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Do Dementia Patients Get Aggressive

What Does Aggression In Dementia Mean

Aggressive Behavior in People with Dementia | Linda Ercoli, PhD | UCLAMDChat

Aggressive behaviour by a dementia patient can indicate the following emotions:

  • Feeling unprotected the involvement of a caregiver in the daily task such as bathing, dressing-undressing, and helping with personal care make the person feel insecure and helpless. The loss of independence may upset them and show in the form of aggression.
  • Frustration the inability to take care of themselves can cause a sense of failure and increases irritation, which may manifest in the form of aggressive behaviour.
  • Confusion worsening cognition affect the orientation to surroundings. The person can feel lost, leading to a sense of bewilderment.
  • Feeling afraid inability to recognise certain places and faces develops fear in the person. The unfamiliar places also increase confusion in these patients. Sometimes, a certain place or a person makes them recall an unpleasant or frightening memory.
  • Needing attention severely affected communication skills in dementia render a patient helpless when they want to communicate something.

Ways To Keep Your Loved One Calm

Once you have an idea of what might be behind the aggression, make a plan and see if it helps. If your first plan doesnât work, try another one. You might need to try several things, and no one plan is likely to always work.

If nothing seems to help, talk to a doctor or counselor for advice.

For aggression triggered by contact with you or other people:

Speak as softly and as calmly as you can, even if you feel frustrated, angry, or sad. If you need to and it’s safe, step away for a few minutes and take some deep breaths.

  • Try to comfort your loved one instead of telling them they’re wrong, even if what they’re saying isnât true.
  • Be as patient and as understanding as possible.
  • Donât point out what they’re doing wrong — that can make things worse.
  • Be clear about what you’d like them to do instead of telling them what not to do. For example, say “Let’s sit in this chair,” instead of “Stay out of the kitchen.”

For aggression that happens during things like bathing, dressing, toileting, or eating:

  • Break the activity into simple steps and give one or two directions at a time.
  • Go slowly and don’t rush them.
  • Explain what you’re going to do before you do it, especially before you touch them.
  • Give them simple choices.

For aggression triggered by their surroundings or routine:

Understanding Alzheimers Or Dementia Behavior Problems

One of the major challenges of caring for a loved one with Alzheimers or another dementia is coping with the troubling behavior and personality changes that often occur. Aggressiveness, hallucinations, wandering, or eating or sleeping difficulties can be upsetting and make your role as caregiver even more difficult. Whatever problems youre dealing with, its important to remember that the person with dementia is not being deliberately difficult. Often, your loved ones behavioral issues are made worse by their environment, their inability to deal with stress, or their frustrated attempts to communicate.

As you try to identify the causes, its important to remember that a patient with dementia responds to your facial expression, tone of voice, and body language far more than the words that you choose. So, use eye contact, a smile, or reassuring touch to help convey your message and show your compassion. And rather than take problem behaviors personally, do your best to maintain your sense of humor.

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Tips To Ease Alzheimers Aggression

Once you understand the triggers for Alzheimerâs aggression, you can take steps to prevent it. A few things to try:

  • Think ahead of time if a situation might make your loved one uncomfortable, overstimulated, or confused.
  • Donât ask too many questions at once, give instructions that are too complex, or criticize. That way, youâre less likely to confuse and upset the person you are caring for.
  • Limit the amount of loud noises, activity, and clutter around them.
  • Donât argue. People with Alzheimerâs disease see a different reality than you do. Rather than challenge them about it, sit and listen. Ask questions about it.
  • Focus on the past. Alzheimerâs affects short-term memory, so itâs often easier and less stressful for someone to recall and talk about distant memories than what they watched on TV the night before.
  • Use memory cues. As the disease gets worse, remembering when and how to do everyday tasks like brushing teeth or getting dressed gets harder. Reminder notes around the house can help prevent frustration.
  • Get A Free Guide To The 7 Stages Of Alzheimers

    Why Do Dementia Patients Become Aggressive?

    Unlike nursing homes, assisted living facilities generally dont have to document their efforts to provide care or demonstrate why they cant provide an adequate level of assistance. In most states, there isnt a clear path to appeal facilities decisions or a requirement that a safe discharge to another setting be arrangedrights that nursing home residents have under federal legislation.

    Its very frustrating because state regulations dont provide sufficient protections, said Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care.

    Sometimes, evictions are prompted by a change in ownership or management that prompts a re-evaluation of an assisted living centers policies. In other cases, evictions target residents and family members who complain about not getting adequate assistance.

    We see this regularly: An assisted living will say your mom isnt looking well, were sending her to the hospital to be re-evaluated, and then, before she can return, theyll say weve determined her care level exceeds what we can provide and were terminating her agreement.

    Amy Delaney, a Chicago elder law attorney, tells of a client in her late 80s with dementia admitted to an upscale assisted living community. When her two daughters noted deficiencies in their mothers care, managers required them to hire a full-time private caregiver for $10,000 a month, on top of the facilitys fee of $8,000 a month.

