How to Manage Self-Care When Your Parent Is Acting Out

One of the seldom talked about aspects of family caregiving is parents behaving badly, but if you ask, you’ll hear stories. Parents who feel ill or are in pain, who are frustrated about needing care or who have dementia, sometimes say and do things that are hurtful or inappropriate. What can you do if your dad or mom is berating you or refusing to cooperate with their prescribed care?

I asked a far-flung group of acquaintances and friends with caregiving experience how they preserve their peace of mind and their relationships with their loved ones when those loved ones are acting difficult. Their suggestions can be found below:

1. Does your parent need to see a doctor?

Not all unpleasant behavior has a physical cause, but it’s wise to seek medical advice if your dad or mom starts acting aggressive, irritable or strange. A medical opinion is especially important if the behavior change is sudden or if your parent has trouble communicating because of dementia or another condition. Nonverbal patients may act out when they’re in pain, are hungry, thirsty or are very tired. Urinary tract infections can cause older adults to act irritable or inappropriate. Some common over-the-counter and prescription medications can cause dangerous behavior changes in seniors. Your parent’s doctor may be able to solve the underlying problem or eliminate the problem behavior.

That’s not to say that there’s a medical fix for all difficult behavior or even most of it. No one is always at their best, especially if they’re in chronic pain or resent not being able to do some of the things they used to do. Add in whatever unique baggage comes with your particular parent-child relationship and there’s always going to be the potential for conflict and hurt feelings. But the caregivers I heard from said there’s a lot you can do to manage your responses.

2. Don’t take your parents’ behavior personally.

More than one healthcare professional said to remember that it’s not about you when your parents act out. Doing this is “simple, but not easy,” said Andy Martin, an addiction-recovery counselor in Austin. “One thing I need to remind myself of when I get a string of difficult patients is, ‘This has nothing to do with me.’” The challenge is tougher for family caregivers because we tend to think of our parents as our parents first, not as people who are coping with sometimes difficult and distressing cognitive changes.

Confusion and pain can make even the most even-tempered people behave in ways they would never do otherwise. Jennifer Rohner, RN BSN, CMSRN, a nurse in Portland, Oregon, experiences this often on the job. “In the trauma ICU, we deal with head injuries, the mentally ill, addicts, and the elderly. I’ve been cussed at, yelled at, punched, kicked, bitten, spit on, and inappropriately grabbed.” To cope, she and other staffers talk often about self-care, setting limits, and managing stress in the moment. “Sometimes it’s appropriate to point out inappropriate behavior or walk away. Three deep belly breaths are often enough time for me to reset and approach with action instead of reaction.” When your parent’s behavior deteriorates, take a step away and calm yourself before you respond.

3. Connect with your fellow caregivers.

Several people said support from other caregivers helps them keep their emotional balance. Where do you find those groups, especially when you’re busy with caregiving?

• Many community centers, medical centers and places of worship host caregiver support groups that meet weekly or monthly for education and social time
• Online caregiver forums, like those hosted by the Alzheimer’s Association and the Parkinson’s Foundation, let you talk with people whose families are going through some of the same things as yours
• Private Facebook groups you create can give you and your caregiver friends a place to talk through your feelings and trade tips
• Your parent’s doctor may be able to refer you to a support group

You can also search for your city or town plus “support group” on SeniorAdvisor.com to find a list of local support, like caregiver resources in Wichita. Make time for yourself and savor it.

“Me time” may sound like an indulgence when you’re busy taking care of your parent, but time to yourself is a must if you want to maintain a good attitude and manage your stress. Options for making that time include hiring in-home respite help for a few hours each week, taking your dad or mom to a local adult day program and asking other family members or close friends who live nearby to take over while you recharge. Then devote your free time to yourself.

“Do something completely unrelated to caring for others but personally fulfilling, even if it’s a reading a book or listening to an album in your car,” suggested Miriam Sisson, a former family caregiver from Oregon. “Don’t grocery shop or pick up prescriptions even though alone time makes these tasks easier.” Passing up the chance to run errands may go against your time-management instincts, but psychologists say focusing on what you’re doing at the moment instead of thinking ahead to the next task on your to-do list can help you regain a sense of calm.

5. Look for ways to lighten the mood.

Several caregivers who responded to my question said humor helps a lot. Finding something funny about the situation you’re in can relieve your stress for a while, lift your parent’s mood and maybe even improve your heart health. Researchers have observed cardiovascular benefits to what they clinically describe as “mirthful laughter.” A little playful silliness can sometimes bring a parent out of a funk, as standup comedian Jim Breuer showed in his documentary about touring while caring for his dad, who had Alzheimer’s.

