When caring for an individual with dementia, they can sometimes exhibit angry and aggressive behavior that may catch you off guard. These incidents can be incredibly distressing for a caregiver, family, and friends— especially if you don’t know how to react to the situation. Understanding why this type of behavior might occur, how you can respond, and preventing future incidents, is the first step to making your loved one comfortable.
Caring for Angry and Aggressive Dementia Patients at Home
An individual’s personality prior to developing dementia may have no effect on how they are currently acting, and this can be an emotionally difficult process for a caregiver. Someone with an even temper and sweet nature, might now act angry and irritated all the time. Unfortunately, aggression is relatively normal in people with dementia, and more than 1/3 of people living with dementia have acted aggressively toward their caregivers (particularly during the final stages of Alzheimers).
This angry and aggressive behavior can be distressing for everyone involved in the situation (including the individual with dementia). There are a few physical and verbal cues that a caregiver or family member should look out for to determine if a loved one is exhibiting aggressive mannerisms:
- Verbal Aggression: Making threats, screaming, shouting, swearing, and even noises like hissing
- Physical: Biting, pinching, scratching , kicking, hair-pulling, and any physical behavior in an attempt to cause an altercation
Many caregivers have the tendency to internalize this type of aggression, and blame themselves. Although aggressive behavior can be rather obvious, understanding why this behavior might occur can help with to cope with the condition and react accordingly.
Why are They Acting This Way?
This might be a question a caregiver will ask themselves a thousand times, and the answer is difficult. For a person with dementia, a variety of factors can contribute to the increase in aggressive behavior. Although people with dementia may be ill, this hasn’t changed their needs, only the way in which they express them.
A loved one may be lashing out aggressively, but it could be because they have a deeper need for social engagement, comfort, to be free from pain, and to have sound emotional well-being. Acting-out might be an attempt for the individual to meet their needs, communicate them, or the outcome of them not being met. Understanding what may be causing this behavior, can help a family member or caregiver find a solution and proactively meet the needs of a person with dementia.
There are three aspects of an individual’s environment that may lead to aggressive and angry behavior. This can include social, psychological, and biological triggers.
A person with dementia may be acting out due to causes in their social environment including:
- Hiding their condition. In the early stages, people may be keeping their condition quiet, and anger can be a common reaction to questions
- Lack of social engagement. A person may become aggressive if they are lonely or bored
- Change in routine. If someone is used to living their life in a particular order, changes in this pattern can be upsetting (even to people without dementia)
Dementia causes an incredible amount of psychological damage to a human being. In addition to being a progressive biological condition, the emotional impact it can have on a person, their family, and friends, can be devastating. Caregivers often have to shoulder many of these emotions, and it is important to understand some of the psychological triggers of the aggressive behavior. Some of these include:
- Depression or other mental illness. A person can develop depression upon being diagnosed with the condition, or it may exacerbate a pre-existing condition
- Memory loss that creates confusion. People may feel their rights are being infringed upon, or they may be experiencing misperceptions and confusion due to the disorder
- Unfamiliar environments. If an individual is relocated to an unfamiliar environment, they may feel threatened, and act out aggressively. They may feel they are in the wrong place, or that strangers have entered their home
- Inability to complete simple tasks. Dementia often leaves people incapacitated, and unable to complete simple tasks they once could. This can cause extreme irritation and anger in an individual
- Dementia is ultimately a biological disease, and there are many factors from a physiological standpoint that can contribute to a person’s aggressive behavior. Some of these include:
- Pain or physical discomfort. People with dementia may respond in an aggressive manner if they are in a state of pain or have become uncomfortable (like being thirsty or sitting too long)
- Dementia affects judgment. The physical effects of the disease can impair an individual’s judgment, and they may misperceive being slighted
- Side-effects from medication. Many of the medications that people with dementia take, can have brutal side-effects. Some may cause people to become drowsy and irritable. This makes them defenseless when attempting to find solutions to meet their needs, and they often lash out in anger
- Poor Eyesight/Hearing. Problems with vision or hearing can lead to misperceptions and misunderstandings, that may upset the individual with dementia
Tips for Reacting to an Incident
How you react to an outburst of aggression, can greatly affect an individual’s behavior. The following are some tips on how to handle a person, when they are experiencing difficult emotions. Steps to take include:
- Breathe. Understand that caregivers may also react with aggression unexpectedly, so take the time to breathe. It may be a good idea to leave the room for a moment, and give everyone space.
- Avoid any confrontation. It is incredibly important that everyone stays calm in the situation, as this will keep the loved one at ease.
- Adapt to their needs. Practice compassion and understand that from their perspective, reason and logic may not be useful. An argument with a person with dementia is unlikely to result in insight or change on their behalf.
- Do not shout or become physical. Although the initial response to violent behavior is to fight back, this will do no good in these situations. Remain calm and immediately leave the vicinity if the person becomes physically violent.
- Listen to them. It shows solidarity, and allows the person to vent. Simply listening and telling the person you understand and want to help, will comfort them.
Tips for After the Incident
Once an incident has occurred, there are certain steps you can take for handling an upset individual. The following are a few key tips for how to deal with a situation once it has already occurred.
- An individual with dementia may still be incredibly upset after the incident has occurred. Focus on them, and not their behavior. It will help them concentrate on more positive emotions
- Never punish them for acting aggressively. A person with dementia is probably not aware of their actions, and punishing them will create further issues
- Do not bottle up your emotions or hold them in. This may make caring for the person too difficult. This will also put focus on the person’s behavior, and not the individual themselves
- Talk to someone else. Take the time to understand you will have emotions about these altercations, and speaking with someone outside of the situation can be incredibly helpful. Other family members, a counselor, or even the primary care physician, can help
Tips for Preventing an Incident
Understanding and preventing an incident from happening will greatly improve the quality of life for both the caretaker and the person with dementia. When looking at ways to manage the aggression, it is important to consider the person’s perceptions (whether or not they are correct). Their entire outlook on life may have changed with the illness, so a caregiver must constantly remind themselves to treat the person and not their behavior.
There is no right or wrong answer for how to prevent these incidents, but everyone should look at the individual’s personality for cues. Using what is known about them, such as their likes and dislikes, is the first step to a problem solving approach. The following are a few steps on how to prevent an incident from occurring in the first place:
- Define the problem. Assess the situation and ask a few questions, like:
- Is their behavior the cause of the incident or is it their environment?
- Are the actions of other people creating an issue?
- Is the person experiencing any pain? Are there other factors involved that are creating an incident?
- Consider the environment. Are there circumstances that could be contributing to the problem, like loud sounds? Perhaps the individual reacts a certain way in different parts of their home or room. Simply removing them from a particular room can help ease aggressive behavior.
- Assess the individual. Do they feel unwell? What types of emotions are they experiencing? Many people with dementia often have feelings of embarrassment or lack of stimulation. Use what is already known about the person to gauge what they could be reacting to. Was it a bad memory, or is it a photo? There are many things that could trigger aggression in a loved one with dementia.
Contact Caring Hands Matter For More Information
Caring for a person with dementia can be incredibly difficult, especially when their behavior becomes angry or aggressive. Understanding the nature of the disease while also taking into consideration the person themselves, is the first step to keeping a loved one comfortable. Assessing their environment and taking control of a caregiver’s own reaction will help a person with dementia get through the incident, and experience a better quality of life. To learn more about caring for a loved one with Dementia at home, contact Caring Hands Matter online or give us a call today.