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    Dementia Behavior: Sleep Problems

    While quality sleep tends to decrease as you age, people who have dementia experience more sleep disturbances than other seniors. In fact, sleep problems affect as many as a third of seniors with dementia.

    Common sleep issues may include:

    • Difficulty getting and staying asleep
    • Agitation and restlessness when trying to sleep
    • Thinking its daytime when its night, going as far as getting up, getting dressed and wanting to start the day, Hashmi says

    Sleep disturbances are hard on patients and caregivers alike, Hashmi says. Its physically and mentally exhausting to be up night after night.

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    Tips For Defusing Aggression In Dementia Patients

    It is not uncommon for a situation to escalate quickly when dealing with aggressive dementia patients.

    You may even find that you do not feel safe. Do you know what to do if that occurs?

    In those instances, if your loved one is in a safe situation without access to anything that may harm themselves or anyone else, you can separate yourself from them by going into another room.

    However, if you find yourself in control and able to deescalate the situation, here are five tips you can use to help diffuse any potential aggression.

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    How To Cope With Common Changes In Behaviour

    Although changes in behaviour can be difficult to deal with, it can help to work out if there are any triggers.

    For example:

    • Do some behaviours happen at a certain time of day?
    • Is the person finding the home too noisy or cluttered?
    • Do these changes happen when a person is being asked to do something they may not want to do?

    Keeping a diary for 1 to 2 weeks can help identify these triggers.

    If the change in behaviour comes on suddenly, the cause may be a health problem. The person may be in pain or discomfort from constipation or an infection.

    Ask a GP for an assessment to rule out or treat any underlying cause.

    Keeping an active social life, regular exercise, and continuing activities the person enjoys, or finding new ones, can help to reduce behaviours that are out of character.

    Read more about activities for dementia.

    Other things that can help include:

    • providing reassurance
    • activities that give pleasure and confidence, like listening to music or dancing
    • therapies, such as animal-assisted therapy, music therapy, and massage

    Remember also that it’s not easy being the person supporting or caring for a person with behaviour changes. If you’re finding things difficult, ask for support from a GP.

    Coping With Agitation And Aggression In Alzheimer’s Disease

    How to Deal with Aggressive Dementia Patients (4 Strategies)

    People with Alzheimers disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesnt seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.

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    Faqs About Mean Dementia Behaviors

    Why is my mom with dementia so angry?

    The short answer is that most of us dont really understand which cognitive skills dementia takes away. More importantly, we do not realize which skills are not lost. And so we inadvertently embarrass people and unintentionally belittle or frustrate them without realizing what weve done by asking them to do something that they cannot do. We then find ourselves on the receiving end of a verbal or physical blow with no idea what went wrong, and their response seems unwarranted or crazy.

    Does dementia cause meanness?

    Dementia patients who are mean and aggressive are most likely feeling fear, anger and embarrassment because they have been asked to use skills that they no longer have. When they fail, they may lash out at us. As companions, we can learn to support them in the areas where they have lost rational thinking skills and capitalize on the intuitive thinking skills that they will never lose. The DAWN Method teaches us to do this through how we interact with them.

    How do I explain something to my husband with dementia without making him angry?

    Not Everyone With Parkinsons Will Develop Dementia

    Despite the fact that the pathology of Parkinsons disease can trigger the development of different types of dementia, not everyone with Parkinsons will develop dementia. About 30 percent of people with Parkinsons will actually not develop dementia at all, as stated by the National Parkinson Foundation.

    However, the vast majority of people with Parkinsons may experience some form of cognitive impairment over time, the foundation says.

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    Can Dementia Cause Aggressive Behaviour

    As a persons dementia progresses, they may sometimes behave in ways that are physically or verbally aggressive.

    This can be very distressing for the person and for those around them. Looking at what causes this behaviour and being aware of the persons needs can help to reduce this behaviour or make it easier to manage.

    • verbal for example, swearing, screaming, shouting or making threats
    • physical for example, hitting, pinching, scratching, hair-pulling, biting or throwing things.

    Some people assume that aggressive behaviour is a symptom of dementia itself. This can be true, but its more likely that there is another cause. Its important to see beyond the behaviour and think about what may be causing it. Reasons for the persons behaviour could include:

    • difficulties to do with dementia for example, memory loss, language or orientation problems
    • their mental and physical health for example, they may have pain or discomfort that they are unable to communicate
    • the amount and type of contact they have with another person or other people
    • their physical surroundings for example, if the room is too dark the person may become confused and distressed because they cant work out where they are
    • a sense of being out of control, frustration with the way others are behaving, or a feeling that theyre not being listened to or understood
    • frustration and confusion at not being able to do things, or at not being able to make sense of what is happening around them.

    You Are In Charge Of Mood

    Reducing Anger In Those With Dementia

    So, if you are spending time with someone whos experiencing dementia, this is the most important principle to understand: You are in charge of mood. You can bring it and you can change it for both of you. This is the only relationship youll ever have in which you actually are in control of mood for both of you.

