How dementia can affect relationships, and how to handle it

 

For the first 30 years of their marriage, Tony teased Christine* about taking too long to get ready in the morning. It became a joke between them. She’d take out multiple outfits to show, and he’d exaggerate his impatience, tapping his foot, and pointing at his watch.

Then the morning ritual started to change. Christine slowed down more, getting stressed about the choice of outfit and struggling to use the right brushes for her makeup. She marveled over her earrings and necklaces as if she hadn’t seen them before—if she remembered where to find them in the first place.

Changes can be frustrating

Tony began to feel resentful. He wanted Christine to stop being so slow and indecisive and get back to being independent and fun. Why was she acting so helpless? His response was to rush her.

Their playful banter turned to yelling and crying. Christine’s anxiety skyrocketed, increasing her confusion and slowing her down further. Too many days were ruined with this cycle of Tony’s frustration feeding Christine’s anxiety and her anxiety raising his frustration level—until they sought medical help, and she was diagnosed with dementia.

That cycle—frustration and anxiety fueling each other—is common in families of those with dementia, particularly in the early stages before a diagnosis is made. It can feel like your loved one is intentionally trying to annoy you. And that can make you feel impatient and confrontational. In addition, the person with the cognitive decline can be defensive and aggressive in responding. This combination often makes the early stages of dementia much worse.

Most of the time, people with dementia understand that they’re losing their abilities and their knowledge. Suddenly, they don’t know what to do with a key or how to get somewhere they’ve been going regularly for years. As a result, they become very fearful and anxious about what’s happening to them.

Adapting to changing roles

Learning to accept dementia-related changes—and the anxiety and frustration they cause—can go a long way. It did for Tony and Christine. 

For example, Tony started having an extra cup of coffee in the morning and reading the paper or paying bills while Christine was getting ready. And he stayed on the alert for the first signs of Christine needing his help. He learned to gently guide her toward making her own decisions as much as possible, rather than hovering over her or ignoring the situation. This helped him avoid focusing too much on the increased time she needed.

It’s important to remember that the disease—not the person—is responsible for the changes you see. By shifting his behavior to adapt to changes in Christine, Tony decreased his frustration level and her anxiety level.

You can look for new ways of managing the changes in your situation:

• Notice when stress tends to peak.
• Identify ways to alleviate frustration and anxiety triggered by that stressful time.
• Make use of memory aids—Post-it notes and alarms or timers can be helpful.
• Plan the day in advance to reduce your loved one’s feeling of being overwhelmed.

The National Institute on Aging has several tips for managing behavior changes that can make everyday life less stressful:

1. Be patient. If you’re frustrated, try not to show it. Speak calmly and avoid arguing.
2. Try to understand what’s causing the behavior. Sometimes, it can be as simple as not remembering where they put something, or maybe there’s a change in their environment.
3. Stick to a routine. Eating, bathing, and dressing at the same time each day will help your loved one know what to expect. And it’ll help them continue doing these things on their own, which inspires feelings of confidence.
4. Make the home environment comfortable. Reduce clutter and noise as much as possible. Keep meaningful items like family photos and books within easy sight/reach.
5. Find ways to be physically active. This can help boost mood and improve sleep and physical health—for everyone.

You can also talk to a therapist about ways to manage your particular situation. Look for someone who is a good listener, who looks at the possibilities for shifting tasks, and who understands how important it is to accept changing relationships. 

Most importantly, accept that things don’t have to be perfect. This will further develop the patience and compassion that you already have, and that is so important to supporting someone with dementia.

*Names and identifying details changed to protect anonymity.

Originally posted: September 2019
Last updated: December 2024

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