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Anger management in the elderly: Patience is key
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Anger management in the elderly: Patience is key

Caregivers and families must have patience and a non-patronising approach while dealing with outbursts of older people
Anger management in the elderly can be a challenge. Caregivers and families must ensure patience and a non-patronising approach while dealing with outbursts of older people
Photo by Anantha Subramanyam K/Happiest Health

The rage of the elderly is a challenge for their caregivers, who face the wrath. The unexplained anger in the elderly has its roots in psycho-social factors, from being helpless and dealing with health issues to their dependency on family members. Anger management in the elderly is a concern in geriatric care, say doctors.

Maya (name changed), a 24-year-old advocate from Chennai, recalls how her 82-year-old grandfather suddenly becomes irritable and angry. The once friendly and soft-spoken person had become an angry old man. “We observed his outbursts in 2019 during the COVID lockdown period. We sensed that he was feeling isolated because he was mostly idle at home,” she said.

Anger management during the pandemic

Concerned over his behaviour, Maya shifted her grandparents to her house. However, her grandfather did not get relief from this arrangement. “He would often feel anxious watching the news. He would get agitated and pick fights with us if we didn’t follow the COVID protocols,” she explains.

As he was under medication to calm him down, Maya says he felt better. Still, he would have occasional outbursts and the family had to take him to a therapist for his anger management issues. While pandemic-related fear was her grandfather’s immediate cause of anger, his  short temper was always an underlying issue.

Anger in the elderly: what are the triggers?

Ravi Kiran from Bengaluru recalls his 95-year-old grandfather’s infamous temperament. “While he was always known as an angry man even in his younger days, it only worsened over time. If his routine changes a bit, he starts shouting and stops taking food. It takes time to calm himself down. My uncle and grandma get worried about his health every time he gets angry and skips meals,” he said. His grandfather’s refusal to meet a psychologist has been an added concern.

Anger or any behavioural changes experienced by the elderly are often due to biological, psychological and social concerns. Experts break this down further:

  • Biological reasons: It is a palpable fact that as one ages, they are bound to undergo changes in various biological processes. This often triggers some physiological complications. “Fluctuations in blood pressure, thyroid and blood sugar levels precipitate behavioural changes,” says Dr Kedar Tilwe, consultant psychiatrist, Fortis Hospital, Mulund and Fortis Hiranandani Hospital, Vashi, Mumbai. He advises that alzheimer’s and dementia are common conditions that contribute to this behaviour, but other conditions should also be ruled out.

Preetha Mathew, a psychotherapist from Goa, highlights that hormonal imbalance can cause outbursts. “Menopause (in women) and andropause (in men) tend to reduce the estrogen and testosterone levels significantly, thus contributing to the rapid mood swings,” she explains.

  • Psychological reasons: Dr Tilwe mentions how the elderly population often experience difficulties in their living conditions. “Coping with retirement or empty nest syndrome has depressive features and can eventually trigger outbursts,” he says, talking about anger management.

Mathew adds that besides death of a spouse or neglect, sometimes it could even be a lifelong struggle for them to cope up with their anger.

  • Social reasons: Dr Tilwe explains that with ageing, the social responsibility of the elderly changes according to the social situations. “For instance, if their elder son asserts himself, he/she tends to react in a problematic manner,” he says.

Mathew adds, “Disruption in their daily routine or the fact that they have to constantly rely on someone do to tasks that they were capable of doing earlier, fuels the frustration.”

Managing anger in the elderly

The rage of senior citizens is often first experienced by their caregivers and kin. Experts suggest the following steps that can help them deal with the exasperation of the elderly:

  • Being gentle and patient: Despite it being a taxing experience to handle their anger, families must remain patient with senior citizens through the outbursts. “Caretakers must understand that the brash reactions stem from a place of insecurity, without losing their own temper. Hence, they must make an effort to identify their triggers,” Dr Tilwe says.
  • Lending an ear to their concerns: Experts suggest families listen to their issues instead of counter-reacting to their fit. “Don’t communicate with them in a patronising tone as it will only flare up their temper,” says Mathew. “Speak to them how you would speak to a child. They are in need of companionship.”
  • Anger management therapy: The elderly like routine and don’t accept change easily. Although making them attend therapy can be a challenging task for the caregiver, it can help them deal with their anger. “Ensure the therapy sessions are as non-clinical as possible,” Mathew advises. “Tell them someone is coming home so they can speak with them about their concerns.”

Can anger outbursts be reversed?

The outbursts of the elderly can be toned down to some extent. However, Dr Tilwe explains that reversibility depends on the cause and the response to the medication. “Preparedness and cooperation for therapy also play a huge role in reducing the anger to a certain degree,” he says.

Takeaways

  • Extreme anger experienced by elderly people can be due to biological, psychological or social concerns.
  • Caregivers and families must ensure patience and a non-patronising approach while dealing with their loved one’s outbursts and addressing their concerns.
  • Anger management therapy can help the elderly to control their anger. However, experts suggest that the approach must be as non-clinical as possible.

Share Your Experience/Comments

One Response

  1. Tuning self from 50’s …like giving commands to self to accept ageing, switching over from being the head to sharing responsibilities to the successor, instructing spouse and children to take brave steps like controlling self when going insane would help ‘self” . For people taking care of the ‘old babies”……
    giving a briefing to visiting guests about the hormonal imbalance of the unwell person, withdrawing their cash and bank transactions from the patients, monitoring their new association would prevent embarrassment

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