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How To Deal With Violent Dementia Patients

Do Not Try To Stop A Person Who Wants To Leave A Room

How to Deal with Aggressive Dementia Patients (4 Strategies)

Staying in one place for long periods may result in behavior problems in the dementia patient. It is essential to have a safe environment where they can enjoy the outdoors without any problem. When someone tries to leave a room, do not force them to stop. Doing this may result in an extreme reaction such as severe distress or injuries.

Instead, it is best to accompany the patient so that they are safe. You can even suggest going for a drive around the block so that they can experience a new environment for a short period. If they do not want company, just let them go but stay close by to make sure that the patient is safe at all times.

Understanding And Managing Difficult Dementia Behaviors

By CRHCF – Published May 31st, 2016

When providing care for a loved one with dementia, there are many challenges you face as a caregiver. As your loved ones condition worsens, so too does the ability to communicate, act and think clearly, and perform many of the common day-to-day tasks that we take for granted.

… the anger and frustration you may feel as a dementia caregiver is normal and does not make you a bad person.

Throughout this mental and physical decline, your loved one may begin to display difficult and sometimes dangerous behaviors that can put their safety, and sometimes the safety of others, at risk. By understanding the root causes behind the behaviors, what may trigger them, and how to best manage these behaviors when they arise, you can better care for your loved one and yourself.

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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Why Are Some Dementia Patients Violent

People with dementia can be aggressive for a variety of reasons: People with dementia may feel unheard or misunderstood because of them. Someone may feel frightened or threatened by something. You might experience feelings of embarrassment, frustration, or annoyance in response to becoming reliant on a friend or family member.

Practical Tips On Medications To Manage Difficult Behaviors In Dementia

How to Handle a Combative Dementia Patient

You may be now wondering just how doctors are supposed to manage medications for difficult dementia behaviors.

Here are the key points that I usually share with families:

  • Before resorting to medication: its essential to try to identify what is triggering/worsening the behavior, and its important to try non-drug approaches, including exercise.
  • Be sure to consider treating possible pain or constipation, as these are easily overlooked in people with dementia. Geriatricians often try scheduling acetaminophen 2-3 times daily, since people with dementia may not be able to articulate their pain. We also titrate laxatives to aim for a soft bowel movement every 1-2 days.
  • No type of medication has been clinically shown to improve behavior for most people with dementia. If you try medication for this purpose, you should be prepared to do some trial-and-error, and its essential to carefully monitor how well the medication is working and what side-effects may be happening.
  • Antipsychotics and benzodiazepines work fairly quickly, but most of the time they are working through sedation and chemical restraint. They tend to cloud thinking further. It is important to use the lowest possible dose of these medications.
  • Antidepressants take a while to work, but are generally well-tolerated. Geriatricians often try escitalopram or citalopram in people with dementia.

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Understanding The Causes And Finding Ways To Cope

While some people living with Alzheimer’s disease or other types of dementia remain pleasant and easy-going throughout their lives, others develop intense feelings of anger and aggression.

When someone with dementia lashes out at you for seemingly no reason, it’s normal to feel surprised, discouraged, hurt, irritated, and even angry at them. Learning what causes anger in dementia, and how best to respond, can help you cope.

How To Handle Personality Changes And Aggression

Do you remember the old story about Dr. Jekyll and Mr. Hyde? Gentle Dr. Jekyll invents a potion to separate the good side of his personality from his darker impulses. At first, he can drink the potion and turn himself at will into his evil alter-ego, Mr. Hyde. Soon, however, Dr. Jekyll morphs into Mr. Hyde without tryingâthe dark side of his personality has taken over.

Sometimes it can seem like dementia is turning a loved one into an aggressive Mr. Hyde, who bears little resemblance to the person you once knew. How can you handle these alarming changes?

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Dont Be Afraid To Ask For Alzheimer’s Support

“Knowing how to detect, defuse, and prevent anger is one of the most important skills for Alzheimers care providers, says Larry Meigs, CEO of Visiting Angels. Its one of the skills we value most in our Alzheimers caregivers.

If you find that you need support in handling a loved ones dementia or Alzheimers care, help from an Alzheimers care provider can be invaluable. To discuss your options for professional, in-home Alzheimers care, call your local Visiting Angels office today.

If you are concerned about sudden changes in your loved ones behavior or have questions about caring for your loved one, please also contact your loved ones healthcare provider for information and support.