What if you’re not naturally funny or everyone’s too stressed out to find any humor in the moment? Have an impromptu TV party, complete with snacks. That’s what Misty Waggoner, a Central Texas artist who cares for her both parents, does when they start feeling irritable. “If it escalates, I leave the room and go into the kitchen. I make a tasty treat – the other day it was sausage cheese dip with chips – and I bring it in with plates and napkins, and everybody digs in. Then I put on Netflix and we watch something funny for an hour. Snacking on something good and watching something just seems to calm things down.”

6. Protect your mental and physical health.

Taking care of another person – or more than one other person – is hard work that can tax your body and mind. Caregivers are at higher than average risk for several types of stress-related health problems, ranging from headaches and joint pain to diabetes and heart disease, according to the American Academy of Family Physicians. The AAFP’s recommendations reinforce what we all know we should do but don’t always make time for: get enough checkups, exercise, nutritious meals and sleep. The caregivers who shared tips with me said daily exercises like walking and yoga helped them manage their overall health and stress.

If you don’t have enough time in the day to eat well, exercise and rest, that’s a sign that something needs to change to protect you and the person you care for. You may need to:

• Ask friends to cover for you while you exercise and go to medical appointments
• Bring in overnight help if your parent wanders at night so you can rest
• Find a good adult day program to free up time for you to maintain your health
• Hire a home health worker to provide a few hours of respite care each week

By taking regular care of your physical health, you’ll be a more effective caregiver, even when your mom or dad acts cranky or unkind.

Your mental health matters, too. Family caregivers are twice as likely to develop depression as the general population, according to an estimate shared by the Family Caregiver Alliance. Different caregivers I talked with said activities like keeping a journal, making time to meditate or pray, and even finding time alone to have a good cry were helpful emotional outlets. A therapist who has experience working with family caregivers can be a valuable resource for getting things off your chest and learning new ways to cope with stress.

Pamela Price, a San Antonio-based author who cared for her mother while also homeschooling her son, said dialectical behavioral therapy (DBT) was “revolutionary” for her self-care regimen while she was managing her mom’s care. DBT encourages people to use meditation techniques, build their tolerance for distressful feelings, manage their feelings and then communicate them more effectively. DBT was developed to help people with borderline personality disorder, which makes it hard to manage emotional reactions and maintain healthy relationships. Now, DBT helps people cope with a range of difficult conditions and situations, from caregiving for seniors to managing chronic pain.

Another relaxation technique, Mindfulness-Based Stress Reduction (MBSR) also includes meditation and mindfulness along with breathing exercises. Two physicians recommended it to me when one of my children had a prolonged illness several years ago, and I found the exercises and readings helpful even without the benefit of a class. The MBSR program started in 1979 at the University of Massachusetts to help people cope with chronic pain and stress. Now there are MBSR practitioners leading classes in cities nationwide, and the University of California San Diego offers free online MBSR resources including guided audio meditation files.

7. Work towards acceptance and compassion.

DBT and MBSR, as well as the world’s major religious traditions, ask us to accept that some things are beyond our control. For people in a culture that says you can accomplish anything if you put your mind to it and work hard enough, accepting that we can’t always fix things can feel wrong somehow, especially when it comes to our parents’ aging. But experienced caregivers say acceptance is critical for avoiding burnout and coping when your loved one is having a truly bad day.

When you have support and time for self-care, you’re better able to respond with calm and kindness even when your parent is having a tough time and acting out. It’s normal to get frustrated or discouraged sometimes, which is why it’s important to take regular breaks and get caregiving help to maintain your compassionate attitude. Even professionals need to step back and breathe so they can be effective caregivers. Jennifer, the nurse in Portland, said she rereads a quote from Buddhist monk Thich Nhat Hanh when she needs to refocus: “When we come into contact with the other person, our thoughts and actions should express our mind of compassion, even if that person says and does things that are not easy to accept. We practice in this way until we see clearly that our love is not contingent upon the other person being lovable.”

Resources for Caregiver Help

Caregivers can reach a crisis point during times of extreme stress, and if this happens to you it’s important to reach out for help. If you have a friend, relative, or neighbor who can come over, call them. There are also hotlines for caregivers:

• The Alzheimer’s Association 24/7 Helpline at 1-800-272-3900 provides information, education, and crisis assistance for caregivers of dementia patients.
• The National Suicide Prevention Lifeline at 1-800-273-8255 has trained counselors who help callers who feel they’re reaching the point of burnout or who feel like they may harm themselves.
• Texting NAMI to 741741 will put you in touch with a crisis counselor.
• The VA Caregiver Support Line at 1-855-260-3274 offers a listening ear and resource referrals for caregivers of veterans.

If you need less urgent help finding family caregiver assistance, you can contact your local Area Agency on Aging or call 2-1-1 for local health and support services information. Be bold about asking for help when you need it. Your family caregiving work is important, not just to your family but also to our society, and you and your parents deserve support.

Casey Kelly-Barton

Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.