Is the nastiness an attempt to exercise some power?

[Anonymous]

I am caretaker for someone who had a debilitating stroke. They have become nasty and seem to take delight in being so unpleasant to me that I start crying. This happens almost every single day, and it’s someone who knows how to push my buttons and get me upset. This is someone who was very capable of being nasty before the stroke and acted that way pretty regularly, but not daily.

Is this a common thing? Someone who has been rendered powerless by a health catastrophe tries to get relief and get a feeling of power over someone else by making them upset to the point of crying? Have others dealt with this?

[Anonymous]

It sounds like someone who had very little filter before the stroke has zero filter now and just says whatever mean thing pops into their head. It's not the behavior that has changed, just the extent of it.

If you are going to continue to be the caretaker you might want to get some help learning how to not be triggered by anything this nasty person says.

[Anonymous]

It's the brain damage.

[Anonymous]

My mom has gotten even nastier with age, but she was always mildly abusive before. The part of the brain that had the ounce of empathy probably got damaged with the stroke (in my non-clinical opinion). Are you related to this person? If so, I would seriously look at whether there is money to outsource this or what is available to this person within their financial means. It only gets worse, especially if you can't medicate the nastiness well.

If you aren't related, can you take another case and allow someone who deals better with difficult people to take this on.

The one time I gave it right back to my mother verbally, not abusive and no name-calling like does, just stating facts and setting boundaries she fell apart and then raged at me in such a way I though I was in physical danger. That's when I realized this could turn into a volatile situation and I needed to manage from a distance. She behaves better for others and is medicated, but still I set off abuse if I go near her.

Better for the person to be cared for by someone who isn't triggered and who can set firm boundaries. Mom is still capable of behaving with strangers who don't take shit.

[Anonymous]

"Nastiness" tends to be one of two things: an expression of frustration, or, as you put it, and attempt to exercise power.

But many have personality changes with strokes that leave them "nasty" as well, and your charge had one. But you say they were nasty before the stroke. So, it sounds like you are just dealing with a frustrated person who was awful to begin with and now feels the need to exercise any kind of power they can. Trifecta. Get out of there.

[Anonymous]

Brain damage makes their personality worse. They were always impulsive and bad-tempered, and now there's no filter.

This is something the person can control, but only in a limited way. You can experiment with a threat to walk out and not help, and see whether they can rein it in. They will have a lot of trouble controlling their impulsivity, so they'll make an effort, and then they'll let a nasty comment slip after a while.

Caring for such people requires you to emotionally detach entirely. Think of it like being the tech for the lion enclosure. There's one particularly nasty lion who tries to corner you every feeding time. But your job is to keep him alive. What do you do?

[Anonymous]

Its damage to the frontal lobe - makes them unable to control their impulses. A bit like a toddler who hasn't had her nap. Don't take it personally - the same way you wouldn't if your child says, "I hate broccoli and I hate you!" (Actual quote from my first child).

[Anonymous]

I think about this a lot with my in laws who deteriorated quickly with dementia, Mom is gone, Dad is declining and it seemed to START for the both of them with a nastiness that offended spouse who felt they were wielding power etc...and I don't even think anyone can be that cunning and crafty with anything neurologically going on - I'm no doctor - but maybe one who's familiar can chime in....it's just a sad thing to have to witness....agree OP that you take care of YOU if you plan to continue care giving.

[Anonymous]

Here's a hot take---hire this out immediately, if you can. They are probably triggered by you and it's not good for anyone. You can care for them by arranging paid caregivers who don't trigger them and who aren't triggered by them.

It's common. My mom is cruel--wildly--but not to paid caregivers. We are both calmer without direct caregiving.

[Anonymous]

Anonymous wrote:I think about this a lot with my in laws who deteriorated quickly with dementia, Mom is gone, Dad is declining and it seemed to START for the both of them with a nastiness that offended spouse who felt they were wielding power etc...and I don't even think anyone can be that cunning and crafty with anything neurologically going on - I'm no doctor - but maybe one who's familiar can chime in....it's just a sad thing to have to witness....agree OP that you take care of YOU if you plan to continue care giving.

With both my mother and my grandmother they absolutely were cunning and manipulative with early dementia. My friend had the same experience. Turning it on for evaluators and outsiders, but raging, pushing every button and then attempting guilt trips, threats etc, to the one there for them most in private. My friend's mom was barely oriented to person, place, time, or anything, yet used every brain cell to seem OK when she met with a doctor. I recall mentioning my experience here and another poster had to secretly film her mother for anyone to take it seriously.

[Anonymous]

Anonymous wrote:Here's a hot take---hire this out immediately, if you can. They are probably triggered by you and it's not good for anyone. You can care for them by arranging paid caregivers who don't trigger them and who aren't triggered by them.