There Are Many Possible Reasons For The Aggressive Behavior

How to Deal with Aggressive Dementia Patients

Every communication from someone with Alzheimers gives us an opportunity to understand what is going on. Aggressive behaviors can tell us whether any of the following might be occurring with the individual:

  • Pain, stress, or fatigue
  • Confusion due to a sudden change in environment a change in routine or the change of a person
  • Reaction to medications, or to the interaction of medications
  • Noisy or confusing surroundings
  • Feeling pushed to do something uncomfortable such as taking a bath
  • Feeling uncertain when asked to do something that seems too hard

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Dealing With Dementia Behavior: Wandering

Two characteristic precursors to wandering are restlessness and disorientation. An Alzheimers patient may exhibit signs of restlessness when hungry, thirsty, constipated, or in pain. They may also become disoriented, pace, or wander when bored, anxious or stressed due to an uncomfortable environment or lack of exercise. As well as adding physical activity to your loved ones daily routine, you can:

  • Immediately redirect pacing or restless behavior into productive activity or exercise.
  • Reassure the person if they appear disoriented.
  • Distract the person with another activity at the time of day when wandering most often occurs.
  • Reduce noise levels and confusion. Turn off the TV or radio, close the curtains, or move the patient to quieter surroundings.
  • Consult the doctor as disorientation can also be a result of medication side effects, drug interactions, or over-medicating.

Seek Outside Help And Advice

If you reach a point where the individuals aggression, rage, or violence is too much to handle, then it may be a good idea to reach out for help. You can speak with the individuals doctor or another professional in the field.

It may also be beneficial to talk to other caregivers who have faced similar situations. They may be able to provide you with additional insight and help for your situation.

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What Causes Aggressive Behaviour In People With Dementia

As human beings, we all have the same basic needs. These include physical, psychological and social needs. We do things consciously and unconsciously to meet these needs. The symptoms of dementia can make it more difficult for someone to do this.

For example, people with dementia can find it hard to understand whats going on around them. This can be confusing and frightening for them. It is likely that they are trying to stop feeling distressed and to feel calmer again. For example, if someone they do not know well or who they no longer recognise is trying to help them undress, they may feel threatened and try to push the person away. Aggressive behaviour may be:

  • caused by the person feeling agitated because of a need that isnt being met
  • the persons attempt to meet a need
  • the persons attempt to communicate a specific need to others .

See below for examples of how different types of needs may cause a person with dementia to act aggressively.

Physical needs

Psychological needs

Consider whether they may benefit from psychological therapies with professionals, such as cognitive stimulation therapy or counselling.

Social needs

The persons aggressive behaviour may be their response to feeling theyre not able to contribute or are not valued by others. Try to encourage the person to have a daily routine and to do as much as they can for themselves. Support them to be as independent as they are able to be.

Dementia Connect support line

Do Make Sure That The Dementia Patient Gets Enough Rest Food And Water

How To Talk To Someone With Dementia That Is Angry

Fatigue, hunger and thirst may cause combativeness. Ensure that the person with dementia is well fed, hydrates enough, and gets adequate sleep and rest. In line with this, they should also have enough bathroom breaks. Research also shows that it may help to reduce loud noises as well as clutter in the space where the patient spends most of his/her time, as both loud noises and clutter tend to over-stimulate people with dementia.

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What Can You Give A Dementia Patient To Calm Them Down

  • Utilizing music therapy to ease tension is vital for seniors and lets them focus on happier matters.
  • and aromatherapy are common uses for this tool.
  • You may touch the ground.
  • Here are some links that will take you to pet therapy
  • Taking the time to be calm is important
  • Create a secure memory care community right now
  • Maintain regular routines.
  • Providing reassurance is our responsibility.
  • Tips For Communicating With Your Parent

    • Avoid power struggles. Dont push, nag or harangue your parents. Making ultimatums will only get their backs up, and yelling, arguing or slamming doors could seriously damage the relationship. Laura Ellen Christian, 15 Expert Tips for When Your Aging Parents Won’t Listen, The Arbor Company Twitter:
    • Ask about your loved one’s preferences. Does your loved one have a preference about which family member or what type of service provides care? While you might not be able to meet all of your loved one’s wishes, it’s important to take them into consideration. If your loved one has trouble understanding you, simplify your explanations and the decisions you expect him or her to make.
  • Don’t fire off questions or ask complicated questions. First off, don’t pepper elders with questions or complicated choices. Instead of saying, Do you have to use the bathroom? say, We are going to the bathroom. If the word shower upsets them, don’t use it. Come with me, you say, and you end up at the shower. If someone with dementia is frightened, acknowledge it and say, You are safe with me. I’ll protect you. After they’re calmer, you can try to get them to do something. The one question that people with dementia often respond to is this: I really need your help. Can you help me with this?” Stacey Burling, They’re Not Just Stubborn: How to Get People with Dementia to Participate, Philly.com Twitter:
  • 6 Ways To Handle Stubbornness In Seniors, Alternatives for Seniors Twitter:
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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

    Five Tips To Manage Aggressive Behaviors

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

    While knowing the common causes of aggressive behaviors helps to minimize their occurrence, these behaviors can still happen. How can you safely manage these behaviors at the time they occur?

