This study tested whether communication neglect (CN) mediated the relationship between caregivers’ reports of care receivers’ cognitive status and/or problem behavior and thoughts about potential harmful behaviors (PHB) toward their care receiver. It also examined if caregivers’ expressed anger and a positive pre-morbid relational history moderated the prediction of CN on PHB. Family caregivers (N = 339) in the U.S. completed the survey via Qualtrics. Results suggested that CN is a meaningful mediator explaining how PHB might occur. Caregiver expressed anger moderated the prediction of CN on PHB/physical abuse. Lastly, caregivers’ perceptions of a positive pre-morbid relational history were a potential protective factor against PHB. When caregiver expressed anger was moderate or high, the prediction of CN on PHB/physical abuse was positive, but its strength was reduced as pre-morbid relational history became stronger.