Management Of Aggression In Dementia
- activity and exercise to help prevent some outbursts
- approaching the person slowly and in full view
- explaining what is going to happen in short, clear statements such as Im going to help you take your coat off
- checking if the aggressive behaviour is about getting what the person wants if so, trying to anticipate their needs may help.
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.
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.
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Responding To Anger In A Loved One With Dementia
Ted, who has early stage Alzheimers disease, is now prone to angry outbursts and accusations. Once so easygoing, Ted often shouts at his wife, Terry. It breaks my heart, says Terry. And sometimes its all I can do not to answer back in the same way.
When people think about the changes caused by Alzheimers disease, they most often think of memory loss and confusion. But for families whose loved ones are living with Alzheimers or a related condition, the personality changes caused by the disease can be more distressing than the forgetfulness. They might feel as if the person they knew and loved has been replaced by an aggressive, angry stranger.
With no cure for Alzheimers disease yet on the horizon, much research is underway to better understand the behavior changes caused by the disease, and to improve care strategies to address them. Experts say angry outbursts and even physical attacks are best understood as expressions of unmet needs. Your loved one may not be able to express what they want or whats troubling them, and aggression born of frustration or fear is the result.
Given These New Understandings Dementia Care Experts Offer Tips For Caregivers:
Always keep in mind the origin of your loved ones changed behavior. There is almost always an underlying reason that your loved one lashes out verbally, or even throws objects or tries to hit someone. They may be unable to express that they are in pain, lonely or afraid. They may be upset that they cant remember something or perform a once-familiar task, especially if they feel pressured by someone else to do so. Their brain may be overloaded in a noisy room with too much stimulation.
Dont argue. Reassure your loved one. Speak calmly. Listen to your loved ones concerns and frustrations. Try to show that you understand. If the disease is causing your loved one to believe something that isnt trueeven if it is an accusation directed at youdont try to talk them out of it. Ask questions and allow them to express what theyre experiencing. Change the subject if you can, perhaps to a pleasurable memory from the past. People with dementia retain old memories longest, and the conversation may take a better turn.
Talk to the doctor. A medical examination may reveal underlying causes of aggressionan infection or a painful condition that your loved one is unable to describe, the side effects of medications, sleep problems, even constipation.
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Try To Engage Conversation
Ask questions about the situation and the events that contributed to this outburst. Above all else, listen attentively to the explanation you receive, keeping in mind whether or not its sensible doesnt really matter.
Conversations give you valuable insight into what is really going on beneath the surface of these emotions.
Selecting The Right In
Most people with Alzheimers disease do best in the familiar surroundings of their own home. Professional in-home care is a great resource to supplement the care family provide, and to allow them respite time to take care of their own health and needs.
But when it comes to dementia care, not all home care is equal. Just as is true with family caregivers, professional caregivers need a good understanding of how the disease affects people with dementia. Right at Home provides this training for caregivers so they are equipped with effective ways to ensure each clients well-being.
Right at Homes caregivers assist with personal care such as dressing, bathing and using the bathroom. They engage clients in appropriate activities. They provide companionship, combined with nonjudgmental, unobtrusive supervision. Support for nutrition and exercise is tailored to the clients needs. All care is delivered with the goal of preserving the clients dignity and sense of independence.
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Common Causes Of Sleep Problems In Dementia Patients
Troubled sleep is thought to be a dementia risk factor as well as a behavioral symptom. Here are some factors that may contribute to your loved ones sleep problems:
- Brain changes. Dementia patients have steeper changes in their brains sleep architecture and their circadian rhythms, causing sleep disturbances.
- Over-the-counter medications. Some over-the-counter medications labeled PM can disrupt sleep by making patients sleep for a bit but then making them more confused or sleepy at the wrong time, Hashmi says.
- Diet. Caffeine, excess sugar , and alcohol can disrupt sleep patterns, Hashmi says.
- Electronic screens. The blue light from a computer, portable electronic devices, and television screens can delay sleep and disturb sleep patterns, Hashmi says.
Take Care Of Yourself Too
Itâs not easy to care for a person with Alzheimerâs disease, especially when they lash out at you. Itâs completely normal to feel overwhelmed, isolated, or sad.
If you are a caregiver, do yourself and the person you care for a favor. Let someone know if you start to feel depressed, anxious, exhausted, or irritable. If you take good care of yourself, you can take better care of others.
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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.
