When Dementia Care Becomes Scary:

A Safety & Boundaries Plan for Caregivers

By Ellen Samson – Dementia Speaker

Have you ever been so afraid of your next duty that your hands start shaking?

Many caregivers will never say it out loud, but dementia care can become emotionally and physically dangerous.

This post is for the caregivers who are silently breaking inside yet still show up to love and serve.

💙 Your safety matters too.

---

SAFETY & BOUNDARIES PLAN

For Caregivers Handling Aggression in Dementia

---

1. Remember: It’s the disease, not the person

When a patient shouts, curses, or becomes physically aggressive, remind yourself:

“This is not about me — it’s his brain losing control.”

This mindset helps you detach emotionally and respond with calm.

You are not their enemy. You are their safety anchor in a storm they cannot understand.

---

2. Stay physically safe

Your safety comes first at all times.

If the patient:

Raises a hand or object:

Step back immediately. Keep a chair or small object between you and them.

Gets verbally abusive:

Do not argue. Quietly step away and wait until they settle.

Tries to hit, grab, or spit:

Exit the room. Take a breath. Re-enter only when safe.

Additional reminders:

• Keep exits clear.

• Avoid dangling accessories that can be grabbed.

• Never restrain unless trained and medically authorized.

---

3. Use a calm, confident tone

Avoid loud commands like “Stop!” or “Huwag!” — these can heighten aggression.

Instead, lower your voice and try:

“Okay po, I’ll wait for you.”

“Safe po tayo. Okay lang.”

Soft voice = safety signal.

Tone matters more than words.

---

4. Document every aggressive episode

Record:

• Date and time

• What triggered it (bath, food, medication, visitors)

• What the patient said or did

• What helped calm them

• Duration of the episode

Share this with the family or attending physician.

Aggression may indicate pain, infection, or medication side effects.

---

5. Coordinate with the family and doctor

Communicate updates not to blame, but to inform.

Suggested phrasing:

“Lately po, he’s been refusing food and shouting. Maybe we can ask the doctor to review his meds or comfort level.”

If aggression becomes dangerous, request a medical review.

Behavioral changes often require medication adjustments.

---

6. Emotional reset after every episode

After an aggressive moment, do a quick 3-minute reset:

• Inhale through the nose (4 counts)

• Hold (4 counts)

• Exhale slowly (6 counts)

• Repeat three times

• Say quietly:

  “It’s not me. It’s the illness. I’m safe now.”

This reduces adrenaline and prevents emotional trauma buildup.

---

7. Build your safety circle

You cannot heal alone.

Have at least one person — coworker, friend, or group — who understands dementia care.

Join a caregiver support group (even online).

You need a safe space to say “Pagod na ako” and be heard.

---

8. Red flags: Seek help if you experience any of these

• Shaking before every shift

• Dreading work

• Nightmares or panic related to caregiving

• Feeling worthless

• Thoughts of self-harm or hopelessness

These are not signs of weakness.

They are signs of trauma that deserve attention.

If you’re in the Philippines:

NCMH Crisis Hotline – 1553 (landline)

Smart: 0908 639 2672

Globe: 0966 351 4518

---

9. End your day with self-compassion

Tell yourself:

“I did my best with what I knew today. Tomorrow, I’ll learn more.”

Caregiving is not about perfection.

It is about presence.

You can only give love if your own cup is not empty.

---

Sana makatulong ito, Dovie.

You are not alone.

Your safety matters just as much as your compassion.

---