Today didn’t go how I’d hoped.
We had a telehealth appointment with a neurobehavioral specialist at a prestigious medical center. A bright, credentialed M.D., trained to understand the behavioral rollercoaster that comes with dementia. I expected insight. I expected help.
Instead, my loved one with Lewy body dementia exploded.
He woke up agitated—grumbling, complaining—and by the time we connected with the doctor, he was already simmering. She asked how he was doing. He latched onto the frustration of being told not to drive after a recent surgery. She calmly mentioned the DMV as an option for evaluating driving readiness and gently noted that sometimes, when cognitive issues are involved, it helps to have a third-party opinion.
And then… he just lost it.
For the next 45 minutes, he yelled. He stood up, stormed off, returned to point fingers at the screen and accuse the doctor of judging him unfairly. He repeated himself in loops. Accusatory, agitated, relentless. I sat frozen. Torn between guilt, embarrassment, and a gut-wrenching grief for the man he used to be.
At the one-hour mark, the doctor wrapped up. She offered some behavior resource links and said she’d call in a new prescription. And just like that, it was over.
But it wasn’t.
My loved one with LBD insisted we drive to the DMV to “prove” he’d passed a test. We stood in two different lines. He bulldozed past people. He got information that neither confirmed nor resolved anything. Then we sat at a park, where he continued to rant—for half an hour. I finally said, “I can’t take this anymore. I’m going home. You’re welcome to join me.” He did. The ranting continued.
Hours later—calm, quiet, even a bit sheepish—he said he was embarrassed about how he’d acted. He wanted to write the doctor an apology. He did, and I sent it.
But here’s the honest, awful truth: I’m still shaking. This disease has taken the gentle, loving man I married and turned him into someone who rages, repeats, and explodes over the smallest perceived slight. These episodes last for hours and leave emotional bruises that apologies can’t erase.
So how does a non-demented partner deal with this?
Here’s what I’ve learned (and am still learning):
💡 When Dementia Rage Happens: What Caregivers Can Do
1. Prioritize Your Safety.
If your loved one becomes physically threatening or won’t stop escalating, remove yourself. Calmly walk away. Call a trusted person or emergency support if needed. You matter too.
2. Don’t Argue. It Doesn’t Work.
Trying to reason with someone in the middle of a dementia-fueled outburst only throws fuel on the fire. Instead, use short, calm phrases. “I hear you.” “We’ll figure it out.” “I’m going to take a break and we can talk later.”
3. Avoid Major Discussions When They’re Upset.
If they’re wound up, delay conversations about driving, doctors, or anything emotionally loaded. Wait for a calmer moment—if it comes.
4. Have a Backup Plan for Appointments.
If your loved one may be triggered by a certain topic, prep the doctor ahead of time with a caregiver note. Some clinics allow you to send messages via portal or email in advance.
5. Take Care of Yourself Afterward.
These episodes take a toll. Journal. Cry. Call a friend. Walk. Rest. You are dealing with trauma layered on top of exhaustion. You are not weak for needing recovery time.
6. When They Apologize—Let It Land Softly.
If they recognize their behavior and say they’re sorry, you can accept the apology without minimizing your hurt. Try saying, “I appreciate your apology. I’m still really shaken, and I need some time.”
I don’t have all the answers. But I do know this: dementia can break your heart a hundred different ways. And yet somehow, we keep showing up—because we love them, and because we’re doing our best in an impossible situation.
You’re not alone. And neither am I.
Warmly,
Nora 🌸