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Why Do Dementia Patients Get Aggressive

Causes Of Aggressive Behavior In Dementia

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

Some dementia patients have trouble revealing or understanding their needs or wants, so in order to express themselves, they may exhibit aggressive behavior. Causes of aggressive behavior may be biological, social, or psychological.

Biological causes of aggressive behavior include:

  • Pain
  • Not liking or trusting a particular carer
  • Hiding their conditions from others

Psychological causes of aggressive behavior include:

  • Feeling ignored
  • Frustration due to inability to complete tasks
  • Misunderstanding of carers intentions
  • Difficulty understanding the world around them

Stage 5: Moderate Dementia

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.

Poor Communication & Mental Triggers

Confusion or misunderstanding can also lead to anger and aggression. According to Visiting Angels, Confusion is one of the leading causes of anger and aggression in Alzheimers and dementia sufferers. Confusion can be triggered by lost trains of thought, mixed up memories, or a sudden change in the environment, such as a change from one caregiver to another.

This is especially important to note for communication as well. As a caregiver, you are in direct communication and contact with the patient, therefore, it is crucial that you articulate your instructions in a simple, concise manner.

Additionally, its important that you as the caregiver try to communicate with as little irritability and stress as possible. We understand that caregiving is a strenuous job, but for the benefit of you and your loved one, it is crucial to make sure you properly communicate with someone who has dementia.

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Do Not Take It Personally

Caretaking for people with dementia carries a lot of emotional and mental weight with it. If anger and aggression outbursts do occur, it is important that you, as the caregiver, do not take it personally.

These fits often come from sources that are completely unrelated to you as the caregiver. Yet, it is important for you to remember that these attacks are not coming from a place of maliciousness.

As a caregiver, it is also important to be forgiving of yourself and build in plenty of me time. Self-care and looking after your own health physical, mental, and emotional is just as important. Your loved one will be able to sense your own distress and emotions as well.

In The Aftermath Of These Momentsself

Dementia Caregiving

These aggressive moments with someone with Alzheimers can be stressful for a caregiver. In the aftermath of these moments, remember to find the time for yourself as a caregiver, to retreat, to reflect, and to decompress from the height of the event. Such time will give you the chance to find the calm and self-assurance to continue doing the important work you do for your care recipient.

* The names and details were changed to protect privacy.


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Why Dementia Patients Get So Angry

Understanding what triggers anger and aggression in your loved one with dementia will help you avoid those triggers and prevent aggressive behavior. Anger prevention and coping strategies will make dementia care much easier for you and your loved one alike.

Anything from boredom to over-stimulation can trigger anger in a person with dementia. Anger in your loved one with dementia can be related to:

  • physical triggers such as exhaustion, discomfort, or soreness,
  • cognitive triggers such as confusion .
  • emotional triggers that usually involve feelings of loneliness, sadness, over-stimulation, or monotony. Studies show that anger issues usually intensify the more severe dementia becomes.

What You Can Do For Your Loved One

As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.

One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.

Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.

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Understanding Why Someone With Dementia Is Being Mean

Does dementia cause meanness or is something else going on? 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. 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.

But think about how you feel when someone you loveor someone you expect kindness fromstarts doing things that make you feel bad. None of us behave well when we feel that were being taken advantage of, made fun of, or picked on. When that happens, we feel indignant and angry and usually tell the other person why. Anger, aggression, frustration, and just plain meanness result when we feel that were not being treated fairly or respectfullyespecially if it happens over and over again with people whom we are close to or expect better;from.

This doesnt change when we begin to experience dementia. What changes is the skills we have available to work with. Dementia takes away skills weve been using our entire lives. And even if our companions love us dearly, their attempts to help us often make us feel;worse.

Look For The Underlying Factor

How to Deal with Aggressive Dementia Patients (4 Strategies)

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.

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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.


Existing Interventions & Previous Related Work

found that only 38.3% of caregivers had received suggestions from healthcare personnel, although 70% of caregivers with a severely aggressive care-recipient had found strategies to avoid conflict. Some of these included: distraction, ignoring, positive nurturing, and maintaining routines. reported on several strategies for reducing conflict that showed promise in the literature, including person-centered care planning, personalized and respectful bathing and toileting routines, personalization of patient’s bedrooms, respect for privacy and dignity, and person-centered interactions outside of ADL management. Effects of these types of interventions were reported to reduce aggression by as much as 60% . Indeed, found strong evidence relating bathing and aggressive behavior in nursing home settings, implying that this is one of the most challenging aspects of care, and that attention to adaptation this task could substantially reduce behavioral disruption.

