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Dealing with Aggressive Behavior in Someone with Dementia

  • 10 tips to dealing with aggressive Alzheimer’s disease or dementia behaviour
  • What to do after the aggressive episode
  • Help with Alzheimer’s disease and dementia in Etobicoke, Mississauga, and Brampton

Caring for an older loved one who’s been diagnosed with Alzheimer’s disease or dementia can be a loving, warm experience, although there are times when challenges such as wandering or sundowning require unique strategies to minimize the behaviours.

Another challenge that can be jarring is when the older person becomes aggressive or combative due to the progression of the disease.

Aggression is a standard part of progressive cognitive diseases and is indicative of the damage being caused to the brain. Even if the person has been kind, patient, and non-violent throughout their lives, they can still have bouts of anger. These episodes can escalate into screaming, cursing, grabbing, biting, hitting, kicking, pushing, or throwing things as they move forward in their dementia journey.

Although you might be tempted to defend yourself with words or fight back, this can only worsen the situation, especially over the long term.


10 tips to dealing with aggressive Alzheimer’s disease or dementia behavior

We recommend trying these nine strategies to help de-escalate dangerous situations and prevent them from happening in the future:

1. Stay calm and use a gentle tone: It’s essential to remain calm in the face of aggressive behaviour from an older adult. If you get upset too, the situation will only get worse. Breathe slowly and keep your tone soft and reassuring. A gentle touch on the arm or shoulder, if appropriate, can also help diffuse the situation.


2. Validate their feelings: Everyone wants to feel validated when they’re angry or upset. Older adults also need validation, but due to declining cognitive abilities, they may not be able to articulate what’s bothering them. Even if you don’t know the cause of the behaviour, reassure them that it’s okay for them to feel the way they do and that you’re there to help.


3. Avoid escalating the situation: Sometimes, simply staying quiet and giving that person some room is all you need to de-escalate and calm the situation. Avoid the urge to argue, talk back, or stop them from doing what they’re doing (unless it will cause someone harm). Listening and observing will give you an opportunity to further understand the person and hopefully discover the trigger of the behaviour.

4. Make sure the person isn’t in pain: Pain or other forms of physical discomfort can be causing aggressive behaviour. Check to see if they need medication for existing conditions that can cause pain, such as gout or arthritis, if they need to use the toilet, or if they’re uncomfortable.

5.  Try to determine what triggers the behaviour: Frustration, fear, and pain are common triggers to sudden outbursts. Can you figure out what happened just before the aggressive behaviour started? Perhaps they see shadows on a wall that frightens them, causing them to become upset. In this case, you can dim or shut off the light that is causing the shadows.

6. Create a calming environment: Excessive noises or stressful, busy environments can cause an older person with Alzheimer’s disease or dementia to become upset. Turning off the television, turning down the volume of music or the radio, and asking other people to leave the room might bring the older person back to a state of calmness.

7. Use redirection to reduce aggression: Redirection is a technique that shifts the older person’s attention from what’s bothering them to something they enjoy. For example, if they seem frustrated, ask them to play a song on the piano or invite them to tell you the story behind a treasured photograph.

8. Play their favourite music: Music has incredible power to set a mood, recall fond memories, or create a desire to dance, sing, or tap along. Refrain from putting the music on too loud or too suddenly, so you don’t startle the older person and possibly upset them further.

9.  Leave the room: The older person may be inconsolable, despite your best efforts to reassure them. When you start to feel frustrated, step out of the room to give both of you some breathing space. Before you go, make sure that the area is safe and that the person likely won’t harm themselves while you’re away. After a short time, the person might calm themselves down or be in a better frame of mind.

10. Call for help in an emergency:

  • If the situation becomes dangerous and you believe one of you might get hurt, call a family member, friend, or neighbor for assistance.
  • In extreme cases, call 911 for help but be sure to explain to the operator and first responders when they arrive that the older person’s behaviour is caused by dementia (or “mental illness” if they’re not familiar with dementia conditions). This information will help them act appropriately.
  • If the older person needs to be removed from the home, ask that they be taken to a hospital and not to the police station as their actions were caused by cognitive decline and not criminal intent.

What to do after the aggressive episode

Once the aggressive episode has passed, and everyone is calm again, there are some things you can do to help give perspective on the situation, heal yourself, and be prepared if it happens again.

  • Reflect on the incident: Aggressive episodes can be traumatic for caregivers. Take some time to reflect on the situation and see what you can learn from the incident. Think about possible triggers, what sort of reactions worked, and which responses threatened to escalate the episode. Also, try to identify patterns leading up to the behaviour to help prevent them from happening again.
  • Seek out support: There may be support groups in your area where you can tell your story, hear about other people’s experiences, and trade ideas for managing aggressive behaviour. If there are no support groups nearby, you can always share your feelings with a close friend, family member, doctor, or religious leader to relieve pent-up stress.
  • Talk to their doctor: If you can, speak with the older adult’s physician to see if appropriate therapeutic or medication options can help lessen aggressive episodes and improve the quality of life for you and your loved one.
  • Hire in-home care professionals: As your loved one continues through their dementia journey, it might be prudent to hire in-home care professionals specializing in supporting people with cognitive decline. In-home care services will take much of the stress away and bring peace of mind knowing that professional care is there when you need it. 

Help with Alzheimer’s disease and dementia in Etobicoke, Mississauga, and Brampton

When you need help caring for an older loved one who’s been diagnosed with Alzheimer’s disease or dementia, CareHop is only a phone call away

We specialize in providing thoughtful, respectful, empathetic care that ensures that all of your loved one’s needs are met. Our team works on a live-in or on-demand basis to bring joy and sunshine into the older person’s life and peace of mind to your family.

For more information about our programs that focus on your family’s needs, please feel free to contact us anytime.


About the Author

Michael Lu is the founder of CareHop. He started the business inspired by his Grandmother to look at ageing as a happy experience to bring sunshine into the homes of others.

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