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What To Do When Alzheimer Patient Gets Violent

Strategies For Dealing With Alzheimers

New approach to care for Alzheimers dementia and aggression

Sometimes prescription drugs can be helpful in treating these behavioral changes. There are medications for anger management, depression and anxiety. Non-drug therapies have also proven to be successful in mitigating and managing behavior issues associated with Alzheimers.

Caregivers cant do much to prevent Alzheimers-related changes in personality and behavior, but there are ways to cope. Try the following strategies:

  • Establish daily routines. Routines build confidence and familiarity for those struggling with the disease. Getting into the car in the morning instead of the usual routine of walking the dog and having breakfast can completely disrupt the day. The simplest changes to routine can be unsettling.
  • Ensure proper nutrition and exercise. A nutritional diet and regular exercise can also help keep the brain engaged and focused throughout the day.
  • Keep daily tasks as simple as possible. Someone with Alzheimer’s may get easily confused. Choosing what to wear and getting dressed can be baffling. Find ways to reduce your loved ones stress in a way that works for them. Try picking out their clothes for them or presenting them with two options to choose from instead of the whole closet.
  • Engage them in activities. Whether its helping set the table or doing a jigsaw puzzle, it will keep them distracted and occupied. Getting them involved in activities can also make them feel they still have control over their life. A sense of contribution and worth can do wonders.
  • 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

    How To Respond To Delirium

    • Teach yourself about delirium and learn more about what brings it about, how to manage it and how to prevent it
    • Be careful about surgery and hospitalizations because these actions present the risks of Alzheimers turning violent
    • Learn to spot delirium in the hospital and address it when it appears.

    It is quite unfortunate that at one point of the progression of Alzheimers, the disease will turn violent.

    Devoted Guardians’ Response to COVID-19

    Devoted Guardians is actively monitoring the progression of the coronavirus, COVID-19, to ensure that we have the most accurate and latest information on the threat of the virus. As you know, this situation continues to develop rapidly as new cases are identified in our communities and our protocols will be adjusted as needed.

    While most cases of COVID-19 are mild, causing only fever and cough, a very small percentage of cases become severe and may progress particularly in the elderly and people with underlying medical conditions. Because this is the primary population that Devoted Guardians serves, we understand your concerns and want to share with you how our organization is responding to the threat of COVID-19.

    We are following updates and procedures from the Centers for Disease Control State Department of Health, local and county authorities, the Home Care Association of America and other agencies and resources. Our response and plans may adjust according to the recommendations from these organizations.

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    Why Do Older People With Alzheimers Sometimes Behave Aggressively

    Aggression in the elderly often manifests itself to express dissatisfaction which can sometimes lead to excessive violence, verbal or physical. The disagreeable behavior is by no means a symptom of the disease and the patient is unaware of his attitude. He does not do it on purpose and does not seek conflict intentionally.

    Remember that seniors with Alzheimers disease can have emotional disturbances. In the vast majority of cases, these can manifest as hostility, either through verbal or physical outbursts.

    The older one realizes that he is becoming more and more dependent. He has more difficulty communicating. There is also the apprehension of change. The fear of death. All this unfortunately sometimes leads to aggressive behavior of the senior with Alzheimers.

    What Causes Alzheimers To Turn Violent

    Alzheimer Treatment Success
    • Physical discomfort
    • Physical pain from infections or the urinary tract can contribute to a change in behavior. This is common for Alzheimers patients. Patients are also unable to articulate or identify the cause of discomfort or pain so they may express it through violence. Other sources of physical discomfort include lack of enough sleep, hunger, and thirst or medication.
    • Environmental factors
    • Loud noises and physical clutter can over-stimulate a person with Alzheimers. If the person is surrounded by unfamiliar people or they feel lost,
    • Alzheimers can turn violent.
    • Poor communication
    • When patients are unable to understand and process the information given to them.

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    If You’re Looking After Someone With Dementia

    Your needs as a carer are as important as the person you’re caring for.

    To help care for yourself:

    • join a local carers’ support group or a specialist dementia organisation â for more details, call the Carers Direct helpline on 0300 123 1053; lines are open 8am to 9pm Monday to Friday, and 11am to 4pm at weekends
    • call Dementia UK’s Admiral Nurse Dementia Helpline free on 0800 888 6678 to talk to a registered specialist dementia nurse; lines are open 9am to 9pm Monday to Friday, 9am to 5pm at weekends

    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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    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.

    Stage : Moderate Dementia

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

    Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

    While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

    Also Check: Is There A Treatment For Alzheimer’s

    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.

    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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    Preventing And Managing Aggressive Behaviour In People With Dementia

    Find ways to prevent and manage aggressive behaviour in the future, to help both you and the person with dementia.

    Working out what might be triggering the behaviour may make it easier to prevent it.;Always try to see things from the persons perspective. Think about the situations where theyve become aggressive, and to try to find what has triggered this response.

    Think about what you know about the person and their life. Be aware of their beliefs and thoughts and try not to argue with them. For example, if the person has always valued their privacy and independence, then being helped with eating or washing might cause them to become angry.

