How to Cope with Aggression in Someone with Dementia

People with Alzheimer’s may become agitated or aggressive as the condition progresses. Aggression may result from a frustrating situation or happen abruptly and without apparent cause. It can be stressful for the individual and those around them.

Aggressive behavior can be verbal (swearing, screaming, shouting, or making threats) or physical (hitting, pinching, scratching, hair-pulling, biting, or throwing things).

Although managing aggression may be difficult, it might be beneficial to understand that the person with Alzheimer’s or dementia is not acting aggressively on purpose. Understanding the person’s needs and examining the factors contributing to this behavior can help lessen or manage it. 

Causes of Aggression

Aggression usually occurs for a reason. Physical discomfort, environmental problems, and poor communication are all potential sources of aggression [1].

If the person with Alzheimer’s or dementia is aggressive, analyze what may be causing the behavioral shift. When it occurs, look for the source and discuss potential solutions with a medical professional. Aggression may occur due to [2]:

• Dementia-related challenges, such as memory loss, language, or orientation issues
• Their physical and emotional well-being—for instance, they might experience discomfort or pain that they can’t express.
• The quantity and nature of their interactions with other people
• Their physical environment—for instance, the individual may become disoriented and upset if the room is too dim since they are unable to determine their location.
• An uncontrollable sensation, anger at the actions of others, or a sense that they are not being heard or understood
• Confusion and frustration at their inability to do tasks or understand what is happening around them

How to Cope with Aggression in a Dementia Patient

The following tips may help you respond to the aggressive behavior of your dementia patient.

• Remain calm and speak gently: Keep calm when an older adult exhibits aggressive behavior. It will only worsen if you also become agitated. Take a deep breath and speak in a soothing, gentle tone. If appropriate, a light touch on the shoulder or arm might also assist in defusing the tension. 
• Validate their emotions: When people are furious or upset, they want to be validated. Although they may not be able to express their concerns because of their deteriorating cognitive abilities, older people nevertheless require validation. Assure them that it’s acceptable for them to feel the way they do and that you are available to support them, even if you are unsure of the reason for the behavior. 
• Do not escalate the situation: Sometimes, all you need to do to settle a heated situation is to be silent and give the other person some space. Refrain from arguing with them, responding to their actions, or stopping them (unless it will hurt someone). You can learn more about the individual and, ideally, identify the behavior’s trigger by listening and watching.

• Ensure that the person is not in pain: Aggressive behavior may be a result of pain or other physical uneasiness. Check to discover if they need to use the restroom, are uncomfortable, or require medication for any pain-causing disorders like gout or arthritis. 
• Try to figure out what causes the behavior: Common causes of abrupt outbursts include pain, fear, and frustration. Try to identify the events that lead to the aggressive behavior. For instance, they may get upset when they see scary shadows on a wall. In this situation, you can turn that light off or down.
• Create a soothing environment: People with dementia or Alzheimer’s may become agitated by loud noises or hectic, stressful situations. Asking others to leave the room, turning off the TV, and lowering the volume of the radio or music could help them regain their composure. 
• Change the focus to another activity: The current activity or situation might be accidentally triggering aggressive behavior. Consider trying something different. 
• Play the music they like best: Music can evoke strong emotions, bring back happy memories, or inspire a desire to tap, sing, or dance. Avoid turning on the music too loudly or too suddenly so that you do not startle the person and potentially aggravate them further. 
• Take a break. You may try to reassure the person, but they may still be upset. Leave the room to allow yourself and the other person some breathing room when you start getting frustrated. Before leaving, ensure that the place is safe and that the individual will not harm themselves while you are away. After a little while, the person may become more composed or feel better. 
• Ensure safety. Verify the safety of both you and the individual with dementia. If the individual can’t ease up, ask for help from others. In an emergency, always dial 911. Tell the rescuers that the person has dementia, which makes them act aggressively if you call 911. 

Alzheimer’s Research Association is a non-profit organization dedicated to helping caregivers of Alzheimer’s disease and dementia. We provide the latest information and news about the illness and helpful tips to help caregivers cope with their daily caregiving challenges. We realize the most important thing that a caregiver needs is financial assistance. Therefore, we provide grants to caregivers to ease their financial burden. Caregivers can apply for grants here: Alzheimer’s Grant Application. 

You can also help caregivers in their endeavor by donating as much as possible: Donation To Alzheimer’s Research Associations.

References

• Aggression and Anger. Alzheimer’s Association. https://www.alz.org/help-support/caregiving/stages-behaviors/agression-anger. Accessed: 6th December, 2024.

• Aggressive behaviour and dementia. Alzheimer’s Society. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/aggressive-behaviour-and-dementia. Accessed: 6th December, 2024.

• Coping With Agitation, Aggression, and Sundowning in Alzheimer’s Disease. National Institute on Aging. https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/coping-agitation-aggression-and-sundowning. Accessed: 6th December, 2024.
• Dealing with Aggressive Behavior in Someone with Dementia. CareHop. https://carehop.ca/blog/dealing-with-aggressive-behavior-in-someone-with-dementia/. Accessed: 6th December, 2024.