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Do Dementia Patients Get Violent

How Dementia Causes Death

How to Deal with Aggressive Dementia Patients (4 Strategies)

A person in the late stage of dementia is at risk for many medical complications, like a;urinary tract infection and pneumonia . They’re at an even higher risk of certain conditions because they’re unable to move.

Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection.

In the end, most people with late-stage dementia die of a medical complication related to their underlying dementia.

For example, a person may die from an infection like aspiration pneumonia. This type of pneumonia usually happens because of swallowing problems.

A person may also die from a blood clot in the lung because they are bedbound and not mobile.

It’s important to know that late-stage dementia is a terminal illness.;This means that dementia itself can lead to death. Sometimes this is appropriately listed as the cause of death on a death certificate.

Make Sure Physical Needs Are Taken Care Of

Sometimes what seems to be the issue is really a symptom of another, underlying problem. If your loved one is experiencing physical discomfort but isnt sure how to tell you , their agitation could turn into aggression. Dr. Beatrice Tauber Prior of Harborside Wellbeing explains, There are many illnesses that can lead to an increase in aggressive behaviors.

If you notice that the usual things that work to calm your loved one are not working, make an appointment to see their medical professional to rule out a physical reason/illness that may be causing the aggressive behaviors, she recommends.

How Hospice Can Help With End

In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.

To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.

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Look For The Underlying Factor

Once you have established your safety and that of the patient, you should then look at what could have triggered such violent behavior.

It is important that you try and understand what may have led the patient to suddenly become violent. Violent outbursts may be caused by:

  • Physical discomfort
  • Frustration
  • Environmental factors like loud noise

When you are able to identify the triggers, try and reduce them. Understanding the stressors will also help you avoid any future incidences of violent outbursts.

Hindrances To Solving The Problem Of Aggressive Behaviour In The Home Care Setting

Elderly Dementia Patients Benefit From Visits With Loved ...

One hindrance to solving the problem of aggressive behaviour towards professional caregivers was the difficulty of identifying aggressive behaviour. Fear of sanctions after reporting aggressive incidents or lack of reaction to such reporting intensified the difficulty of reporting aggressive behaviour in the home care setting . In the inpatient setting, shame or fear of not being considered resilient enough was one of the reasons for not reporting aggressive incidents . Whether these aspects influence professional caregivers in the home care setting is not known. Furthermore, home care is characterised by working alone without an opportunity to discuss and to classify the incident. Therefore, there is a lack of reporting structure as well as a lack of social control. Additionally, home caregivers shy away from leaving the care recipient alone, particularly if she/he is affected by dementia. However, abandoning the person with dementia and interrupting care activities, particularly interventions associated with personal hygiene, can also help to calm down the situation. In this case, leaving the home of the person with dementia might also prevent further aggressive behaviour .

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Things To Do After Dealing With Aggressive Behavior In Dementia

1. Learn from what happenedAfter giving yourself a chance to calm down and de-stress from the episode of aggressive dementia behavior, take a step back to see what you can learn from the situation.

Analyzing the situation also helps you take it a little less personally and makes it easier to think about what you could do differently next time to try to avoid an aggressive reaction.

Think about possible triggers, which responses helped calm things down, and which responses seemed to make the situation worse.

It often helps to take notes on your observations to see if you can spot patterns or figure out new ways to try to prevent a similar outburst in the future or cool things down if it does happen.

2. Find sources of supportIts essential for your well-being to talk with people who understand and can help you cope with these tough situations and deal with the conflicting emotions.

Share your experiences with members of a caregiver support group, a counselor or therapist, or with supportive friends or family members.

Getting your feelings out is an important outlet for stress. Plus, you might get additional tips and ideas for managing aggressive dementia behavior from others who have dealt with it.

3. Consider medicationWhen non-drug techniques arent working and challenging behaviors become too much to safely handle, it might be time to work with their doctor to carefully experiment with behavioral medications.

Implications For Health Policy

Recognising the growing challenges in the home care setting and appreciating home care as necessary part of the health system will be critical. The policy of shortening hospital stays and discharging patients quicker and sicker results in increasingly complex home care situations. Therefore, action is necessary regarding the growing number of persons with dementia. To ensure person-centred home care for persons with dementia, political support for further education is required as well as the adaption of insurance schedules.

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Give Parents And Senior Loved Ones Their Space

This tip can be important for both you and a parent or senior loved one with dementia. First things first, it may be necessary for your own safety.

Giving the parent or senior loved one their space if they begin to show signs of aggression or frustration can also help prevent fits of rage or violence. Taking a minute to regroup and return to the situation gives you space to decompress the nerves before re-addressing the issue, says;GinaMarie Guarino, mental health counselor.

The Seven Stages Of Dementia

How to reduce violence in dementia

One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

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Triggers To Violence & Issues Of Homecare And Healthcare Services

There are a number of things which have been correlated in the literature as triggers for violence, including: pain, reduced vision and/or hearing, changes in the environment, excessive noise or activity, locked doors, limited privacy or space, and quality of relationship with caregivers . Depression and premorbid aggressive personality traits may also be related to aggressive or violent behavior . found a significant correlation between depression and physical aggression against the caregiver , and some evidence suggests that testosterone levels may be related to aggression in dementia patients, although not agitation .

To complicate matters, although physical or chemical restraints are frequently used to try to manage behaviors, there is little evidence that restraint of any kind is either an effective or safe method, although some medications have been found to have more impact than others . Questions have been raised about the ethical implications of medication and restraint use, noting that such methods are the antithesis of person-centered care , and some additional cautions in the literature note that some classes of medications may actually increase behavioral disruptions . note that âMany patients … are often inappropriately prescribed psychotropic medications, which are then inadequately monitored and reviewed, with the potential for serious detrimental consequencesâ .