    These principles about mood management are among the first that I teach to families and caregivers in my classes, because if we can inadvertently cause someone whos experiencing dementia to feel angry and hurt, we can also consciously cause them to feel happy and safeonce we understand how what they can and cannot do affects their moods. I created the DAWN Method® to do exactly this: to teach caregivers and families how to bring a sense of peace and safety to the people who need it the mostthose who are losing skills to dementia.

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    How Is Age Related To Pdd

    Both PD and PDD are more common with increasing age. Most people with PD start having movement symptoms between ages 50 and 85, although some people have shown signs earlier. Up to 80% of people with PD eventually develop dementia. The average time from onset of movement problems to the development of dementia is about 10 years.

    Paranoia Delusion And Hallucinations

    Distortions of reality, such as paranoia, delusions, and hallucinations, can be another result of the disease process in dementia. Not everyone with dementia develops these symptoms, but they can make dementia much more difficult to handle.

    Lewy body dementia, in particular, increases the likelihood of delusions and hallucinations, although they can occur in all types of dementia.

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    Manage Stress In An Alzheimers Or Dementia Patient

    Different stress-reducing techniques work better for some Alzheimers patients than others, so you may need to experiment to find the ones that best help your loved one.

    Exercise is one of the best stress-relievers for both the Alzheimers patient and you, the caregiver. Regular walking, dancing, or seated exercises can have a positive effect on many problem behaviors, such as aggression, wandering, and difficulty sleeping. Indoor shopping malls are vast walking opportunities protected from the weather.

    Simple activities can be a way for your loved one to reconnect with their earlier life. Someone who used to enjoy cooking, for example, may still gain pleasure from the simple task of washing vegetables for dinner. Try to involve your loved one in as many daily activities as possible. Folding laundry, watering plants, or going for a drive in the country can all help to manage stress.

    Remembering the past may also help calm and soothe your loved one. Even if they cant remember what happened a few minutes ago, they may still clearly recall things from decades ago. Try asking general questions about their distant past.

    Use calming music or play your loved ones favorite type of music as a way to relax them when agitated. Music therapy can also help soothe someone with Alzheimers disease during mealtimes and bath times, making the processes easier for both of you.

    Take time to really connect with the person youre caring for

    Differences In Aggression Among People With Dementia

    How to Deal with Aggressive Dementia Patients
    Lund University
    Physical aggression among people with dementia is not unusual. A study showed that one-third of patients with the diagnosis Alzheimers disease or frontotemporal dementia were physically aggressive towards healthcare staff, other patients, relatives, animals and complete strangers. This manifestation of disease must be both understood and addressed in the right way.

    Physical aggression among people with dementia is not unusual. A study from Lund University in Sweden showed that one-third of patients with the diagnosis Alzheimer’s disease or frontotemporal dementia were physically aggressive towards healthcare staff, other patients, relatives, animals and complete strangers. This manifestation of disease must be both understood and addressed in the right way.

    “The prevalences are not surprising, but we noted a difference between the two groups in terms of when in the course of the disease aggressive behaviour manifested and how serious the violence was,” says psychiatry resident Madeleine Liljegren, doctoral student at Lund University and lead author of the study.

    The study is based on a review of brain examinations and patient journals of 281 deceased people who between the years 1967 and 2013 were diagnosed with Alzheimer’s or frontotemporal dementia. The researchers have followed the entire duration of the disease for this group, from the patients’ first contact with a physician to follow up after death.

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    What Happens In Pdd

    People with PDD may have trouble focusing, remembering things or making sound judgments. They may develop depression, anxiety or irritability. They may also hallucinate and see people, objects or animals that are not there. Sleep disturbances are common in PDD and can include difficulties with sleep/wake cycle or REM behavior disorder, which involves acting out dreams.

    PDD is a disease that changes with time. A person with PDD can live many years with the disease. Research suggests that a person with PDD may live an average of 57 years with the disease, although this can vary from person to person.

    Tips For Handling A Seniors Aggression

    Most importantly, try not to take the aggressive behavior personally, Hashmi says.

    The classic line I always use is that this is the disease talking. It is not the person, Hashmi says. There is a lack of awareness in that moment. Its not your mom or dad or spouse saying that. Its the disease.

    When you are faced with a loved ones aggression, Hashmi suggests employing these 4 Rs:

  • Reassure. It can be difficult to do in the moment, but start by reassuring your loved one. For example, Hashmi suggests you might say something like, Im here for you. Im still here for you. Its OK.
  • Reorient. If they are disoriented, reorient them to their environment and with a familiar object. Say, Look, were at home. Heres a picture we have.
  • Redirect. Redirect your senior toward a familiar object, anything that gives them joy and comfort. It may be family photos, it may be a keepsake, it may be something that has great meaning and value to them, Hashmi says. It helps redirect and also helps reorient them.
  • Reminisce. Help them connect to a long-term memory. E.g., Remember when Joe was born?
  • When theyre feeling calmer, Hashmi says, you can try asking yes/no questions to help determine whether an unmet need is causing the behavior. Ask: Are you hungry? Are you thirsty? Are you in pain? Are you tired?

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