Its Not A Dementia Anger Stage Its A Natural Stress Response To Something That Is Upsetting
However, if I were experiencing dementia, I couldnt do any of that because I would have lost the necessary skills. If my friend sounds distant and uninterested, I will take it personally. If my husband looks irritated when I slam down the phone and say something mean about her to him, my anger will increase and become grumpiness that persists. I might again be mean to my husband immediately or I might be surly or even aggressive with the next person I meet.
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Strategies To Help You Manage Grief
- Feel the pain. Allow yourself to really feel what you are feeling, no matter what that is. Denying your feelings only intensifies and prolongs the pain.
- Talk about what your grief. Share the pain. It’s important to talk about your feelings even at the most difficult times. Sharing grief will help diminish it. It can be helpful to talk to a person outside the family, such as a counsellor or trusted friend. Joining an Alzheimer Society support group gives you the opportunity to talk with others who are on a similar journey.
- Keep a journal. A journal is a private place where anything can be written including unfulfilled wishes, guilt, anger and any other thoughts and feelings. A journal is a place where you can explore your frustrations and express your thoughts and ideas without interruption.
- Find comfort. Different people have different ways of finding comfort. For many there is comfort in rituals, such as prayer, meditation or other activities.
- Hold off. Tread carefully before making decisions. Thoroughly explore all options before making major steps. You may be unable to make important decisions at times.
Why Aggressive Behavior Happens
Aggressive behavior is almost always triggered by something. Figure out what that something is and youll both be much happier. If your loved one seems angry and is acting aggressively, check for pain first. Someone with dementia may not know how to express discomfort or pain. To identify the cause of aggression, look for these signs: Stroking or pulling on a particular part of the body. Facial contortions like clenched teeth or inverted eyebrows. Body language, like rocking or pulling away. Appetite change An existing condition like arthritis Dental problems like a toothache Nails that are too long Constipation
Is it a reaction to other people? Is something wrong in the environment? Does the aggressive behavior happen at the same time every day, or in the same place? Maybe a particular person coming to visit will cause your loved one to get upset.
Finding a pattern will help explain, and ultimately manage, your loved ones aggression. One good idea to help is keeping a caregiver diary that lists what was happening when your loved one became angry. Details like time of day, what activities were going on previously or were anticipated, and how exactly the lashing out occurred can be useful in identifying the problem. If you need to see a doctor to address behavior issues, having notes will be helpful for forming a medical opinion. Was the person tired? Uncomfortable? Embarrassed about something?
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The Challenges Of Caregiving
It can be very challenging to care for a loved one with dementia who develops neuropsychiatric symptoms Ã¢â¬â even with simple, everyday and mundane tasks like eating. It is important to reach out to health care providers, both for the individual with dementia as well as for yourself, in order to ensure the physical and mental health of both caregiver and receiver. Many resources are available online and locally which may be useful in helping you care for your loved ones. For example, the Alzheimer’s Association is a nationwide organization devoted to research on Alzheimer’s disease, as well as to directing patients and their families towards local caregiving resources. More information about the Alzheimer’s Association can be found at: http://www.alz.org/. The National Institute of Mental Health is another nationwide organization devoted to the treatment of mental illness, including dementia, which can be useful for identifying treatment directions, and for assisting caregivers with supportive resources. More information about the National Institute of Mental Health can be found at: https://www.nlm.nih.gov/medlineplus/dementia.html
Following A Partner Or Carer Around
Dementia makes people feel insecure and anxious. They may “shadow” their partner or carer as they need constant reassurance they’re not alone and they’re safe.
They may also ask for people who died many years ago, or ask to go home without realising they’re in their own home.
- have the person with you if you’re doing chores such as ironing or cooking
- reassure them that they’re safe and secure if they’re asking to go home
- avoid telling them someone died years ago and talk to them about that period in their life instead
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Needs Of The Caregiver
Looking after an Alzheimers patient is extremely difficult and stressful. For the caregiver, this can result in enormous stress and sometimes even a physical and/or mental breakdown. To help manage a patient with Alzheimers disease, here are some tips:
- Get help from other family members if there is no family, consider hiring a nursing healthcare provider to help with some of the daily living activities.
- Try and get a break from caring for example, if the individual is asleep, get some rest yourself.
