"Sometimes she gets so angry. She never used to be that way - she was a gentle person. Now you never know what will set her off."

* Remove the person from the stressful situation or place. Simplify the environment by reducing extra clutter, people, noise, activity.

* Keep tabs on when the catastrophic reactions occurs. Is there a pattern (e.g., time of day, type of activity, specific person) that can be identified and altered?

* Distract the person with a calming or pleasurable activity. Try soft music, a walk outside, a favorite snack.

* Try to establish and stick to a regular daily routine that includes more stressful activities when the person is better rested. (e.g. Plan baths for morning if person tends to be tired and irritable at night .

* Encourage daily exercise to reduce excess stress and energy.

* Do not try to reason with the person. The impaired person's ability to reason logically is impaired - you may only make things worse. If you feel threatened, remove sharp or dangerous objects from the area and stay out of reach.

* Try to calm them with slow movements or gentle touches. Approach the person from the front and use a soothing, reassuring voice.

* Limit choices and state directions clearly. Offer activities that the person is able to do and watch for frustration levels.