Aggression in Dementia Individuals: Why It Happens and How to Cope

Aggression in Dementia Individuals: Why It Happens and How to Cope

Once a month, Oxnard Family Circle ADHC has an Alzheimer’s Cafe group for caregivers who are taking care of dementia individuals. I attended the group recently and sat next to a man who is providing care for his wife, who has Alzheimer’s. The man told me that he had attended the Alzheimer’s Cafe group in the past, and that he wanted his wife to join Oxnard Family Circle’s program. Not only because it would be beneficial for her, but because he needed help providing care.

This man loved his wife, but she had aggressive tendencies that were sporadic, nerve wracking, and even heartbreaking at times. He told me, “Sometimes she’s exactly like her old self and sometimes I feel like she just hates me. It’s really difficult.” I could see in this man’s tired eyes that he was doing all that he could, and tried to reassure him and tell him that her agitation was most likely not directed at him personally. He is one of many caregivers for dementia individuals that experiences the pain of aggression from their loved ones.

All dementia individuals develop some changes in their personality and behavior as the disease progresses. Sometimes they may seem like their old selves and sometimes they may be extremely volatile and aggressive. Aggressive behavior in dementia individuals may consist of (but is not limited to) the following:

• Verbal abuse/verbal threats
• Being physically threatening (such as pinching or kicking)
• Lashing out violently at people or physical property
• Overreacting to situations or becoming very agitated as a result of what is a minor setback or event

Why Does Aggression Occur?

Aggression in dementia individuals can occur for a number of reasons, and often times the aggression is very irrational behavior. Some of the reasons include:

• The person feels frightened, confused, or humiliated
• They feel frustrated by not being able to understand others or not being able to make themselves understood
• Loss of inhibitions/decreased awareness of rules about what is considered to be appropriate behavior
• Physical affects of dementia can cause judgement or self control to deteriorate over time

How to Deal With Aggression

• It is better to distract the person with dementia as opposed to attempting to reason with them. Most of the time, reasoning with a person with dementia will make them more agitated. Try to direct their focus on something pleasant by suggesting to take a walk, playing some music, or serving your loved one their favorite food.
• Take the environment your loved one is in into consideration. Is it too hot or cold? Is it easy for him or her to move from place to place? Is it safe (i.e. sharp objects put away, cords or throw rugs that could cause your loved one to fall secured)? Individuals with physically non – aggressive behavior may respond well to a safer environment.
• Develop routines; dementia individuals often benefit from consistency. Serve meals at the same time each day or try taking a daily walk at the same time each day.
• Ask closed-ended questions/make suggestions to avoid confusion (Try asking ‘Would you like chicken soup for lunch today?’ as opposed to ‘What would you like for lunch?’)
• Focus on responding to the emotions of your loved one and making them comfortable as opposed to the content of them verbally lashing out.
• Reminisce with them to keep pleasurable experiences in their thoughts as opposed to whatever is agitating them.
• If the person is physically violent, consider leaving the room until you have both calmed down. If necessary, call for additional help.

How to Cope Emotionally:

• Don’t take it personally. The behavior your loved one is exhibiting is most likely not deliberate. The person’s feelings for you have not changed; the structure of their brain is changing and is altering their reactions to situations. Remember that the person with dementia will most likely forget any outburst they have.
• Stay calm, give the person space, and don’t forget to breathe. Acknowledge that you understand your loved one is upset and reassure them that everything will be fine.
• Distract your loved one with something pleasant, such as a favorite song, pictures of loved ones, etc.
• Try not to show anxiety about the situation in front of your loved one. This may increase their confusion or agitation.
• Take a break. Talk to a friend, have a cup of tea, or read a book. The important thing to keep in mind is that you not only have to provide care for your loved one, you also have to take care of yourself.

How can Oxnard Family Circle help?

The day program at Oxnard Family Circle ADHC has a Memory Care Unit that is specifically designed for dementia individuals. The Memory Care Unit is a safe and secure area for your loved one where they can relax and be monitored to prevent wandering or unpleasant behavior. We provide caregiver respite during the day and support groups for all caregivers twice a month, allowing you to meet with fellow caregivers and share your experiences and advice. Oxnard Family Circle provides transportation to and from the center and two home-cooked meals per day, as well as a variety of activities for all of our participants.

We are all in the fight against dementia together, and our best method of approaching dementia is with as much understanding as possible. Coping with aggression in your loved one is extremely hard, but it is another way of combating dementia and finding the person inside the disease.