3 Dementia Caregiver Tips: How To Control Anger, Deal With Paranoia & Sundowning
Caring for a loved one with dementia often means navigating challenging behaviors and emotional moments. But what if those behaviors, often labeled as “challenging,” are actually normal human responses magnified by communication gaps?
In this episode, we tackle real caregiver questions about controlling anger, managing paranoia, and determining when a loved one can no longer live alone. Using a practical framework, we offer actionable insights to help caregivers respond with compassion and clarity.
Reframing Challenging Behaviors
Many caregivers describe behaviors like anger, frustration, or paranoia as “challenging,” but this episode encourages a mindset shift. These behaviors are often ways your loved one is trying to communicate unmet needs or feelings.
Recognizing this helps reduce frustration and creates opportunities for connection.
Introducing the PEACE Framework
To better understand and address behaviors, the PEACE framework provides a simple yet effective tool:
- Person: Assess their basic needs. Are they hungry, tired, or in pain?
- Environment: Evaluate their surroundings. Are they too noisy, cluttered, or uncomfortable?
- Activity: Consider how meaningful their engagement is. Are they feeling included and purposeful?
- Care Companion: Reflect on your own emotions and actions. Are you bringing calm or unintentionally contributing to stress?
- Evaluate and Educate: Review patterns and share findings with others in their caregiving circle.
This framework helps you become a “dementia detective,” identifying triggers and patterns to create a more peaceful environment.
Managing Anger and Frustration
Anger and frustration in a loved one with dementia often stem from unmet needs or feelings of fear and disconnection. Use the PEACE framework to assess:
- Are they physically uncomfortable?
- Are they frustrated because they can’t express themselves?
- Are they overwhelmed by their surroundings or activities?
Responding with calm and curiosity can help de-escalate situations. Remember, your energy affects theirs—staying composed is key.
Addressing Paranoia
Paranoia often arises from memory loss and confusion. For example, a loved one may misplace their belongings and believe someone has stolen them. To navigate paranoia:
- Use open-ended questions like, “Can you tell me more about what you’re feeling?”
- Check for environmental factors like shadows or noises that might cause fear.
- Focus on reassurance rather than reasoning—emotions, not facts, often drive paranoia.
When Is It Time to Transition from Living Alone?
Determining when a loved one can no longer live alone is one of the hardest decisions caregivers face. Key indicators include:
- Difficulty locating items or food in their environment.
- Inability to call for help in an emergency, such as after a fall.
If your loved one struggles with these tasks, it may be time to consider additional care options.
Faith and Caregiving: Finding Strength in God
Throughout the caregiving journey, faith serves as an anchor. When moments feel overwhelming, leaning into prayer and trusting God’s guidance provides strength and peace.
This episode emphasizes that caregiving is not just a responsibility—it’s an opportunity for growth and sanctification through serving others. and wisdom can guide you, even through the hardest days.
Read more:
How to Have a Good 2025 Even When Dementia Caregiving
Know When Isolation In A Person With Dementia Is Detrimental
Ever Wonder How To Know What Is Causing Your Caregiver Stress?
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[0:00] Hey Christian Care Companion, welcome to Dementia Caregiver Support for Christians,
Introduction to Dementia Caregiving
[0:06] where we equip Bible-believing Christians to overcome the challenges of dementia today and tomorrow. If you are a Christian Care Companion who is a spouse or a child or a family member of a person living with dementia and want practical caregiving solutions and Christian support, this podcast is for you.
[0:35] Here, we make caregiving easier by cutting out the stress and the overwhelm
Q&A Format for Today’s Episode
[0:43] so common to caregiving. Well, I am excited about today’s episode. It is going to be a little different again, because I thought I would come on and do a couple of question and answer formats for today’s episode.
[0:59] And so the topic of today’s program is something that is very frequently mentioned in dementia caregiving, and that is the challenging behaviors in inverted commas, or what is also known as responsive behaviors.
