Finding Calm in the Chaos: Navigating Care-Recipient Anger With Compassion

Discover ways to manage and support your loved one during episodes of anger

Paul Wynn,

AARP

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En español

Published June 26, 2025

care recipient in a wheelchair yells in anger as a caregiver covers their ears

Rob Dobi

Laurel Wittman and Eddie Lopes met in 2001, five years after he was diagnosed with multiple sclerosis (MS) at 23 years old. At the time, Lopes was still mobile and working as a real estate developer for adult communities. But his physical decline was swift, leading him to rely on a wheelchair three years later; he became a quadriplegic within a decade. Despite health challenges, they were in love and tied the knot in 2005. Alongside the physical deterioration, however, Lopes developed significant cognitive and emotional issues, including profound anger and rage.

Wittman initially approached Lopes’ outbursts as though they were typical marital problems, attempting couples therapy and improved communication strategies. Unfortunately, these efforts proved futile due to the underlying neurological causes of his anger. “This was the beginning of an unpredictable time in our marriage that no conventional solution could easily solve,” says Wittman, copresident of the Well Spouse Association, which provides support for spousal caregivers. “His rage nearly destroyed our marriage and almost led to a divorce because his anger became harder to cope with than other aspects of his MS.” Lopes is now 51, and his anger has softened as his cognitive abilities have declined. “He has less energy to fight, so there’s a lot less conflict, and that’s made a positive difference in our relationship,” says Wittman.

Understanding the roots of rage

Anger and aggressive behavior are common in people with chronic diseases and can significantly strain relationships with caregivers, family and friends. These outbursts can happen anywhere — at home, a nursing home and in public.

“Chronic illness often brings out anger in people because it can be a multifaceted issue. It might stem from the disease process itself, difficulty communicating need or even side effects from medications,” says Badr Ratnakaran, M.D., chair of the American Psychiatric Association’s Council on Geriatric Psychiatry and assistant professor and division director of geriatric psychiatry at Virginia Tech Carilion School of Medicine in Roanoke, Virginia. “Additionally, the loss of independence and changes in daily life that come with chronic conditions can lead to immense frustration and anger.”

A 2021 study in the journal Neurology Clinical Practice found that 18 percent of caregivers reported physically aggressive behavior among people living with advanced Parkinson’s disease. A separate analysis of 17 studies found that about 28 percent of people with Alzheimer’s disease show aggressive behavior, such as hitting and yelling, compared with about 7 percent of those with mild cognitive impairment.

“Individuals with cognitive impairment may experience frustration and confusion due to memory loss, communication difficulties and the inability to perform daily tasks. This frustration can manifest as anger or aggression,” adds Ratnakaran.

Often, anger is a secondary emotion, a reaction to something deeper. It can mask feelings of fear, anxiety, sadness or a sense of helplessness. “Taking a moment to identify what’s truly triggering the rage can be empowering,” says psychologist Deborah Derrickson Kossmann, author of Lost Found Kept: A Memoir. “Understanding the source of the anger and frustration is the first step toward addressing it effectively.”

Wittman adds: “Knowing that anger is often a part of the disease and not a personal failing can be the most comforting, yet hardest, truth for a caregiver to hear and accept.”

Common causes of anger

Anger in people with chronic conditions can stem from many causes, ranging from anxiety, cognitive decline and communication issues to infections, medication side effects and physical pain. Ratnakaran, Derrickson Kossmann and other caregivers recommend paying close attention to these eight causes of anger issues.

Caring through the conflict

At home or in long-term care settings, aggressive and angry behavior by loved ones strongly correlates with stress, social withdrawal and burnout among caregivers.

Scott Moore, a 67-year-old retired police officer from Wolcott, Connecticut, worked through many tough times after his son, Brett, 39, sustained a severe traumatic brain injury in a car accident at age 20. Moore thinks his son’s anger stems from the profound losses he has experienced due to his brain injury, including his aspirations for a family, a career and a social life.

“It’s difficult to cope with his outbursts when he becomes angry. It wears on me as his caregiver,” Moore admits. After many attempts to get him into therapy, he recently went with Brett to meet a therapist to help him work through his emotional issues. “He finally agreed that he was ready, and yeah, it’s 18-plus years later, but better late than never.”

