of neurological involvement, has little control over his temper, then the prescription of mood-stabilizing drugs may modify his emotional expression. If the patient is clinically depressed or severely anxious, then antidepressants may relieve these psychiatric symptoms and make it more likely that he will refrain from lashing out.
Heed patterns and signs: Oftentimes, a care-receiver’s outbursts occur at particular times of day, such as the evening when they are more fatigued or (as a result of sundowning) confused. Or difficulties with specific tasks, such as toileting or feeding, may be likely to set them off. Observe your loved one’s behavior and determine which situations are flashpoints for him. Also note the signs of a brewing storm—for example, increased crankiness before a blow-up. Then devise a plan for handling those times and situations differently. For example, plan for rest periods to cut down on fatigue. Or enlist others’ help to manage toileting or feeding so you aren’t in the line of fire.