[1:17] Well, my philosophy is that responsive behaviors or challenging behaviors are really just normal adult, normal human behavior, not adult behavior, but normal human behavior magnified because we, the people around the person, are living with dementia, do not necessarily recognize what they are trying to communicate with us. So the vernacular is it’s a challenging behavior, but I honestly just don’t believe that anymore. I believe because we serve a holy God and a God that has created order and a God that has created us to be in relationship, I actually believe it’s because we are struggling to communicate with one another, and it is impacting our relationship. And we have this thing that occurs that the world calls challenging behaviors. So we’re starting the conversation out with what I believe related to this. Now, the first question, and these questions actually come out of people joining my free Facebook group. So I don’t know if you know, but if you don’t, you’re welcome to join. But there is a free Facebook group called Dementia Caregiver Support for Christians.
[2:34] The purpose behind that group is for you to be in an environment of other Christian believers. We pray in there, I answer questions in there, and it is another free resource for you to go check out.
Managing Anger and Frustration
[2:46] So hop into the Facebook group and come hang out with me there. But the first question I received in one of the first questions that we’re going to talk about today, we’re only going going to do three, is controlling anger and frustration. So to start the conversation with, that is literally all the information I have, is controlling anger and frustration. So I don’t know if the anger and frustration is the person who is the caregiver, how they need to be able to control their own anger and frustration, or whether it is for the person living with dementia, how to control their anger and frustration. But for purposes of today’s episode, I’m going to answer the question as if it is dealing with.
[3:37] Coping with how to control the anger and frustration of the person living with dementia. So another episode that I just recently did related to this topic that was a dementia caregiver support in action episode is episode 216. And that is an episode where we talk about dealing with aggression. So go ahead and check out that episode as well. So how do we control anger and frustration in people living with dementia? The first thing I want us to consider that I want you to consider is I have a very easy, very basic.
[4:17] It’s the tip of the iceberg type of a framework that I teach people in my community to run everything that the person is experiencing or exhibiting or showing these responsive behaviors through this filter. It’s a very easy framework. It is literally four steps. And the fifth one is to evaluate and educate the people around the person with dementia. So the first one is, it’s called the peace framework. I call it the dementia peace framework. Person living with dementia, environment in which the care occurs, the activity engagement or meaningful participation of the person in their environment, and then how we as the care partner, as the care companion, contribute to what we see. So when you are looking at any kind of a normal human behavior magnified, i.e. A responsive behavior, run What has just happened because the thing that you see is the tip of the iceberg. There’s a whole bunch of stuff that either came before or is underneath the surface that you are not seeing. You’re just seeing this response.
[5:33] So when you are contending with controlling anger and frustration or the person is exhibiting anger and frustration, I want you to run it through the following things, right? The person with dementia. their basic needs. Are they hungry? Are they tired? Did they not sleep? Are they feeling too hot or too cold because they don’t have the right clothing on? Do they need to go to the bathroom? Are they overtired?
[6:00] Run it through thinking of, are they afraid of falling? Are they afraid of being abandoned or feeling left out? Are they frustrated because they’re not able to communicate with you? Are they feeling threatened because the people are too close to them? Are they needing social interaction? Are they not being included in decisions? All of these types of things need to be considered when we are looking at the person and their response. So we see the behavior, we see the anger, we see the frustration, but when you as the family caregiver or the person around that person, and you just look. And it’s very easy. Just take a piece of paper, write down person, environment, activity.
[6:52] Care companion, and then evaluate and educate. So just literally sit and think. Take five minutes to reflect on what just happened. who was there? What time of day was it? Every single factor that you can think of, write it down on that piece of paper. And you might need to have seven or eight pieces of paper where these things actually happened for you to be able to start to put together what might be contributing to this thing that you just saw happen. I’ll use a person in my community right now, we have a lot of difficulty with some exit-seeking behavior at a very specific time of day. And so it could be sundowning, it could be other things. But as we’ve started working through teaching her, the daughter.
