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It's best to physically remove yourself from the fray. Walk into another room, talk a short walk, deep breathing the whole time. Mother will occasionally rage at me and I DO have the option of leaving, often for months at a time. If she lived with me--well, I'd be stark raving mad by now.

Better to walk away and not fall into a trap where you also start to lose it. With dementia often comes irrational rages and anger. Try not to take it personally. (Yes, I DO in fact know haw hard that is).
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I don't know if there is a best thing to say. My Mom isn't really narcissistic, but she does rage. Sometimes I tell her, "I'm so sorry you are angry, I wish I could fix it for you." Sometimes that actually calms her down. Sometimes she tells me to go to hell. No matter what I say, it's a gamble. LOL
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It is SO difficult. I read your question and just thought sadly "I don't know."

The last time I saw my MIL do this there were three of us in the room and we just stood there and gaped at her. One was her paid companion, one was her daughter, who's a consultant psychiatrist, and one was me, who stopped caring what MIL thought about anything twelve years ago.

She was having an insane meltdown over a kitchen fitting that she'd wrenched off its fixings, and the poor caregiver was trying to put it back under a barrage of accusation and insult. We just let it burn itself out, there was no distracting MIL or getting her out of the room and the dam' thing did have to be put back, nothing for it...

So above all, do not ever blame yourself for finding this kind of situation difficult to manage with grace and elegance. It's a bummer!
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If I can’t leave and get in my car to go home, I leave the room. If I can’t put physical distance between us, I don’t speak or look at the one raging.
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Can you go to another room, at least?
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Usually I leave the room, but I have had occasional success in calmly telling my mother to stop acting like a 4-year old. Your mileage may vary.  It's a tough one for sure.
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Dear midkid58: Someone on this site suggested a counselor so I could vent a little. I feel guilty even leaving for 90 minutes,but it does help. And like you advised, not taking it personally I'd like being given freedom. Grateful for your words☺
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Pick up the phone and call someone. Do this in her presence.
If your mother has any filters at all, she will stop, not wanting others to hear her.

Or call your voicemail if you don't want anyone to hear her. Pretend you are talking to someone. Then leave the house for your safety.
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