Handing the anger and aggressive behaviors in someone suffering from Alzheimer’s is one of the biggest challenges for family and caregivers. Whether the aggression is verbal and/or physical, there are several things that may contribute and there are definitely some things you can do to diffuse the situation.
Aggressive behavior can occur suddenly, with no apparent reason and often builds up over time. All of the sudden a mother who has always been meek and calm may have an outburst of rage. That is because it is the deterioration of the brain causing the behavior and is often involuntary. Aggression can be especially hard to deal with, but understanding what causes anger and how to respond can help you handle the situation more effectively.
What Causes Anger and Aggression in Dementia and Alzheimer’s
The first step in dealing with anger in Alzheimer’s and dementia is to understand where it is coming from. This behavior can seem spontaneous and seemingly unprompted. Generally, anger stems from four main triggers: physical, emotional, mental, and environmental.
- Physical Triggers: The person may be in pain and unable to express that, so it comes out as dementia anger and aggression. It’s often common for them to also be restless and tired or angry due to discomfort, soreness, dizziness, nausea, or pure exhaustion.
- Emotional Triggers: The person may become angry from either over-stimulation or boredom. Feelings of being overwhelmed, lonely, or bored can all trigger anger or aggression. They may also be frustrated by the inability to do simple physical tasks and realizing they should be able to do things that they no longer can, which is an emotional and frustrating experience.
- Mental Triggers: Confusion is one of the leading causes of dementia anger and aggression in those who are suffering from the disease. What starts as a lost train of thought leads to confusion and suddenly morphs into anger. Mixed up memories or difficulty in communication cause mental triggers of anger when they don’t feel that they are being understood.
- Environmental Factors: Any type of change in the environment can also trigger dementia anger and aggression. If they are overstimulated by loud noises, crowds, or in a situation with strangers or unfamiliar surroundings, they may begin to feel lost or overly alert which can lead to apprehension, anxiety, and anger.
If you find your loved one getting angry, consider the situation and what might be contributing to the behavior. When you understand the root cause, it also makes it easier to understand how to respond and diffuse the situation.
How To Respond to Anger and Aggression in Dementia
- Try to identify the immediate cause – Instead of focusing on the behavior itself, think about what happened right before the reaction that may have triggered it.
- Rule out pain as a source of stress – Ensure that the person is comfortable. Pain can cause a person with dementia to act aggressively and they may not complain of pain at all, but rather act out in anger.
- Focus on feelings, not the facts – Don’t focus on specific details of what happened or he said/she said, focus on the feelings and emotions expressed instead.
- Don’t get upset – They are often more upset than anyone because their emotions are layered and confusing. Be the calm one, give them positive and reassuring feedback. Keep your voice slow and soft.
- Limit distractions – Make sure that their environment is not overstimulating. This may require simplifying their space and helping their environment to adapt to them rather than expecting them to have the ability to adapt to distractions in the environment.
- Try a relaxing activity – Turn on some music soft and low, offer to rub their back or go for a walk to help soothe the person through a relaxing, familiar activity.
- Shift the focus to another activity – Similar to redirecting a child, you can redirect the adult to another activity or focus rather than the situation that may have unintentionally caused the aggressive response.
- Avoid using restraint or force – Unless the situation is serious and the individual is harming themselves or others, avoid physically restraining them at all. This usually causes them to become more frustrated and cause more harm than good.
- Take a break – If the person is in a safe environment and you are able to leave, walk away and take a moment for yourself. This can help you maintain a calm demeanor, lower your voice and avoid elevating the situation further.
- Ensure safety – Always ensure that safety is the number one concern. If the person is unable to calm down first seek assistance from others, including healthcare providers. If necessary, always call 911 in emergency situations. If you do call 911, tell responders the person has dementia, which causes them to act aggressively.
Caregivers Need Care Too
Even if you do everything right, there is no way to completely prevent anger outbursts. The most important thing to remember is that you should not take the dementia anger and aggression personally. No matter what they say, it is the disease talking, not the person. They should never be punished, chastised, or reprimanded for their behavior. The person with dementia or Alzheimer’s doesn’t truly know what they are doing and reacting to the situation personally or defensively will only lead to more anger or aggression.
Instead, always lead with love and understanding to get through any of these episodes. Be their soft place to fall, and reach out for help when you need it. The caregivers who are untrained in dementia often take the brunt of this anger and you don’t have to face it alone. Finding support for handling your loved one’s dementia or Alzheimer’s can be invaluable.
Talk to your loved one’s doctor about their anger and their care needs in order to provide the best care for them while taking care of yourself as well. If you’re concerned about their safety, always contact their doctor as soon as possible.