Caring for a “challenging” parent can be one of the hardest things you’ll ever do. I know — I went through a year of hell before I figured it out.

I had been the light of my father’s life — but with the onset of dementia he turned on me, doing and saying things that I would have never believed he could do. It was the very beginning of dementia making his actions intermittently illogical and irrational. Having no experience with dementia, I just didn’t get it. His behaviorial changes should have sent up a big flag.

The intermittent lapses are generally ignored by families. In fact families statistically wait four years before they reach out for help — usually after a crisis. In the beginning a raging temper tantrum can suddenly turn into sweetness. There are usually long periods of normalcy between rages and the tendency is to want to forget about the irrational incident instead of seeking help.

Stage One dementia in Alzheimer’s patients typically lasts two to four years. By the time they enter Stage Two they need full time care. The latest Alzheimer’s drugs can delay the progression of Alzheimer’s and are most effective when administered as early in Stage One as possible. By waiting four years to seek professional help and a diagnosis means it may be too late to slow the progress of the disease, and the time for full time care has arrived.

When a loved one needs full-time care, it may mean hiring a full time professional caregiver – family members are entitled to time off and time to themselves. Adult Day Care coupled with all-night supervision can work for some families. A professionally run Alzheimer’s Day Care setting provides social, physical and intellectual stimulation during the day for the patient, and time to have a life for the family. During the night a caregiver can monitor night-time behavior. For some families finding an Alzheimer’s community is the better answer.

Success in a continuous home environment past stage one requires applying tough love techniques and medications administered by a physician specializing in Alzheimer’s. Depression, anxiety and agression may be treated chemically to make for more tolerable behavior.

Once the brain chemistry is properly balanced for the dementia, possible depression and perhaps even aggression, behavior modification techniques can be used on a challenging elder.

As amazing as it sounds, the use of tough love coupled with rewards and consequences worked to turn around the most obstinate man on the planet: my father. By being 100 percent consistent, never rewarding bad behavior and using praise to encourage good behavior, he did modify his behavior patterns to “catch more flies Color with honey than vinegar.

Jacqueline Marcell


  • Jacqueline Marcell is an international speaker on Eldercare and Alzheimer’s, host of the COPING WITH CAREGIVING radio show, and author of the bestselling book, ELDER RAGE, a Book-of-the-Month Club selection receiving 50 endorsements, 300+ five-star Amazon reviews, is required reading at numerous universities for courses in geriatrics, and being considered for a film.