It can be difficult to see your once mild-mannered mother snap at you. Or to have your longtime spouse, so full of love and joy, get angry for seemingly no reason. A dementia diagnosis causes changes in the brain that may be responsible for a loved one’s uncharacteristic behavior. One common dementia-related behavior is anger and/or aggression, which is oftentimes hard for family members and caregivers to cope with.
The first step in dealing with this dementia-related behavior is understanding that the person is not acting this way on purpose. The next step is trying to identify the reasons for the behavior.
Factors of Aggressive Behavior
Aggressive behaviors may be verbal or physical and can occur suddenly with no apparent reason. Many things can play a part in the behavior including physical discomfort or pain; environmental factors; frustration; or poor communication. It’s important to assess what is contributing to the situation. For instance, when it comes to communication consider asking yourself these questions:
- Are the instructions simple and easy to understand?
- Am I asking too many questions or making too many statements at once?
- Am I giving the person enough time to respond?
- Is the person picking up on my own stress or irritability?
Possible Causes of Anger
Triggers for aggressive behavior for someone living with dementia fall into four categories: emotional, social, physical and environmental.
- Emotional feelings that may cause an older adult to manifest anger include: feeling bored, sad, tired, embarrassed, affectionate, supported, stressed, afraid, frustrated, valued, lacking trust, unsafe.
- Social triggers include: an inability to talk; feeling left out; lacking relationships; a struggle to accept change; or feeling isolated, bored, or lonely.
- Physical causes should also be considered. For instance, is the individual overheated or chilled? Are they wearing uncomfortable or restrictive clothing? Consider if they are in pain, hungry, or thirsty?
- Environmental triggers to consider include: a crowded or room, new or different surroundings, living with clutter, feeling over-stimulated, living with poor lighting, or being introduced to strangers.
Positive Ways to Respond to Aggressive Behavior
It’s important to respond positively and effectively at the first sign of anger or aggressive behavior. Try incorporating these suggestions into caregiving routines.
- Try to identify the immediate cause
- Ensure safety for yourself and the individual
- Rule out pain as the cause of the behavior
- Validate the person’s feelings. Apologize and take the blame if needed
- Don't get upset – be positive and reassuring
- Provide comfort – hug, massage and hand on the back
- Speak slowly in a soft tone and give them time to respond (at least 10 seconds)
- Limit distractions
- Redirect at the first sign of agitation and try again later
- Try a relaxing or enjoyable activity
- Take a break or give space or try a change of scenery, going for a walk etc.
- Consult a healthcare provider
Finding Support
Managing uncharacteristic angry and aggressive behaviors can be disconcerting and hard to deal with on your own. There are a number of resources available to offer support. Groups are led by credentialed social workers and trained group leaders who have experience supporting Alzheimer's caregivers are an important resource. The local chapter of the Alzheimer’s Association may be offering virtual and in-person support groups.
Many families also find that at some point, they need additional help. Respite care benefits both family caregivers and the individual being cared for. For family caregivers, finding care professionals adept at dealing with Alzheimer’s or dementia behaviors is the key to feeling comfortable about accepting help.
At Home Instead, our Care Professionals receive special dementia-specific training. The Person-Centered Care Training for Alzheimer’s and Other Dementias by Home Instead is recognized by the Alzheimer’s Association® for incorporating evidenced-based dementia care recommendations.
To learn more about respite care or professional caregiving support contact the health experts at Home Instead – available 24/7
Call 604-432-1139
