How to Deal with a Difficult Elderly Parent

It is very common for people to find their parents demanding, difficult, or irritable as they age. There are many possible reasons for why they act the way they do with the oncoming of old age, and here are some ways to help deal with any problems you may have.

What Happens to the Brain and Body with Age?

As people age, many changes gradually occur both physically and mentally, which may help to explain difficult or demanding behaviour. Physical changes in the body may be frustrating as older adults may not have the ability to do the things they used to do. Elderly people will see a decrease in overall muscle strength, stamina, smell, hearing, and have a weaker immune system, which leaves them more susceptible to illness or disease. Eyesight tends to worsen as visual sharpness diminishes, distance perception is worsened, and you will be more sensitive to changes in light levels as the adaptation to these changes becomes less acute.

Many mental and cognitive changes take place as well. This is due to a gradual loss of the net amount of brain cells that starts in early adulthood. By age 80, there is on average a 5% reduction in brain cells overall. This leads to slower reaction times, less problem-solving ability, slower speech, and a worsened memory. Atrophy, or breakdown of tissues, in the frontal lobes tend to decrease inhibitions in many individuals as well. This may explain anger outbursts or inappropriate behaviour in elderly people. This loss of inhibition may also allow unpleasant behavioural traits that have always existed to become more prominent. In some cases, a substantial loss of brain cells may occur due to abnormal again, which can lead to neurocognitive disorders (NCD’s), which may be more commonly known as dementia. This abnormal again of the cells causes a series of small strokes and brain tumors to occur over time which causes mental erosion. Alcohol abuse may also speed up this process. One of the most commonly known forms of dementia is Alzheimer’s disease. Alzheimer’s is described as a neurocognitive disorder entailing a progressive decline in memory and other cognitive abilities. It affects about 3% of the population over 75 and can be very difficult for individuals and their caregivers to deal with.

Why Do Elderly People Need More Attention?

Much of the difficult and insecure behaviours of elderly people who seem like they require more attention stems from the cognitive and behavioural effects due to coping with aging. As they age, so does everyone around them leaving many elderly persons to feel deprived of loved ones through profound absence due to deaths of close friends, family members, or spouses. Losing people close to them may leave them feeling alone or trigger periods of depression. On top of this, many elderly people either live alone or in other residences, which can add to the feeling of loneliness or cause feelings of abandonment. This may be especially relevant in elderly parents in nursing homes or retirement residences as even with regular visits from family, they tend to spend most of their time alone. Physical limitations may also force a change in an active social life, so elderly parents may place more importance on phone calls or video calls. As their health deteriorates, they may feel that sickness is catching up to them. They may feel that time cannot go back so they choose to accept the situation or seem to give up on life in some instances. Any physical diseases or disabilities that can be developed can limit mobility and may restrict them from activities they love. As well, as the body ages, small, everyday activities become harder and more time consuming to perform. This can be frustrating to many.

The way individuals choose to cope with aging may vary, with some seemingly ‘giving up’ as mentioned previously. Through positive acceptance, people can accept the everchanging situation with a good attitude and acknowledge the things they cannot change, even the negative ones. This is the best form of acceptance in this situation. While others may passively accept the situation, which is when individuals are perceived to be giving up. The reason behind passive acceptance according to Lazarus is that the elderly can see death approaching and can not see any immediate solution to health problems or difficulties. In this situation, an elderly parent may seem to require more attention or be more difficult.

What Causes Elderly Parents to Have Anger Outbursts?

Anger outbursts in elderly parents are often due to an insufficient coping process. This is often seen with passive acceptance of negative acceptance of their situation. They may feel angry due to losing control over their lives and other things they cannot change. They may dwell on regrets in their life they cannot go back to. They may respond to the situation with a sense of desperation, frustration, resignation, or irritation. They may feel confused, isolated, abandoned, or neglected if they live alone, are put into a nursing home, or are not receiving as much attention as they once did. Sometimes health deterioration can be very sudden which can usually entail periods of depressive reactions and lowered self-esteem. This can also be the case with the sudden loss of loved ones as well. These reactions may be a result of a low grade of acceptance and a lowered activity level. Loss of rhythm in life may also occur due to progressing physical restrictions. All of these factors can lead individuals to seem more irritable, short-tempered or defensive. Additionally, the need to be dependant on others almost always results in a defensive relationship. So, if your parent seems to have anger outbursts, try to be patient, and understand how they are feeling.

Behavioral Similarities Between Elderly and Youth.

You may notice that some of the behaviours and actions portrayed by your elderly parent are childish. There are actually many similarities between the actions and behaviours of children versus elderly adults, although they are usually for different reasons as elderly adults have more of an understanding of their actions than young children. Actions and behaviours that appear often as childish include being disobedient, not listening, refusing to talk, becoming incontinent, or being manipulative. Elderly parents may also be very demanding. They may demand your time, attention, or for specific things and objects. They also may complain a lot and treat their caregiver as more of a servant by taking advantage of them and their jobs. Or they may take advantage of you if you are the caregiver. They may guilt trip you into getting what they want, all the time. Some elderly adults may be stubborn or obnoxious, by refusing to get out of bed or refusing to eat for example. Other extreme behaviours may be observed as well, like screaming or throwing temper tantrums. Temper tantrums can be described as a childish verbal and physical expression of grief or anger; however, these are often more violent in older adults than children including swearing, yelling, and using an angry tone of voice.

