14 Ways to De-escalate a Tense Caregiving Situation

If it’s your mother, for example, you might say something like: “Mom, I’m sorry you’re upset, but I want you to know that I love you and I’m here for you.”

Presume nothing. Don’t ever presume you know for sure why they are crying or upset, says Shaw. You will often be wrong. Instead, a potent way to acknowledge their pain is to ask: “What are your tears for?”

Distract lovingly. Sometimes the best way to de-escalate an uncomfortable situation is to distract your loved one in a positive way. For example, says Shaw, if your loved one favors sweets, you might say, “Let me bring you a cookie.”

When tense situations arose with his ailing wife, he says, “The most calming thing I could do was to bring her an ice-cream cone.”

Stop and walk away. At the height of a negative encounter, often the best thing a loving caregiver can do is to remove themselves from it by simply walking away, says Pamela Wilson, a family caregiving consultant. But inform them exactly what you’re doing, she says. 

For example, she says, you might say, “I hear you yelling, and I feel your anger. So I’m going to stop what I’m doing and walk away for five minutes. Then we can talk about what you’re upset about.”

Change your approach. If possible, it might be a good idea to remove the source of the irritation, says Wilson. For instance, if your mother is angry because you told her it’s time to take her shower, stop reminding her.

Instead, says Wilson, you might encourage her to do it on her own by turning on the shower and stepping away for a moment. This is an opportunity to observe whether your mother is more receptive, since it now feels like her own idea.

Stop rushing. Caregivers often tend to be in a hurry, while their loved ones typically are not. Rushing older adults into taking actions that you want them to do is a scenario that’s doomed to fail, says Wilson. For example, even if you’re running late for a doctor’s appointment or perhaps an appointment at the hair salon, it will only escalate an already tense situation if you push your loved one to go faster.

This is actually a time to slow down, says Wilson. Take a moment to realize that your loved one is not operating on your hurried timeframe. That’s why it’s always smart to build in extra time for appointments outside the house.

Communicate openly. Too often, caregivers and their patients operate in “networks of silence,” says Allison Applebaum, author of Stand By Me: A Guide to Navigating Modern, Meaningful Caregiving. As a result, she says, both parties are inadvertently avoiding the very topic they want — and need — to discuss. It’s very common for both parties to avoid discussing advance care planning, she notes. That’s because the caregiver and the loved one are often giving each other the unstated message that this is too difficult a topic to discuss. Yet, ultimately, that’s precisely what both need to talk about.

But prolonged silence can escalate into situations that could have been avoided with open conversation. The best way to prevent these unfortunate situations, she says, is to be honest.

Don’t take it personally. It is vitally important for caregivers to always be aware that the person’s patient’sperson’s anger — or hostility — is rarely a reflection of any real anger toward them, says Applebaum. Instead, she says, it is anger at the illness and sadness around how greatly circumstances outside their control have changed their life.

Apologize. Few things solve a disagreement faster than a sincere apology, says Wilson. The sooner you apologize, the better, she says, but even an apology the following day can be helpful.

Your apology should not blame the other person. It’s an opportunity for you to explain the way you were feeling and take responsibility for it, says Wilson.  And keep it short.  Something like: “I was tired, and I didn’t have a good day. I’m sorry.”

Give them options. Stop forcing one specific thing on your loved one; instead, try to give them options, says Daria Lewis, a family nurse practitioner who specializes in mental health. 

For example, she says, to give them a greater sense of autonomy, you might give your loved one the option to write down on a piece of paper — or even in a spreadsheet —what they like to eat on Mondays, Thursdays or weekends. That would include which specific desserts they favor, she says. Even small acts of independence like these can help to build confidence and avoid heightened situations.

Discuss how to improve — later.  You don’t necessarily want to try to have a rational conversation in the middle of their anger, but it’s smart to use it as an opportunity to discuss options for change after things have cooled down, says Wilson.

When you have this conversation, says Wilson, validate their unhappiness and remind them that you recognize they don’t like how you handled the situation. This also gives you the opportunity to ask them how the problem might be handled better next time.