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Repeating The Same Question Or Activity

Repeating the same question or activity may be a result of memory loss where the person cannot remember what they’ve said or done.

It can be frustrating for the carer, but it’s important to remember that the person is not being deliberately difficult.

Try to:

  • be tactful and patient
  • help the person find the answer themselves, for example, if they keep asking the time, buy an easy-to-read clock and keep it in a visible place
  • look for any underlying theme, such as the person believing they’re lost, and offer reassurance
  • offer general reassurance, for example, that they do not need to worry about that appointment as all the arrangements are in hand
  • encourage someone to talk about something they like talking about, for example, a period of time or an event they enjoyed

Our Most Frustrating Rational Thinking Losses

How to Handle Alzheimerâs Aggression ...

If Im experiencing dementia and you ask me to do something I cant do, Ill feel embarrassed, angry, hurt, or all three at once. Its essential that you understand what someone experiencing dementia is no longer able to comprehend for you to avoid getting combative, aggressive, and mean;reactions.

Rational Thinking Loss #1Becoming unable to understand why.

Rational thinking skills are for understanding how, why, when, who and whatthe ability to perceive relationships between facts. Dementia takes that away. So if you try to explain to your loved one why they need to do something, or what went wrong, or how to do something, they will not be able to follow you and will end up embarrassed or concluding that youre making fun of them. Anger or hurt feelings will result. Whenever you catch yourself explaining why, stop. Youre asking them to do something they can no longer do. Youll have pleasanter interactions once you build new conversational habits and turn your focus away from why to talking about things that are;pleasant.

Rational Thinking Loss #2Becoming unable to see cause and effect.

Rational Thinking Loss #3Becoming unable to follow sequences.

Rational Thinking Loss #4Becoming unable to prioritize.

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Dying From Dementia With Late

The death of your loved one can be a hard concept to wrap your head around and accept. But knowing what to expect can help you when your loved one has late-stage dementia. It might help to know what will happen in the future so that you can be prepared emotionally and logistically.

This article discusses how dementia progresses and what to expect during late-stage dementia.

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 .

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The Message Behind The Behaviour

Because of the way dementia affects the brain, the person may have lost some of the inhibitions that would have prevented them from showing their feelings in this way previously. But the feelings being expressed now are important because they represent the persons way of saying something significant. And we need to understand the message. This could be, for example, I feel like a prisoner, Im frightened I dont understand whats going on, Im in pain, or Im so frustrated.

Alzheimers Care Challenges: Handling Dementia & Anger

How to reduce violence in dementia

Handling anger is one of the biggest challenges when caring for a person whos suffering from Alzheimers or another form of dementia. While almost everybody shows some form of aggression every now and again, Alzheimers and dementia can make anger issues much worse or develop anger issues in people who previously had none. Studies show that anger issues generally worsen the more severe an Alzheimers or dementia sufferers condition becomes.

Managing anger in dementia sufferers can be difficult. It may often mean reacting against your first instincts, but proper anger and dementia strategies can make care much easier for loved ones and caregivers alike.

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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.

Triggering Factors For Aggressive Behaviour Of Persons With Dementia In The Professional Home Care Setting

The current research and practice experience indicate similar triggering factors for aggressive behaviour in both settings. However, there is a lack of research concerning specific risks in the home care setting. Additionally, it is not known which unmet needs play a key role in triggering aggressive behaviour. Thus, knowledge about how professional home caregivers could improve their communication and interaction skills to prevent aggressive behaviour is required, particularly facing the consequences of aggressive behaviour of persons with dementia in the home care setting.

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There Are Many Possible Reasons For The Aggressive Behavior

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;

Dementia And Aggressive Behavior: Causes And Prevention Tips


Written byMohan GarikiparithiPublished onNovember 18, 2016

Some dementia patients may start exhibiting aggressive behavior as the disease progresses. There are different causes for behavioral changes in dementia which dont necessarily revolve around the disease itself. For example, behavioral changes may be associated with some sort of difficulty brought on by dementia, side effects of medications, changes in environment, social interactions, habits, and mental and physical health.

Aggressive behavior can be verbal or physical. In verbal aggressive behavior, patients may swear, scream, shout, or make threats. Physical aggressive behavior is when the patient hits, pinches, scratches, bites, or pulls hair.

Aggressive behavior may stem from the patients behavior prior to diagnosis, or it can develop as the disease progresses even if the patient wasnt aggressive before.

Dealing with aggressive behavior can be quite challenging for a caregiver and at times scary because they may feel threatened or worry about their own and the patients safety.

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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.

Try to:

  • 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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