    When you are on the receiving end of an outburst or a physically aggressive behavior, your safetyas well as that of the one with Alzheimers, and the safety of anyone else to whom the aggression is being directedis paramount. Here are some tips for managing the immediate situation:

  • When the aggression is being directed at you, keep a safe distance from the one with Alzheimers, and remain calm, speaking slowly, softly, and with reassurance
  • When the aggression is directed at someone else who needs your assistance, step in between them, and have the victim step away as you do that. Again, maintain a calm demeanor, speaking slowly, softly, and with reassurance
  • If necessary to protect the one with Alzheimers from hurting him or herself, call for help from others. If necessary, call 911
  • Once everyone is at a comfortable and safe distance from each other, continue to speak softly and slowly with the person with Alzheimers
  • Re-direct: change the focus to another activity. A calming activity that persons can comfortably participate in is best.
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    Do Not Engage In Arguments

    One of the worst things a person can do to an individual who has dementia is to start an argument or even force them to do something that makes them upset or angry. When the discussion or argument is too heated, it may be better to walk away to create an environment where everyone can remain calm. Experts agree that one of the ways that can yield results when it comes to dementia behavior problems is to get rid of the word no when dealing with patients. Avoid forcibly restraining a dementia sufferer at all costs.

    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.

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    How Do You Calm An Angry Person With Dementia

  • The immediate cause should be identified
  • Clarify that pain is not the cause of the behavior
  • Dont read the facts in order to achieve your goals. Focus on the feelings rather than the words.
  • Please dont get upset.
  • Make sure you stay focused on what matters.
  • Its important to engage in some relaxing activities.
  • Concentrate on something else
  • You need to take a break.
  • Types Of Medication For Difficult Behaviors In Dementia

    How to Deal with Aggressive Dementia Patients

    Most medications used to treat difficult behaviors fall into one of the following categories:

    1.Antipsychotics. These are medications originally developed to treat schizophrenia and other illnesses featuring psychosis symptoms.

    Commonly used drugs: Antipsychotics often used in older adults include:

    • Risperidone
    • Haloperidol
    • For a longer list of antipsychotics drugs, see this NIH page.

    Usual effects: Most antipsychotics are sedating, and will calm agitation or aggression through these sedating effects. Antipsychotics may also reduce true psychosis symptoms, such as delusions, hallucinations, or paranoid beliefs, but its rare for them to completely correct these in people with dementia.

    Risks of use: The risks of antipsychotics are related to how high the dose is, and include:

    • Increased risk of falls
    • Increased risk of stroke and of death this has been estimated as an increased absolute risk of 1-4%
    • A risk of side-effects known as extrapyramidal symptoms, which include stiffness and tremor similar to Parkinsons disease, as well as a variety of other muscle coordination problems
    • People with Lewy-body dementia or a history of Parkinsonism may be especially sensitive to antipsychotic side-effects in such people, quetiapine is considered the safest choice

    2. Benzodiazepines. This is a category of medication that relaxes people fairly quickly. So these drugs are used for anxiety, for panic attacks, for sedation, and to treat insomnia. They can easily become habit-forming.

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    What Is Aggressive Behaviour In Dementia

    Aggression is a common challenging behaviour seen in dementia patients. Aggressive dementia can manifest in the physical or verbal form. Physically, patients may attack the caregiver. They can hit and throw objects, kick, pinch and scratch, bite and pull hair. Verbally, they may become abusive and curse, yell insults and threaten the caregiver.

    This behaviour is very disturbing for both the patient and family. The severest form of aggression in the dementia patient is physical aggression. Residing in a community, this type of behaviour has serious consequences. This aggression may lead to mental suffering, injury, hospitalisation, and increased need for an assisted living or admission to institutional care settings. Aggression in dementia patients can affect the carer too, increasing their burden and causing other consequences. The carer may become depressed, mentally exhausted, or maybe injured because of an assault, which may in turn lead to elder abuse.

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