[7:45] This framework, she has actually come back to me and expressed that she is starting to notice a pattern because this is what it is. It’s just noticing the patterns. And it seems, and we’re still at the very beginning of the data gathering, so this is your data gathering phase, to try to figure out what is contributing to that exit-seeking behavior. But I’m having her go through this exact process with her dad and with her situation that she is in. So know that this framework works. It’s not a light switch on and off. It doesn’t work just one time. You cannot do this just once. You’re teaching yourself to be a dementia detective. You are teaching yourself a framework to run every situation through because you can very quickly think peace, dementia, peace, person, environment, activities.
[8:47] Caregiver contribution, care companion contribution, and then evaluate and educate the people around the person to really unpack any and all responsive behaviors or the tip of the iceberg or normal human behavior magnified, just always run it through this framework. So that’s the very first thing that I would recommend if you were trying to figure out how to control anger. And this is something, and I’ll just add this as an aside because I want to get to the other questions.
[9:23] Check your own emotions. If the person’s getting angry, as a care companion, we really need to check our emotions and see whether or not we are getting angry too, because they will suck up your energy like it’s nothing. So if I’m angry, my dad’s angry. If I’m angry, you know, the cat’s angry, right? It doesn’t matter the person living with dementia. They are very intuitive to your emotional needs.
Understanding Paranoia in Dementia
[9:48] Now, when this episode airs, it will be January the 17th. And so there’s still time if you have not yet, joined one of my dementia caregiver support in action sessions called Ask the Dementia Coach, which is a live question and answer ability to actually come on and ask questions of a dementia expert. The next one is January 23rd at 6 p.m. Eastern. So I invite you to go to the show notes and get the link and sign up for the next Ask the Dementia Coach. So the next question is, how do we deal with paranoia?
[10:27] So paranoia is definitely something that happens very frequently in later stages of dementia. And there are a lot of reasons why people become paranoid or have paranoid ideation when they are living with dementia. And it can look a lot of different ways for a lot of different people. But frequently, you know, the paranoia that people have is oftentimes related to not remembering things. So, for example, they may be paranoid because they cannot remember where they put their purse. So therefore, somebody came into the house and stole it, right? So paranoia and delusions are oftentimes hand in hand. And I just did a recent episode, also a dementia caregiver support in action episode, and it is episode 215. So just the last couple of weeks. and that is essential tips on how to manage delusions in dementia.
[11:27] So delusions and paranoia go hand in hand. And since we just had an episode, I’m not really going to unpack delusions and paranoia too much today. But the same thing related to paranoia is with any type of a normal behavior that we see, right? So anger and frustration, some of these responsive behaviors, we need to be looking for what is triggering it.
[11:54] Now, paranoia, there are, you know, certain things that are actually happening to the person’s brain, which means that there are physical changes to their brain, which sometimes, you know, we cannot, there’s a lot that we can do to mitigate these responses, but then sometimes for certain things, and hallucinations can be one of them, paranoia can be another one of them. There really are things that we can do to decrease or mitigate some of the impact of it, but we may not be able to take it all the way away. But still, your biggest takeaway for today is take a piece of paper, write down person, environment, activity, participation, and caregiver contribution, and then evaluate and educate. And then just start to look at the situation around the paranoia and start to write it down. What is going on with the person? Are they overtired? Are they in pain? Are they not sleeping?
[13:03] All of these factors are things that we need to look at to see how we can change these different things to see if we can decrease these responsive behaviors. The environment, is there a fan? Is there a light on? I’ll use myself as an example, and this is a very stupid example, and it has nothing to do with dementia. But I remember one night I was by myself, and I wear glasses intermittently. These are my readers, But I was sitting and every single time I would see something out of the corner of my eye. And I was starting to get a little worried because I’m like, oh my goodness, who’s in the apartment with me? Who’s in the house with me? And I couldn’t figure it out, but I was seriously getting afraid, right?
