When a senior with dementia begins to rant at you, is it better to "let them vent" or redirect them?

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lyhinwpg Asked March 14, 2024

When a senior with dementia begins to rant at you, is it better to "let them vent" or redirect them?

My dad is 99 and loves to talk. He has been in a nursing home since November 2023. His aging brain shows typical signs of dementia (rambling thoughts which don't always make sense to us) though he is still aware and able to have a conversation (kind of). Since leaving his assisted living home, he has been furious with his 3 daughters for moving him there, but forgets that we involved him in the decision at every step. He angrily goes over and over the same story of what he feels is betrayal. He doesn't realize how much care he needs.

My question relates to how best to respond to him. I feel it's better when I visit to let him vent a bit, but then take him to activities, sing with him rather than letting him continue to rant. I also realize my limits in taking his rants. My sister (who is power of attorney) thinks he needs to "vent" (he is verbally abusive), but I worry she will burn out (plus I don't know if that helps him). Any advice from those with experience is appreciated. Our mom passed in 2015 but her death was sudden and so this is my first time going through this.

Alzheimer's & Dementia Communication & Language Dementia Behaviors

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score 1 · Answer 1

When you visit your father and he’s venting about being in the nursing home, just try your best to tune him out and just let him continue to vent without saying anything in return to him. Once his venting becomes abusive to you, it’s time for you to get up and leave.

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score 2 · Answer 2

Letting him vent is one thing.
Him being abusive is another.
You can't "remind" him that he was involved in the decision because he probably doesn't.
You can say:
"Dad, I'm sorry you feel that way. Why don't we go see if there is any ice cream (or whatever he likes) Or let's go for a walk outside"
"Dad, I don't like it when you yell at me like that. If you keep yelling I will leave." And do just that if he keeps yelling or being abusive leave. Before you go give him a hug and tell him you will see him soon. If he calms down when he sees you leaving stay a bit longer.

If your sister thinks letting him vent while she is there let her stay. That is her decision.
I don't think venting helps or hurts him. Just like a child that has a temper tantrum it is a way to express himself.
"Filters" that allow us to keep emotions under control get lost with dementia so it is not something that he has full control of.

If this increases or he becomes more abusive talk to his doctor about medications to help with the anger and anxiety.

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score 2 · Answer 3

Make visits as frequent as you like and leave when the ranting begins. It is a sort of Pavlovian training method that likely won't work whatsoever, but it will get you out of the place. He is very likely unaware of how long and how often he goes on as well as of how long and how often you visit. He is luckily in care. When your visits bring him more distress than happiness it is time to spare both of you.

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score 3 · Answer 4

Dementia robs people of their memory, reason and logic and they therefore cannot bring themselves to a mental/emotional place of acceptance or peace so they need help doing this: whether it is through redirection/distraction or meds or both.

When my 100-yr old Aunt with severe dementia would start ranting at me I'd tap her on the chest with my finger then wait for her mind to disconnect from her rant and look down. I kept my finger there, and naturally she would eventually look up at my face wondering what was going on. Then I'd take that opportunity to change the topic or activity.

I think your strategy of taking him to an activity is a solid one. Maybe don't wait for him to rant before doing it. My hubs is the champ of showing my Mom YouTube or Tiktok funny animal videos or (her favorite) people falling down. I think it's "easier" to distract them with something visual, so have it ready to deploy when you get there.

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Great strategy— tapping

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score 1 · Answer 5

Try different ways, which ever way stops them sooner . Ignoring might stop the ranting, walking away, laughing. Which ever works

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score 1 · Answer 6

Laugh

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When my Husband would get something in his head that he wanted or wanted to do and I would try to redirect him. Once He was being VERY determined to do what he wanted and I just burst out laughing because the whole thing seemed radicicolous and he stopped, looked at me and he started to laugh and we were both laughing and I was able to get him to go sit down. After that I often used laughter as a way to diffuse a situation.
GREAT strategy

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score 0 · Answer 7

A lot of times you can disarm them by agreeing with them and then doing nothing and or leaving right after you agree. If you can mentally disconnect, it’s no sweat to agree with them.

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Like “you betrayed me!” And you reply “oh yes we sure did. That is awful and I see you hate it.”

“You abandoned me in this place,” “oh yes, that we did.”

It would be interesting to see how he would react to that. Like, you know, there is nothing he can say or do that will change where he is or how he got there so why dwell on it? You do have to be secure in yourself and feeling no guilt that he is where he needs to be.

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score 3 · Answer 8

He's 99. There's not really a manual for the care and feeding of someone so old.

When my mom would get 'snarky', I would simply give her a hug and go home.

My MIL spent the last month of her life screaming at everyone in her sight. The only thing they could do was to keep her as sedated as possible. She wasn't making any sense and was unable to do anything but rage at everyone.

Lots of benzos probably saved the family's sanity. You couldn't mis-direct her or ask her to please speak kindly--whatever. Her language at the EOL was what DH basically referred to as "word salad'. Just words--not connected to each other. That may be happening to your dad.

I would personally think that the venting is not good for him. A little, a small complaint, but not to point they are just raging.

Is he on medication for this?

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True, his rages are just adding negative juicy brain chemicals into his body

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score 0 · Answer 9

Redirect if at all possible! If not, listen briefly and leave.

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score 5 · Answer 10

I'd listen to my mother's rants for a very short time before leaving her presence at the Memory Care Assisted Living facility she resided at. I'd try to divert her, which didn't always work....my husband had better luck with her on that than I did. Seems to me these elders respond better to "outsiders" than to their children who they feel angry at for everything. Mom blamed me for everything wrong in her life, as if I was responsible for her old age and infirmity. Ativan did help her agitation some, so ask dad's doctor about it.

I'm with Barb....agitation is good for nobody ever. The goal with demented elders is to keep them calm at all times, not ranting!

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Good idea to check into Ativan. I think you're right that he responds better to outsiders and health care aides than he does to us.

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score 5 · Answer 11

Is your dad on any meds for agitation and/or depression?

I don't believe that agitation is good for anyone. I would speak to the Psych staff at the NH.

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He has taken Citalopram for years for anxiety/depression. I like your suggestion to talk to the Psych staff at the care home. I suggested to my sister that maybe it's time to revisit his prescription, so we'll see. Thank you.

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When a senior with dementia begins to rant at you, is it better to "let them vent" or redirect them?

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