When Alzheimer’s Patients Get Angry

A Reaction Not A Symptom

Aggressive behaviour is by no means a common response from people with dementia. Only rarely is it actually a symptom of the dementia. If aggression does occur, the most likely reason is that the person is reacting to a distressing situation for example, they are being stopped from leaving their own home or being helped with bathing by a person they do not recognise who has not explained what they are doing. The starting point in understanding aggressive behaviour from a person with dementia is to consider what might be going on from their point of view.

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?

Physical Causes

Emotional Causes

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?

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Trying To Identify The Cause

One of the best ways to deal with an angry person is to try and figure out what has triggered the mood swing.

Numerous factors can cause this type of reaction.

This can include physical discomfort which can be as a result of medical conditions, lack of enough sleep or rest, hunger, thirst, or side effects caused by medications a person is taking.

Environmental factors such as feelings of being lost or overstimulation can also evoke anger in a person who is affected by the illness.

Identifying the CAUSE of the behavior helps you to rectify it fast to ensure that the person with dementia is as comfortable as possible.

For instance, if the individual is hungry or thirsty giving them a drink and food can help correct the problem.

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:

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How To Handle Alzheimers Aggression

One of the biggest challenges for people taking care of elderly parents with Alzheimers disease or other types of dementia is dealing with outbursts of agitation and aggression.

Techniques for managing AD aggression, such as redirecting their attention or medication, can certainly help. However, Cindy Steele, RN, nurse scholar for Copper Ridge, a residential care community located in Utah, says the key to handling anger and aggression is finding out what is causing the outburst.

Dismissing aggression as a normal behavior associated with Alzheimers doesnt enable the caregiver to fix whatever is causing the outburst, explains Steele. Why do they seem to get upset? What causes it?

Steele focuses on behavior management for Alzheimers and dementia patients and says agitation and aggression are typically caused by one or more of the following five factors.

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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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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.

You Are In Charge Of Mood

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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Ignore The Angry Behavior

It is definitely not easy to get hit and ignore because there will be some pain and hurt. But an Alzheimers patient will hit you one minute and forget what they did in the next minute. So when they hit you, ignore. Secondly, make sure they are unlikely to harm themselves. Finally, stay clear of them until they calm down. Dont allow the situation to get out of control or even more violent.

Tips To Help Manage Dementia Sleep Problems

There are ways to help your loved on get a better nights sleep, Hashmi says.

Avoid things that disrupt sleep.

• Limit caffeine, alcohol, and sugar near bedtime.
• Avoid over-the-counter sleep aids. Instead, Hashmi suggests you talk to a doctor about whether melatonin might help your loved one sleep.
• Remove electronics from the bedroom.

Create a routine that supports sleep.

• Make sure your loved one gets enough daytime light to help with circadian rhythms.
• Change into comfortable clothing, signaling nighttime.
• Consider warm milk, a hot shower, relaxing music or reading before bed.
• Pick a bedtime not too late and stick with it every night.

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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:

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?

The Rules In Relationships Change With Dementia

If youre spending time with someone whos experiencing dementia, you can avoid the dementia anger stage , but only if you become more aware of whats causing it. When dementia comes into a relationship, the rules change. A relationship including dementia is different from any youve experienced before. You will need to understand the cognitive skills we all normally useand then which ones we continue using when were experiencing dementia.

In my first article in this series , I described our two thinking systems and explained the most frustrating rational thinking losses caused by dementia. I also described our intuitive thinking skillsthose that we continue using. It will be helpful to read that article first if you havent yet.

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Body Languagestop And Face Them

Next, we have to think about posture. When someone lacks memory skills, it changes how they interpret gesture and posture. Suppose Im making sandwiches for lunch and my husband walks into the kitchen and asks what Im doing. If he isnt experiencing dementia, I dont need to stop and turn around to face him. I can simply direct a brief answer over my shoulder, because if hes not experiencing dementia our previous conversations and exchanges will be there in his mind to temper my lack of attention during this moment.

However, if hes experiencing dementia, he will by default interpret my posture as dismissive, because for him its our first interaction and for him my posture will speak louder than my words. So, if my husband is experiencing dementia I need to pause and turn to look at himand make eye contactto avoid inadvertently hurting his feelings.

An Ounce Of Prevention Is Worth Pounds Of Cure

As with most things in life, prevention if possible is key. And the more you understand the triggers, the better you will be at circumventing and avoiding angry outbursts. That said, it’s almost impossible to avoid all triggers all the time. Yet, if you can practice anger prevention, it’s best to do so.

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Your Superpowerpositive Eye Contact

Eye contact. This is a critical nonverbal communication tool with dementia. Eye contact is your superpower if you spend time with people whore experiencing dementia. You can use it to send instant messages of love, acceptance, gladness, and gratitudeeven when your hands are full and youre at a loss as to what to do next. You can use it to prevent your loved one from sinking into the anger, hurt feelings, and misunderstandings that result in combative or aggressive behaviors.

And the opposite is true, too. If you dont understand that eye contact is more necessary than usual with dementia, you are inadvertently communicating disinterest and lack of caring. People whore experiencing dementia are living in the three-second nowa place that lacks any previous messages of love, acceptance, and appreciation.

So, when you find yourself wondering how your loved one became so mean, angry, and unhappy, remember these tools that you have at your disposal and they do not. Remember that wetheir companionsare able to manage their moods while they are not. And that we can change what we are inadvertently communicating into messages of love and acceptance.

If Youre Looking After Someone With Dementia

Your needs as a carer are as important as the person youre 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 UKs 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

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Refusing To Accept Outside Caregivers

It is an important milestone when family caregivers decide to hire in-home care for their loved ones, but this plan is often derailed when seniors refuse to let the new caregivers into their homes. Other elders will welcome home health aides in only long enough to tell them that they are fired!

Coping With Elders Refusing Care

The presence of an outsider suggests to the elder that their family cant take care of them. It also magnifies the extent of their needs and makes them feel vulnerable. Work to understand your loved ones reasons for resisting in-home care, which could include fear, embarrassment, resentment or some mix of the three. Talk to them about their feelings and work together to find solutions that everyone can live with. For example, if Mom hates the thought of letting a stranger into her home, arrange for her to meet the professional caregiver at the home care companys office or at a café for coffee first.

Ask your loved one to simply give home care a try on a temporary basis. Instead of immediately introducing full days of hands-on care, it may help to have a home health aide come in for one day a week to do light housekeeping and meal preparation for a few hours. Experienced home care companies know how to handle situations like this, so dont hesitate to ask for their advice. Once the senior gets used to having someone in the house and establishes trust with a caregiver, they will be more comfortable with accepting additional help.

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Thoughts On How To Manage Your Anger When Caring For Someone With Dementia

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