    Get A Free Guide To The 7 Stages Of Alzheimers

    What to Do When Alzheimers Patients Become Violent & How ...

    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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    Why Is This Happening

    Some reasons why a person with dementia might be aggressive include:

    • The person might be feeling unheard or misunderstood.
    • The person might be feeling threatened or frightened.
    • The person might be feeling embarrassed, frustrated or annoyed because they need help to do things they used to do independently.
    • The person might be asserting their own wishes when others are trying to make them do something they dont want to do.
    • The person might be in pain.

    How To Deal With Aggression In Alzheimer’s Patients

    Though violence is not a common feature of dementia, if it happens when a caregiver is not prepared, it can become dangerous quickly for both the patient and their family. With an Alzheimer’s patient, it may be possible to encounter aggression from time to time. Thats why its important to be prepared for the worst. What should one do if someone with Alzheimers, or another form of dementia, becomes aggressive?

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    First, let’s talk about why people with dementia get violent in the first place. As everyone may know, its not really a hallmark of the disease. Rather, it arises when anger and frustrations take over because the persons judgment and memory are impaired. Usually, this happens in Alzheimers patients who are in the middle phase of their disease, a time when they really begin to lose their independent function but are still strong enough to physically hurt themselves by accident. This can quickly become a dangerous recipe for disaster.

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    Ways To Reduce And Manage Mean Dementia Behavior

    1. Calm the situation downThe first thing to do is reduce the tension in the room.

    Start by limiting the distractions in the room, like turning off the TV or asking others to leave.

    And if you stay calm, theyre also more likely to calm down.;

    It might help you to count to 10 or even leave the room for a short time to cool down. Repeat to yourself its the disease as a reminder that theyre not intentionally doing this.

    If the current activity seemed to cause the agitation, try shifting to a more pleasant, calming activity. Or, try soft music or a gentle massage.

    2. Comfort and reassure while checking for causes of discomfort or fearTake a deep breath, dont argue, and use a calm, soothing voice to reassure and comfort your older adult.;

    It also helps to speak slowly and use short, direct sentences.

    Then, check for possible causes of agitation or fear, like:

    • Feeling disturbed by strange surroundings
    • Being overwhelmed by complicated tasks
    • Frustration because of the inability to communicate

    It also helps to focus on their emotions rather than their specific words or actions. Look for the feelings behind what theyre doing as a way to identify the cause.

    3. Keep track of and avoid possible triggersWhenever difficult behavior comes up, write down what happened, the time, and the date in a dedicated notebook.;

    Also think about what was going on just before the behavior started and write that down as a possible trigger.;

    Taking some time away can help both of you.;

    Types Of Medication For Difficult Behaviors In Dementia

    How to Deal with Aggressive Dementia Patients (4 Strategies)

    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.

    Also Check: How To Prevent Alzheimers And Parkinsons Disease

    Aggressive Behaviour In Dementia

    In the later stages of dementia, some people with dementia will develop what’s known as behavioural and psychological symptoms of dementia .

    The symptoms of BPSD can include:

    • increased agitation
    • aggression
    • delusions
    • hallucinations

    These types of behaviours are very distressing for the carer and for the person with dementia.

    It’s very important to ask your doctor to rule out or treat any underlying causes, such as:

    If the person you’re caring for behaves in an aggressive way, try to stay calm and avoid confrontation. You may have to leave the room for a while.

    If none of the coping strategies works, an antipsychotic medicine can be prescribed as a short-term treatment. This should be prescribed by a consultant psychiatrist.

    Common Changes In Behaviour

    In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.

    Some common changes in behaviour include:

    • repeating the same question or activity over and over again
    • restlessness, like pacing up and down, wandering and fidgeting
    • night-time waking and sleep disturbance
    • following a partner or spouse around everywhere
    • loss of self-confidence, which may show as apathy or disinterest in their usual activities

    If you’re caring for someone who’s showing these behaviours, it’s important to try to understand why they’re behaving like this, which is not always easy.

    You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.

    Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.

    Read Also: How To Diagnose Alzheimer’s Early Onset

    Understand Why Someone With Dementia Says Mean Things

    First, its important to understand why this hurtful behavior is happening.;

    Dementia is a brain disease that causes parts of the brain to shrink and lose their function, resulting in cognitive impairment.;

    These different parts control functions like memory, personality, behavior, and speech. Dementia also damages the ability to control impulses, which means actions arent intentional.

    Even though its difficult, do your best to remember that they truly dont intend the mean things they say.

    These mean comments and hurtful accusations often happen because the person is unable to express whats actually bothering them.

    It could be triggered by something in their environment that causes discomfort, pain, fear, anxiety, helplessness, confusion, or frustration.

    Working to accept the fact that theyre not doing this on purpose helps reduce stress and makes their behavior easier to manage.

    The overall strategy is to take a deep breath, remind yourself that its not personal, take care of; immediate discomfort or fear, and try to find the cause behind the behavior.

    Next, look for long-term solutions that will help you get the support and rest you need to keep your cool in challenging situations like these.


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