How To Deal With Aggression And Dementia

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  • How To Deal With Aggression And Dementia

  • Aggression is one of the worst parts of caring for;a parent or senior loved one with dementia, but youre not powerless. Having a number of strategies on hand to deploy whenever you need them gives you the means to handle;a loved ones aggression any time it rears its head.

    Learn more about how to cope with aggression and dementia.

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    Five Ways To Help Identify The Causes Of Problem Behavior

  • Look at your loved ones body language and imagine what they might be feeling or trying to express.
  • Ask yourself, what happened just before the problem behavior started? Did something trigger the behavior?
  • Are the patients needs being met? Is your loved one hungry, thirsty, or in pain?
  • Does changing the environment by introducing favorite music, for example, help to comfort the person?
  • How did you react to the problem behavior? Did your reaction help to soothe the patient or did it make the behavior worse?
  • Common Causes of Problem Behavior

    Planning For When Your Loved One Does Wander

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    In case your loved one does wander, its a good idea to have a plan in place.

    • Notify neighbors and local police about your loved ones tendency to wander, and circulate your phone number.
    • Have your loved one wear an ID bracelet or labels in clothing. Digital devices using GPS technology can track your loved ones location.
    • In case a police search becomes necessary, have a recent photo of your loved one and some unwashed clothing to help search-and-rescue dogs.
    • In the U.S., sign up for the Alzheimers Associations Medic Alert and Safe Return Program, an identification system to help rescue lost Alzheimers patients.

    How to find a missing Alzheimers patient

    A person with dementia may not call out for help or answer your calls, even when trapped somewhere, leaving them at risk for dehydration and hypothermia.

    Check dangerous areas near the home, such as bodies of water, dense foliage, tunnels, bus stops, and high balconies.

    Look within a one-mile radius of where the patient was before wandering.

    Look within one hundred feet of a road, as most wanderers start out on roads and remain close by. Especially look carefully into bushes and ditches, as your loved one may have fallen or become trapped.

    Search in the direction of the wanderers dominant hand. People usually travel first in their dominant direction.

    Investigate familiar places, such as former residences or favorite spots. Often, wandering has a particular destination.

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    Differences In Aggression Among People With Dementia

    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.

    Story Source:

    Stage 2: Age Associated Memory Impairment

    This stage features occasional lapses of memory most frequently seen in:

    • Forgetting where one has placed an object
    • Forgetting names that were once very familiar

    Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.

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    How To Handle Aggressive Or Combative Behavior

    A lot of times, aggression is coming from pure fear, says Tresa Mariotto, a social services supervisor in Bellingham, Washington, and certified trainer in dementia and mental health. People with dementia are more likely to hit, kick, or bite in response to feeling helpless or afraid. Managing aggression can be stressful for both you and your loved one.

    • Try to identify the behaviors cause.
    • Keep your tone light and supportive.
    • Redirect your loved one by involving them in another activity or conversation.
    • Remove your loved one from surroundings or environments that may be overstimulating during an outburst.

    This is where truly knowing your loved one is so important, says Ann Napoletan, writer at the blog;The Long and Winding Road: An Alzheimers Journey and Beyond. In my moms case, she didnt like to be fussed over. If she was upset, oftentimes, trying to talk to her and calm her down only served to agitate her more. Likewise, touching her even to try and hold her hand or gently rub her arm or leg might result in her taking a swing. The best course of action, in that case, was to walk away and let her have the space she needed.

    Natural reactions to dementia behaviors can be ineffective or make the situation worse.


    Definitions Incidence And Correlations To Premorbid Personality Traits

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

    Behavior is communicative for cognitively impaired individuals who may have lost other means of expressing needs. Violent or aggressive behavior, however, can have substantial consequences on the quality of care received, the use of chemical or physical restraints, increased caregiving burden and potential for trauma, and increased healthcare costs, as well as the safety and health of the caregiver . For these reasons, more information and interventions to effectively manage violent and aggressive behaviors while preserving the communicative properties of these expressions are needed.

    In the case of military veterans, there may be exceptional risks. In a study of newly dementia-diagnosed veterans in 2008, Orengo et al. found that 20% of all participating veterans exhibited aggressive behavior at the baseline screening, somewhat higher than estimates of early stage aggression in the general public . However, Kunik states, âThere is no aggression gene. There are no absolute indicators in a personâs history that they will develop aggression. It is not directly connected to combat duty or PTSDâ . Despite this caution, a recent study led by his team found a tenfold increase in injury rates related to violence by veterans with dementia being cared for in their homes . Further study with this population is clearly warranted.

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    Violent Behaviors In The Elderly

    • We tend to think of temper tantrums as only pertaining to small children or teens, but even the elderly act out at times. Learn what’s behind these angry outbursts and how to best handle them without losing your own temper.


    • Its impossible to anticipate how a senior may interact with other residents and staff in settings like assisted living facilities and nursing homes, but staff should be prepared to handle difficult interpersonal issues and defuse tensions.


    • Seniors with urinary tract infections may not exhibit classic physical symptoms. Instead, confusion and mental and behavior changes can be the tell-tale signs of a UTI.


    • One of the biggest challenges for dementia caregivers is dealing with anger and aggression. Understanding how and why these behaviors occur can help you defuse them.


    Signs Of Dying In The Elderly With Dementia

    Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.

    Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.

    Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.

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