Understanding Caregiver Resentment & Anger

This page is for caregivers who feel angry at the person with cancer they look after. It covers why it happens, what may be medical, where the line is, and how to lighten the load.

NCI says giving care can be a challenge. Many caregivers put their own needs and feelings aside to focus on the person with cancer. That is hard to keep up for long, and the stress can affect both body and mind. NCI also says it is very common to feel confused and stressed.

Anger can be part of that strain. Saying it out loud can feel monstrous next to someone who is seriously ill. You can care deeply about a person and still be worn down by the work.

NCI adds that unspoken needs can build into resentment. Telling people how you feel, and what you need, can help.

Common triggers include:

• Refusing food, medicine, physical therapy or the thing the team asked for.
• Refusing outside help, so the load stays entirely on one person.
• Continuing to smoke or drink.
• Directing their own fear and anger at the nearest person, who is you.
• Never saying thank you, or saying it in a way that lands as a complaint.
• The same question, forty times.
• Siblings who visit twice a year and have opinions.
• Being treated as staff by someone who used to treat you as an equal.
• The person who was difficult before the diagnosis being difficult still.

NCI says caregivers who do not look after themselves cannot keep caring for others. Its tips include enough rest, at least 15 to 30 minutes a day for something you enjoy, and asking for help. It says to talk with your doctor if lack of sleep becomes an ongoing problem.

NCI also says to watch for signs of depression or anxiety. If changes last more than two weeks, talk to your doctor.

If you treat the anger as a character flaw, the real problem goes unaddressed. Often that problem is too little sleep, too little relief and too little help.

Before you conclude that someone has become deliberately cruel, ask whether something is causing it.

NCI describes delirium as a confused mental state. It changes awareness, thinking, judgment, sleep and behavior. It usually starts suddenly, within hours or days, and it may come and go. A person may be restless, anxious, or suddenly agitated and uncooperative. Many episodes are caused by medicines or dehydration and can be reversed.

NCI lists several causes of delirium. They include advanced cancer, older age, brain tumors, dehydration, infection, high doses of opioids, and stopping certain medicines.

None of this makes the behavior easier to live with. But it changes what you do about it. Report sudden changes to the care team. Do not argue about them.

If you feel your temper rising, step out of the room, but only if the person will be safe on their own. Later, talk to someone who will listen, such as a friend or a support group. NCI notes that support groups can help you feel you are not alone. If the person is confused, arguing about facts is unlikely to help.

Feeling anger is not the same as acting on it. Some actions are never acceptable, however tired or provoked you are. MedlinePlus describes elder abuse as mistreatment of an older person, usually by a caregiver. It includes:

• physical or emotional abuse
• neglect or abandonment
• stealing money or belongings

MedlinePlus says elder abuse will not stop on its own, and someone needs to step in. If an older person is in urgent danger, call 911. Otherwise, contact adult protective services. These are state programs that help protect vulnerable adults.

If you are frightened of what you might do, say so plainly to the oncology team or hospice nurse. Ask for help right away.

Anger can ease when the hours fall. Under the Medicare hospice benefit, inpatient respite care is covered on an occasional basis for no more than five days in a row. You may pay 5 percent of the Medicare-approved amount. Home health aides, adult day programs and paid overnight help may also be options. Ask the oncology social worker what help is available. NCI's Contact Center is at 1-800-4-CANCER. The Eldercare Locator, on 1-800-677-1116, lists services for older adults.

• Call 911 or go to an emergency department if you are close to hurting the person you care for and you cannot get out of the room safely.
• Call or text 988 now if you are thinking about ending your life or hurting yourself (MedlinePlus lists 988 for this). If you have already acted on those thoughts, or you have a plan and the means at hand, call 911 instead.
• Call 911 or go to an emergency department if the person turns confused, suspicious or agitated suddenly, over a few hours. MedlinePlus lists confusion that comes on suddenly as a reason to call 911 (MedlinePlus). Do not drive yourself.
• Call your care team right away, at any hour, if the same change builds over a day or two. That pattern can be delirium. NCI says many episodes are caused by medicines or dehydration and can be reversed. If the person is getting chemotherapy, call right away even with no fever. NCI lists infection as a cause of delirium. If the person is in hospice, call the hospice team.
• Call your care team right away if the change began after a medicine was started or changed, or if pain looks poorly controlled. NCI says medicines can cause delirium and that reducing or stopping them may help. Do not stop a medicine on your own.

• NCI - Support for Caregivers of Cancer Patients
• NCI - Delirium and Cancer Treatment (PDQ)
• MedlinePlus - Elder Abuse
• MedlinePlus - Confusion
• MedlinePlus - Suicide
• Medicare - Hospice Care Coverage (inpatient respite)
• eCFR - 42 CFR 418.204 Special coverage requirements (respite care)
• Eldercare Locator (Administration for Community Living)