[13:54] And finally I figured out the thing I was seeing out of the corner of my eye was a reflection of my eye blinking, which meant that every single time I closed my eyes, I would see this movement, and I thought somebody was in the house with me. So when we are helping somebody who is dealing with paranoia, we need to think very creatively. Are they seeing a shadow in the room? Is there a noise that they are hearing that might be an auditory hallucination? All of these kinds of things, is it because they are misplacing things because they don’t remember where they put it. And now it looks to them like they have somebody coming into the house. What is… Could be contributing to the paranoia. So the best thing you can do is ask leading open-ended questions.
[14:48] Well, tell me more about that. Well, continue to tell me what you think might
Transitioning from Living Alone
[14:54] be happening or ask some open-ended questions. And the last question for today’s short little episode is on how to help ease the transition of a person with dementia from living alone to not being able to live alone anymore. And the person is getting very upset and going into tears, just wanting to go home. So yet again, this is a general question and there are a couple of benchmarks. And so this one isn’t quite, well, it is, but it isn’t. We’re not really going to talk about the responsive behavior of sundowning as much because with sundowning, we’re going to run it through the same filter.
[15:36] You’re going to look for the things that might be the trigger. So for example, my client right now, one of the things that we’ve noticed with the sundowning is the exit-seeking behavior that he has. And one of the things that the daughter is noticing is that there might be a trigger related to a mass being on in the background in the TV or his wife telling him to go lay down and take a nap. And when he gets up, even though he hasn’t taken a nap, he’s trying to exit the house. So we’re trying to figure out those triggers, but we’re running it through the same framework. Now back to how do you know whether a person can still live independently. I thought this was really, really the crux of this question. How do you know when somebody is not safe to be living home alone anymore? And one of the biggest things is whether or not there are two things. Can the person scan their environment and locate things that are not in sight anymore? And.
[16:46] Is the person able to call for help if something happens? So if they fall, would they be able to use a remote button, use their cell phone call for help, and or can they go to a fridge if they are hungry and open the fridge door, locate food, know what to do with said food, and be able to find things that are not within sight. So if the person is at the point where they cannot open a drawer to locate an item, if they cannot open a fridge to find food, a closet to find food, this person is not safe to be home by themselves.
[17:34] And so another episode recommendation for you related to this is episode 155, where we have some five quick tips about sundowning. So this question was about living alone independently, as well as sundowning, and just wanting to go back home.
[17:53] So broader question was kind of divided into three little sections. We looked at how people can, how do you know somebody can still be home alone? How do you know that they’re still safe? What to do, you know, to look at some sundowning, which is a responsive behavior, and then what to do about somebody saying just, I’m just wanting to go home. And so when you’re talking to somebody who says they’re just wanting to go home, ask open-ended questions. Well, tell me about home. We want to get as much information as we can because we do not know you. Where in their journey, in their history, they are now maybe stuck as a broken record.
Closing Thoughts and Future Questions
[18:36] So I hope today’s short question and answer format was helpful to you. We’re going to be including some of these throughout where these are actual questions from people in the audience that I’m going to be answering. And hopefully over the next couple of weeks or months, I will be able to give you guys a link where you can actually ask the question and we can just put the audio stream in the episode, or you can email me the question and I can answer the question on the podcast. But I’m trying to make these episodes a little bit more nitty gritty.
[19:14] Granular, real rubber meets the road type of episodes for you. And so I really hope that these resonate with you. Yet again, if you haven’t been to one of the Ask the Dementia Coach live question and answer, so these other ones are not live, but if you want to come to an Ask the Dementia Coach live question and answer, the next one is January 23rd, which is in a little over a week or so, you still have the opportunity to sign up for one of these episodes. It’ll be next week on Thursday. It’s a Thursday evening, so go ahead. The link is in the show notes, and I hope to see you there.
