If you feel like you are always on edge, waiting for the next outburst, refusal, or argument, you are not imagining it. Many family caregivers live in a constant state of alert. You are tired, but your body never fully settles because you do not know what the next interaction will bring.
Aggression, repeated questions, and refusing care wear you down over time. You may find yourself explaining things again and again, correcting what is being said, or trying to reason your way through the moment. Not because you are doing it wrong. Because you are trying to keep things from spiraling.
When those strategies stop working, it can feel personal. Like you are failing. Like you should be able to handle this better.
What is actually happening is an emotional regulation problem in the brain.
That phrase can sound clinical, so let me say it another way. Emotional regulation is the brain’s ability to notice big feelings, tolerate them, and then settle back down. Dementia changes how well the brain can do this. Emotions can come on fast, feel overwhelming, and linger longer than they used to. Once that happens, reasoning and logic are no longer accessible in the same way.
This is not a communication problem. And it is not a lack of patience on your part.
It is a brain that is struggling to regulate emotion. And understanding that can shift how you respond. Not to fix every hard moment. But to stop carrying blame that does not belong to you.
What Emotional Regulation Means in Everyday Life
Emotional regulation is the brain’s ability to manage stress, frustration, fear, and discomfort without becoming overwhelmed. It allows us to pause and respond instead of reacting.
In dementia, this ability changes. The brain has a harder time filtering what feels important. Small frustrations can feel big. Simple requests can feel threatening. Once emotions surge, the brain struggles to settle.
This is why reactions can seem sudden or out of proportion. It is not a choice. The brain is reaching its limit more quickly than it used to.
When emotional regulation is compromised, logic and reasoning are often unavailable. Even familiar explanations can feel confusing or intrusive. The brain is focused on getting through the moment, not understanding details.
This helps explain why calm explanations sometimes make things worse instead of better. The words are not wrong. The brain simply cannot process them when it is dysregulated.
Why Explaining and Correcting Backfires
Most caregivers explain and correct because they are trying to help. You are trying to keep things calm, safe, and on track. You are trying to make the situation make sense.
When someone is emotionally regulated, explaining can work. Reasoning, reminders, and reassurance rely on parts of the brain that can process language and logic.
When someone is emotionally dysregulated, those parts of the brain are not fully available.
In those moments, more words can feel overwhelming. Corrections can feel threatening. Even gentle explanations can increase stress instead of easing it. The brain is already overloaded, and additional information adds pressure rather than clarity.
This is often when behavior escalates. Repeating increases. Refusals become firmer. Aggression can surface. Not because you said the wrong thing, but because the brain cannot handle what is being asked of it.
This is where many caregivers start to doubt themselves. You may think you need to explain better, stay calmer, or try harder. In reality, the strategy itself is mismatched to what the brain can do in that moment.
You are not failing at communication. You are encountering a limit in emotional regulation.
Understanding this gives you permission to stop correcting and start supporting the nervous system instead. Fewer words. Less demand. More space for the emotion to settle before anything else is asked.
Aggression, Repetition, and Refusal Are Signals
When emotional regulation breaks down, behavior becomes the language.
Aggression, repeating questions, and refusing care are not random. They are signals that the brain is overwhelmed and trying to protect itself. These responses often show up when the brain feels unsafe, confused, or overwhelmed.
Aggression can show up when the brain feels cornered or rushed. It is a fight response, not a personal attack. Even when it feels targeted, it is usually rooted in fear, frustration, or loss of control.
Repetition often appears when the brain cannot hold onto reassurance. The question is asked again because the feeling underneath it has not settled. The words fade, but the emotion remains.
Refusing care is often about control. When emotions run high, saying no may be the only way the brain knows how to create space or regain a sense of safety.
None of this means the behavior is easy to live with. It can be exhausting. It can feel scary. It can wear you down over time. Understanding the signal does not erase the impact.
What it does change is how you interpret the moment. Instead of asking, “Why are they doing this to me?” you can begin to ask, “What might their brain be reacting to right now?”
That shift matters. It moves the focus away from blame and toward support. Not to excuse the behavior, but to understand what the brain is struggling to manage.
Once you start seeing these behaviors as signals of dysregulation, the goal changes. The first goal is no longer compliance or correction. It becomes helping the brain settle enough to move forward.
What Helps When Emotions Are Running High
When emotions are running high, the goal is not to fix the feeling or move things along quickly. The goal is to help the brain feel safe enough to settle.
