Dear Dr. Lauren: My 81-year-old mom has been diagnosed with dementia and early Alzheimer’s. She lives with me. The changes in her are subtle and sometimes drastic. For example one day she is perfectly fine and the next she says things that are totally untrue or attacks me for something I did not do. It is hard for me to wrap my head around the fact that this is a disease and not react in the moment when she is accusing me of something bizarre like taking her car because most of the time she seems fine. My family doesn't get it and believes what she says. I feel lost, sad, and unloved by my mom, and I know it is not rational because she cannot help it. How do I deal with these changes rationally? Thanks, M.B. 

Dear M.B.,

First, I want to say give yourself some grace and forgiveness for becoming frustrated. This is a normal reaction to a very stressful situation. Please get some support from friends, family, local organizations Senior Services of Alexandria, national organizations such as the Alzheimer’s Association, Alzheimers.gov, the Alzheimer’s Foundation of America, or any local support groups that are available to you. 

In terms of your family, they do not sound very supportive and I think it would serve you to create some very clear emotional and psychological boundaries around those who are not supportive. One way to express a boundary would be to say, “I love my mother and am doing my best to take care of her. It is very difficult to watch her suffer and become paranoid and aggressive toward me. I have no reason to make up any of this and I would appreciate it very much if you could be supportive of me through this difficult time. When you discount what I am telling you, it makes me feel unsupported and alone and I cannot allow that into my life at this moment.” 

In terms of feeling “lost, sad, and unloved” I am wondering if her attacking you is triggering any memories of feeling rejected from an earlier period in your life. Often, adult experiences that trigger us are reminders of unmet childhood needs. Ask yourself, what thoughts enter your mind when she is being mean to you, and what feelings come up in your body? Do those thoughts and feelings remind you of any early childhood experiences related to not being good enough or feeling out of control? If so, please find a safe person or a therapist to process these feelings to be able to feel grounded, safe, and in control when she is attacking you. 

Because Alzheimer's is a progressive disease, it will be important for you to find ways to ground yourself when she is becoming aggressive. Grounding can be anything that helps you stay in the moment and calm such as deep breathing, visualization, and even removing yourself from the stressful situation to engage in a calming activity. This takes practice but will become easier as you commit to disengaging from the interaction and telling yourself that she is not able to be coherent. It will also be helpful if you have a mantra that gives you permission to disengage such as “I love myself.” or “I am doing my best.” 

Caring for family members with Alzheimer's is very difficult, but you will never err on the side of attempting to provide love and care to the best of your abilities.

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*Names used in this article are fictitious. 

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