When To See A Doctor
Forgetfulness and memory problems dont automatically point to dementia. These are normal parts of aging and can also occur due to other factors, such as fatigue. Still, you shouldnt ignore the symptoms. If you or someone you know is experiencing a number of dementia symptoms that arent improving, talk with a doctor.
They can refer you to a neurologist who can examine you or your loved ones physical and mental health and determine whether the symptoms result from dementia or another cognitive problem. The doctor may order:
- a complete series of memory and mental tests
- a neurological exam
- brain imaging tests
If youre concerned about your forgetfulness and dont already have a neurologist, you can view doctors in your area through the Healthline FindCare tool.
Dementia is more common in people over the age of 65, but it can also affect younger people. Early onset of the disease can begin when people are in their 30s, 40s, or 50s. With treatment and early diagnosis, you can slow the progression of the disease and maintain mental function. The treatments may include medications, cognitive training, and therapy.
Possible causes of dementia include:
- Alzheimers disease, which is the leading cause of dementia
- brain damage due to injury or stroke
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Faqs About Dementia And Anger
Is anger a sign of dementia?
Not necessarily. Dementia may result in anger because people whore experiencing dementia have lost the ability to consider why other people say or do things and so, take things personally. If a person with dementia feels safe, listened to and respected in your care, anger is much less likely. The DAWN Method is a set of tools that help families and caregivers support their loved one with dementia in a kind way and capitalize on the skills that they will keep.
Why do dementia patients get angry?
Dementia patients often get angry because of how we interact with them. We can easily upset them without even knowing that weve done it. A person with dementia is very adept at reading body language, but at the same time, they have lost the ability to understand why someone may have said or done something. If you look irritated, they will take it personally. If you look distracted, they will assume that you dont care about them. On top of that, a person with dementia has lost the ability to control their mood . Because of this, once they are angry, they will have a hard time letting that bad feeling go. The DAWN Method teaches us how to interact in a way that decreases anger and stress for both the dementia patient and the caregiver.
Is there an anger stage of dementia?
How To Prevent Dementia And Angerits All About Body Language
And finally, because of all this, we need to become very aware of our nonverbal communications. In my article on mean dementia I explained that reading nonverbal communication is one of our intuitive thinking skills, and so it is something not lost to dementia. We begin learning to read our companions expressions, body language, and intonation at an incredibly young agewithin hours of birth. And we keep those skills in dementia.
Dementia will take away our ability to understand language and eventually the meaning of even the first words we learned as toddlers, but people who are experiencing dementia remain very aware of their companions expressions, body language, and intonation. And without memory skills to distract them with memories of the past, or rational thinking skills to distract them with plans or anticipation of the future, people who are experiencing dementia are entirely presentfully alive in the moment and to whats happening around them.
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Responding To Anger And Aggression In People Who Suffer From Dementia
Now that we have identified the three sources of anger and aggression, we will discuss the best ways to respond to this behavior. These situations can be stressful, but there are a number of ways to respond to a variety of different causes.
Of course, one of the most important steps is to establish that both you and your loved one are safe. If the person is unable to calm down, the best course of action is to seek assistance from others. In emergency situations, it is always best to call 911. If you do, inform the responders the person has dementia, which is the cause of the aggression.
With that established, there are a number of effective methods to respond to anger and aggression to avoid escalation. Below, we highlight some of the best steps and outline what kind of situations you might use them in.
Ways To Reduce Anger In Dementia
1. Accept their limitationsAvoid pushing seniors with dementia beyond their limits by expecting them to do things theyve been struggling with.
They arent refusing to do things because theyre lazy or refuse to remember.
Their brains are failing and theyre losing the knowledge and abilities they need to accomplish those once-easy tasks.
Accept where they are now and work with the skills they have today.
2. Reduce complex decisionsMaking choices about every part of their day isnt necessary, but there are some decisions your older adult may still want to make.
The goal isnt to take away their right to choose, but to simplify to make choices easier too many options are confusing and overwhelming.
For example, when changing, lay out all the clothes they need, but offer a choice between two shirts the red shirt or the blue shirt?
This way, theyre still participating in the process, but wont have to find and select all the other clothing items they need.
Similarly, for lunch you could offer a choice between two entrees you know they enjoy a ham sandwich or split pea soup?
That decision is much easier to respond to than a broad question like What do you want for lunch?
3. Slow downWere used to moving at a normal pace, but thats because our brains are fully functional and can quickly process information and thoughts.
When someone has dementia, those cognitive processes slow down significantly.
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