Many of these behaviors in elderly persons stem from feelings of anger, frustration, fear, unmet expectations, or loss of control overall. The loss of inhibition that may come with age also is an explanation for these behaviors as they might not realize these actions are wrong. Additionally, some of these actions, like screaming or refusing certain actions, may be a result of confusion. Often people exhibiting this type of behavior feel misunderstood and feel there is a lack of communication between them and their caregivers. Elderly people may also begin to feel they are being placed in lower social status, as they are often forced to be more dependent on others and feel a loss of approval. This social status is viewed as similar to that of younger children.

How to Calm Aggression in Elderly Adults?

A major factor behind calming aggression in elderly adults is to understand their reasoning behind their actions and push towards resolving any negative feelings. Many times, aggression may stem from the inability to accept the situation they are in, and they may feel depressed, have low self-esteem, or be in denial. What can be considered the normal rhythm – or routine – of a person is usually altered significantly with the effects of aging on the body. A way to aid with negative feelings surrounding this change is to create a new rhythm or routine. This routine should make the individual feel comfortable and allow time for hobbies or discovering new hobbies. Consider scheduling out their day, having meals at certain times, waking up and going to bed at the same time of day, or watching scheduled tv shows. Scheduling these simple actions may give them something to look forward too in a day. Another factor that may contribute to negative feelings towards aging is the inability to take part in certain hobbies they once loved. What may help with this is striving to find new hobbies and interests and performing simpler activities that they are able to carry out. Some hobbies favored by other elderly people include:

  • Reading
  • Watching movies
  • Doing crosswords
  • Knitting
  • Creating or listening to music
  • Needlework
  • Betting on football or horses
  • Making food
  • Cleaning
  • Talking on the phone or video chat

Overall, encourage your elderly parent to focus on things they can do and enjoy promoting more of a positive acceptance rather than being stuck in feelings of anger and denial. This also allows them to feel they can take back control of their life. Remind them not to give up on life, not to dwell on an uncertain future, and deal with any future issues as they appear, one thing at a time.

What to Do if Elderly Parent Refuses Care?

If your elderly parent refuses care, the first step to take is to accept and reassure their feelings. Talk to them about what they are feeling, and why they are acting the way they are. Try spending more time with them allowing for free, open communication between yourself and them. Ask them about their preferences. It is best to ask one question at a time that allows for yes or no answers. At the same time, ensure to be straightforward and assertive while avoiding pushing, nagging, or ultimatums. If your parent is refusing care because they are frightened – possibly due to confusion – be sure to reassure them that they are safe and try again a few minutes later. For parents who are forgetful, try creating a calendar or list with scheduled tasks, like a medication schedule with specific times. In more difficult cases, counseling may be required to help your parent show acceptance, be less confrontational, show less retaliation, and encourage independence. In very extreme cases where the parent may be violent, or their actions are life-threatening, medical intervention may be required through the use of physical or pharmaceutical restraints.

How to Be More Patient?

A large amount of patience is required when caring for a difficult or demanding parent. Some ways to help maintain a patient attitude in difficult situations is to try to understand how your parent is feeling in that situation and understand that memory declines with age. If you get frustrated, it may be beneficial to take a short break by removing yourself from the room or situation for a few minutes and breathe. Remember to appreciate the time you have with them, as time is valuable. Showing them respect, empathy, dignity, and affection will help you as well as your parent.

Practicing patience, in general, will also help you to be more patient in any situation. Practicing mediation and mindfulness helps with this as it allows you to feel aware of your thoughts and feelings, and to appreciate the small things. It also allows you to breathe and relax to push away any negative emotions from your mind. Try to always focus on the bigger picture in difficult situations and accept what you cannot change. Finding a healthy outlet for stress, like running or yoga, is found to be very helpful as well.

 

Citations.

Birkeland, A., & Natvig, G. K. (2009). Coping with ageing and failing health: a qualitative study among elderly living alone. International Journal of Nursing Practice, 15(4), 257-264.

Cornock, M. (2015). Refusing, or being unable, to provide consent. Orthopaedic & Trauma Times, (26), 9-10.

English, J., Morse, J. M., & Scholar, N. R. (1988). The ‘difficult’elderly patient: adjustment or maladjustment?. International Journal of Nursing Studies, 25(1), 23-39.

Feinman, S., & Coon, R. H. (1983). The Effect of Status on the Evaluation of Behavior: Elderly, Adults, and Children Aged 5-65. Research on Aging, 5(1), 119-135.

Myers, D. G., & Dewall, C. (2015). Psychology (11th ed., pp. 214-226). New York, NY: Worth Publishers.

Strulik, H. (2012). Patience and prosperity. Journal of Economic Theory, 147(1), 336-352.

Jillian Crosmas is a 3rd year B Sc student at the University of Ottawa majoring in biochemistry with a focus on microbiology and immunology. She has worked in the pharmaceutical industry as well. She is on track to graduate with honors. As a post-graduate she wants to continue her studies in emergency medicine or genetic research.

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