A diagnosis of Alzheimer’s disease or another type of dementia brings a variety of challenges, with most of those challenges coming and going throughout the disease process. As a family caregiver, it can be difficult to adjust and adapt to new behaviors or changes that come along with cognitive decline. Perhaps the most burdensome part of dementia caregiving is coping with the personality changes, which can include aggression and anger. Here’s what you need to know about aggressive dementia behavior, as well as how to approach it in the short and long term as you care for a loved one with dementia.
Why does aggressive dementia behavior happen?
Dementia, including Alzheimer’s disease, does not affect every person in the same way. However, some common symptoms occur during certain stages of the disease, which can make it a bit easier for a caregiver to forecast what might be coming next. Aggression typically occurs in the middle stage of the disease, though it can occur earlier on as well.
During the middle stage of dementia, communication becomes significantly impaired. The person living with the disease might struggle to define and state what they want or need. They might also find it difficult to understand complex instructions or participate in conversations around them. Their environment might also contribute to their communication difficulties, as loud noises or bright lights can feel overstimulating and leave little room for listening or talking.
In many cases, aggression is a way to communicate. Family caregivers can choose to look at aggressive dementia behaviors and episodes as a way their loved one is trying to tell them something. Many professional senior living caregivers who work in memory care communities are experts at this tactic, choosing to investigate what happened before the behavior began so they can find out what it might mean.
Short-term solutions for aggressive dementia behavior
When your loved one is being aggressive, whether that involves shouting at you, throwing items, or even trying to shove you away, you don’t have time to complete a full investigation of why the behavior happened. Instead, you need to ensure your loved one is safe and restore peace as quickly as possible.
Speak softly and calmly
Your first tool in your aggression toolkit is your voice. If your loved one is escalating or already in an aggressive episode, adjust your voice so that you are speaking in a calm tone. If possible, speak a little softer than usual, as long as the person can still hear you. You can also adjust your words to ensure you are speaking in short, clear sentences.
Take a step back
If your loved one is safe, take a step back during an aggressive episode. This can immediately lighten the tension and give your loved one some space.
Quiet the environment
An overstimulating environment can make aggression more prevalent and make it more difficult to calm down. Do a quick scan of your loved one’s environment. Can you turn down the television? Can you move them to a quieter location? Can you dim the lights? These small steps can go a long way in creating a calm environment that can help to de-escalate the situation.
Listen
If your loved one is speaking (or yelling) during the aggressive episode, stop talking and listen to them. Their words or body language might give you clues to what is bothering them. Pay attention to what they are saying verbally and with their body.
Try a distraction
Leading your loved one to another activity to focus on can sometimes help them calm down. Just be sure the activity is something easy and that burns off some restless energy, such as walking around the house, dusting the counters, or even clapping along to a favorite song.
In all cases, ensure your loved one is safe before implementing any potential solutions.
Long-term interventions for aggressive dementia behavior
Now that the aggressive behavior has passed, you can take some time to investigate potential causes. Common things that can cause aggression in people living with dementia include:
- Pain.
- Feeling too hot or too cold.
- Feeling hungry or thirsty.
- Overstimulating environment.
- Confusion.
- Anxiety.
- Inability to communicate their needs.
- Feeling grouchy for no reason (which happens to all of us).
If you’re able to identify what might be happening to cause aggressive behavior, you can work on implementing interventions that could lessen the episodes.
Stay on top of pain medication
About 50% to 80% of people living with dementia experience some type of pain daily. However, they are often not able to communicate their pain, which leads to undertreatment. Work with your loved one’s physician to get a pain management plan in place that might include regular ibuprofen throughout the day. You can also look for other signs of pain, such as if they tap a certain body part repeatedly, limp, or favor one side of the body.
Plan their day
Many people living with dementia experience increased restlessness or anxiety in the late afternoon or evening. This is sometimes referred to as sundowning, and it can create the perfect environment for aggressive dementia behavior. However, you can choose to create a more calming environment in the home beginning in the late afternoon, keeping all activities outside the home or events that are loud and complex to the morning hours. You might also choose to help out with personal care tasks such as showers prior to the afternoon or evening.
Set the stage
Creating a calm and comfortable environment is especially important to combat aggression. Try using lavender essential oil for relaxation and playing their favorite music from the past. Keep a routine so they know what comes next, even if they are feeling extra anxious.
Keep their hands and feet busy
Your loved one’s aggressive behavior may be because they are bored. Try keeping them busy with tasks around the home like helping you fold the laundry or make a meal or snack, taking a walk around the neighborhood, arranging some flowers in a vase, or looking through photographs.
Consider senior living
Some senior living communities offer specialized neighborhoods designed specifically for people with dementia. Memory care units are created to provide safe, comfortable environments that combat the challenges of cognitive decline. They operate with specially trained staff, familiar daily routines, and plenty of shared and safe spaces.
The majority of people living with dementia end up needing some type of senior living support in order to be safe and healthy. You can begin touring communities and learning more about them as soon as your loved one receives their diagnosis. Planning ahead can help you make the best decision for your situation.