It's common. My mom is cruel--wildly--but not to paid caregivers. We are both calmer without direct caregiving.

This is some of the best advice I have seen. My mother's behavior was abusive and frightening with me and getting worse by the minute. She could turn it on for others. My health deteriorated-physical quite rapidly to a serious illness after a few years and mental health. I had 2 life changing epiphanies:

1.) She will hate me, resent me and rage at me no matter how much I help and the more I help the more miserable I am. If I step back and outsource EVERYTHING she will hate and resent me, but I have some hope of regaining my mental and physical health.

2.) It isn't good for her mind or health in general to rage at me. The cortisol and other things released are damaging. Also, even if she is addicted to rage and gets a dopamine hit, that is not a safe addiction to feed.

Outsourced everything and doctors are truly amazed at how my physical health has improved. I have also lost weight. I actually wake up again with a sense of hope. People from work comment that I seem more relaxed. I found a lot of things needed addressing at home with my teens and I could tackle that. I can carve out more time for my husband. AND Mom is properly cared for. She behaves better for strangers and when she doesn't and they set boundaries she has learned from enough people quitting, she needs to shape up.Yes, I do believe in the early stages they have some capacity to control things and respect boundaries if a stranger sets them.

Oh and to answer your first question YES, my mom absolutely wanted power. She has always been entitled and uppity so she would say anything, no matter how damaging to me in an effort to make me cower and be subservient. I was started to sense if I had not stepped back she would have attempted physical assault.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Here's a hot take---hire this out immediately, if you can. They are probably triggered by you and it's not good for anyone. You can care for them by arranging paid caregivers who don't trigger them and who aren't triggered by them.

It's common. My mom is cruel--wildly--but not to paid caregivers. We are both calmer without direct caregiving.

This is some of the best advice I have seen. My mother's behavior was abusive and frightening with me and getting worse by the minute. She could turn it on for others. My health deteriorated-physical quite rapidly to a serious illness after a few years and mental health. I had 2 life changing epiphanies:

1.) She will hate me, resent me and rage at me no matter how much I help and the more I help the more miserable I am. If I step back and outsource EVERYTHING she will hate and resent me, but I have some hope of regaining my mental and physical health.

2.) It isn't good for her mind or health in general to rage at me. The cortisol and other things released are damaging. Also, even if she is addicted to rage and gets a dopamine hit, that is not a safe addiction to feed.

Outsourced everything and doctors are truly amazed at how my physical health has improved. I have also lost weight. I actually wake up again with a sense of hope. People from work comment that I seem more relaxed. I found a lot of things needed addressing at home with my teens and I could tackle that. I can carve out more time for my husband. AND Mom is properly cared for. She behaves better for strangers and when she doesn't and they set boundaries she has learned from enough people quitting, she needs to shape up.Yes, I do believe in the early stages they have some capacity to control things and respect boundaries if a stranger sets them.

Oh and to answer your first question YES, my mom absolutely wanted power. She has always been entitled and uppity so she would say anything, no matter how damaging to me in an effort to make me cower and be subservient. I was started to sense if I had not stepped back she would have attempted physical assault.

One more thing...part of her behaving for strangers is her staying on her mood regulating meds. She kept going off them and raging even more at me. The people managing her care read her the riot act if she pulls this and so do her doctors. nobody cared when I was the victim, but when strangers keep quitting they know something is up.

[Anonymous]

Maybe the person became depressed as he/she is now so incapacitated. Who would be happy living like this and getting closer to death every day? It’s depressing and depressed people lash out.

[Anonymous]

OP, is outsourcing care a possibility?

My family has had a + experience with Visiting Angels as home health aides.

Does the person have any home PT assigned or a visiting nurse? Those, unlike a home health aide, are covered by Medicare.

You may want to reach out to their neurologist and express concern re: the behaviors. Perhaps they can be medicated in a different way that may help?

[Anonymous]

Anonymous wrote:OP, is outsourcing care a possibility?

My family has had a + experience with Visiting Angels as home health aides.

Does the person have any home PT assigned or a visiting nurse? Those, unlike a home health aide, are covered by Medicare.

You may want to reach out to their neurologist and express concern re: the behaviors. Perhaps they can be medicated in a different way that may help?

All of these are great suggestions for OP.

I went the empathy route and people suggestion "experts" like Teepa Snow, but after enough time I think all of that was brainwashing me into accepting abusive behavior and feeling guilty for hating every second. If this is a family member, better to get distance and easier for strangers to use techniques. Then when you visit you can hold it together and be pleasant for a short period of time. If it's a charge, just request a new one. The risk you have to keep in mind when someone is nasty to you is the risk you could at some point lose it and be nasty back and then it can cross into abuse. When I had an ill spouse and my own illness, I would tell her off right back and that wasn't good for either of us. I had to back away and outsource everything. Just my face makes her want to hurl insults.