Anger and aggression are among the most challenging behaviors caregivers face. It’s easy to feel overwhelmed or even mirror the anger when reacting. But staying grounded is key. Derrickson Kossmann shares the following practical tips to help caregivers defuse tension and protect their own well-being while supporting a loved one with compassion.

Rule out physical causes first. Before addressing anger as a behavioral issue, caregivers should always investigate potential physical causes. This includes a thorough medication review to identify any drugs or drug interactions that may be causing irritability, as well as ruling out physical issues and discomfort. Unacknowledged pain, hearing or vision loss and even unmanaged conditions, like diabetes, can significantly contribute to anger.

Recognize behavioral issues. Know that anger, especially in individuals with cognitive decline, can be a manifestation of unexpressed needs, like hunger, or discomfort. It can also stem from grief and loss over diminished independence or be a symptom of depression or anxiety.

Practice de-escalation. When faced with anger, caregivers should focus on toning down the situation rather than engaging in conflict. This involves staying calm, taking a breath, speaking gently and steering clear of arguments or power struggles. It may even mean walking away without saying a word. Showing patience and empathy helps reduce tension and prevents the situation from getting worse.

Adapt the environment. Modifying the living space to support your loved one’s independence can greatly reduce frustration and anger. Simple changes like installing grab bars in the bathroom, improving lighting to minimize shadows and removing clutter to clear pathways can make daily life easier and safer.

Validate feelings and avoid correction. When a loved one with dementia or cognitive decline expresses anger or frustration, it’s essential to validate their feelings rather than arguing, correcting or engaging in confrontation. Phrases like, “I can see you’re really upset right now,” followed by an offer of comfort (e.g., “Would you like me to play some music?”) can de-escalate situations. Understanding that anger may stem from fear, confusion or anxiety can help foster empathy and a softer approach.

See a therapist. When someone is struggling with anger and aggressive behavior, it’s important to see a mental health professional, such as a psychologist, psychiatrist or specialized therapist. This expert guidance helps them understand the underlying emotional issues rather than just reacting to outbursts. Ultimately, professional intervention ensures the individual’s comfort, safety and emotional well-being by addressing the complex roots of their anger.

Medication options. Antidepressants and antipsychotics may help manage aggression in individuals with neurological conditions. If non-drug approaches don’t work, discuss these options with a doctor. If medication is prescribed, make sure to tell the doctor if the person taking it experiences any side effects.

Don’t forget self-care. Caregiving can be emotionally, physically and spiritually bankrupting, especially when dealing with anger issues. It’s crucial to implement self-care rituals, like meditation, eating well, pursuing hobbies or therapy — not as a luxury but as a must-have to prevent burnout and effectively care for your loved one.

Understanding anger in long-term care: support, not eviction

As Lopes’ MS progressed, so did his anger, creating an increasingly volatile home environment. Wittman found herself in a constant state of panic. The emotional toll was immense, leading to a critical juncture in 2016, when Lopes explicitly stated he wanted a divorce.

This declaration, coupled with the escalating difficulty of managing his behavior at home, led to the challenging decision of placing Lopes in a nearby assisted living facility in Virginia. Wittman describes this period as a “reset” for their relationship. Being out of the direct line of fire provided her with much-needed distance and relief. She considers herself fortunate that his physical disabilities made assisted living an option, offering a necessary break from the relentless emotional strain.

What happens if your loved one directs their anger toward staff at a long-term care facility? Will your loved one be asked to leave or thrown out without warning? In most cases, the answer is no. Except in extreme, violent situations, when a resident may be admitted temporarily to a hospital, most facilities work closely with families.

“We don’t just kick people out. That’s a misconception. Even when a resident gets angry and throws something at the staff, that’s not reason enough for us to send them to the hospital,” says Anshu Raina, executive director of The Village at Victory Lakes, in Lindenhurst, Illinois, a continuing care retirement community. “Trust between families and staff is critical. Open communication prevents small issues from turning into big ones, because we all want what’s best for the resident.”

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Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community, both as a family caregiver and as a journalist covering caregiving issues for national publications.