That starts with less language. When the brain is overwhelmed, more words can add pressure. Short phrases or quiet presence often help more than explanations.
Slowing the pace also matters. Moving too fast, even with good intentions, can increase stress. Pausing, softening your movements, and giving a little more time can help reduce that sense of urgency the brain is reacting to.
Predictability can be grounding. Familiar routines, familiar voices, and familiar steps give the brain fewer things to process. When emotions are high, novelty often makes things harder, not easier.
Reducing demand in the moment is another form of support. If care can wait, letting it wait can help the brain reset. If a task feels like too much, breaking it into smaller steps or stepping away altogether may prevent escalation.
Your calm presence matters, but it is not a guarantee. Being calm does not mean the emotion will disappear. It means you are not adding to the overload. That is not failure. That is support.
Sometimes the most regulating thing you can offer is space, quiet, and time. Not to give up. But to allow the nervous system to come back online before asking more of it.
What This Means for You as a Caregiver
If emotional regulation is the issue, then your job is not to explain harder or stay endlessly patient. Your job shifts from correcting behavior to supporting a brain that is struggling to cope.
This means you can stop trying to talk someone out of big emotions. You can stop correcting every misunderstanding. You can stop believing that a calm explanation should always work.
It also means you are allowed to step back when things escalate. Pausing is not giving up. It is responding to what the brain can handle in that moment.
Some days, nothing you do will prevent dysregulation. That is not because you missed something or handled it wrong. It is because the brain is having a harder day.
This work is heavy. Being on edge all the time takes a toll. If you feel tired, frustrated, or worn down, that does not mean you are doing this wrong. It means you are human.
Understanding emotional regulation does not make caregiving easy. But it can make it steadier. It can help you respond with less self-blame and more compassion for yourself and the person you care for.
Bringing It Back to Function
Emotional regulation does not exist on its own. It is shaped by what the brain is taking in through the senses, how the body feels, and how much the brain is being asked to process.
Pain, fatigue, noise, hunger, unfamiliar spaces, rushed care, and too many demands all place extra strain on emotional regulation. When those pieces stack up, emotions are often the first place things fall apart.
That is why behavior makes more sense when you look at function instead of intention. The brain is not trying to be difficult. It is trying to cope with a system that is under stress.
If you take nothing else from this, take this with you. When emotions run high, the goal is not to reason or correct. The goal is to help the brain feel safe enough to settle.
In the next post, we will look at the physical component of function and how changes in the body can quietly drive emotional reactions and resistance to care. It is another piece caregivers are rarely taught to notice, but once you see it, it changes how you respond.
You are not doing this wrong. You are supporting a brain that is changing. And learning to look at function gives you a steadier way forward, one grounded moment at a time.
Stay Connected
If this post put words to something you have been feeling, you are not alone. I share reflections like this in my weekly email newsletter, where I help caregivers make sense of hard moments without blame or overwhelm. It is a quiet place to learn, reflect, and feel a little less alone. You can join here. Click here to receive weekly newsletter
Notes
- Dicker, E., Jones, J. S., & Kunik, M. (2025). Emotion regulation strategies to improve outcomes in family caregivers of people with Alzheimer’s disease and related dementias: A systematic review. Journal of Health Psychology, 30(14), 4564–4580. https://doi.org/10.1177/13591053251354882
- Hua, A. Y., et al. (2021). Emotional and cognitive empathy in caregivers of persons with dementia. Frontiers in Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240761/
- Perach, R. (2020). Emotion regulation and decision-making in persons with dementia: A scoping review. https://pmc.ncbi.nlm.nih.gov/articles/PMC8216314/
- Panzeri, A. (2024). Emotional regulation, coping strategies, and resilience in informal caregivers. Behavioral Sciences. https://www.mdpi.com/2076-328X/14/8/709
- Brandão, T. (2024). Emotion regulation in dementia caregiving: Individual differences in caregiver responses. Journal of Geriatric Psychiatry. https://journals.sagepub.com/doi/abs/10.1177/08919887231195228
- Sola, C. (2025). Understanding basic and social emotions in Alzheimer’s disease and related dementias. Frontiers in Psychology. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2025.1535722/full
- Supportive Organization Resource
- Alzheimer’s Society. (n.d.). The psychological and emotional impact of dementia. Alzheimer’s Society. https://www.alzheimers.org.uk/get-support/help-dementia-care/understanding-supporting-person-dementia-psychological-emotional-impact
Disclaimer
The information provided in this blog is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual’s needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
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