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How to Respond to Anger and Aggression in Your Loved One with Dementia

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How to Respond to Anger and Aggression in Your Loved One with Dementia

At-home caregivers of loved ones living with Alzheimer’s disease or other forms of dementia face an increasing number of challenges as the disease progresses.  Two of the more challenging symptoms that can present themselves are anger and aggression.

Susan Irrgang, Executive Director and Administrator at Bryn Mawr Terrace, located in Bryn Mawr, PA, says, “Because loved ones with dementia are often unable to clearly communicate or express the frustration or discomfort they are feeling, they can become angry and even aggressive. When this occurs, it is important for caregivers to be understanding and not take it personally. They are not the cause of their loved one’s anger. Rather, it is the dementia and the major frustrations it creates. 

“Dementia care experts explain that anger and aggressiveness can manifest themselves either verbally or physically. Also, such outbursts can occur spontaneously or be the result of building frustration. Since anger and aggression can be triggered by a variety of factors such as physical discomfort, poor communication and environmental factors, it is important for caregivers to assess what might be causing the behaviors in order to address them properly.”

Typical Causes of Anger and Aggression in Loved Ones with Dementia

Because loved ones with dementia often can’t communicate what it is that’s troubling them, the responsibility for identifying the cause of the problem typically falls to the caregiver. Fortunately, the Alzheimer’s Association® has compiled a list of the most common physical, environmental and emotional causes of anger and aggression that can make the job of identifying the source easier. These include:

  • Physical pain or discomfort – Is the person with dementia able to communicate that he or she is experiencing physical discomfort or pain? Do they need to use the bathroom?  It is not uncommon for persons with Alzheimer's or other dementias to have urinary tract or other infections. Due to their loss of cognitive function, they are unable to articulate or identify the cause of physical discomfort and, therefore, may express it through physical aggression.
  • Fatigue – Is the person tired because of inadequate rest or sleep?
  • Hunger or thirst – Is your loved one hungry or could they be dehydrated?
  • Medication side effects – Are medications causing side effects? Side effects are especially likely to occur when individuals are taking multiple medications for several health conditions.
  • Overstimulation – Is the person overstimulated by loud noises, an overactive environment or physical clutter? Large crowds or being surrounded by unfamiliar people — even within one's own home — can be over-stimulating for a person with dementia.
  • Time of day -- Most people function better during a certain time of day; mornings are typically best. Consider the time of day when making appointments or scheduling activities. Choose a time when you know the person is most alert and best able to process new information or surroundings.
  • Communications issues -- Are your instructions simple and easy to understand? Are you asking too many questions or making too many statements at once? Is the person picking up on your own stress or irritability?

Expert Tips for Coping with the Anger and Aggressive Behavior of Dementia

Once you have a sense of what is causing the anger or aggression in your loved one, it is much easier to resolve it. For example, their anger or aggression might be easily resolved by a trip to the bathroom, turning down a TV that’s too loud, turning off bright lights or turning down the heat.

However, sometimes the cause of their anger or aggressiveness is not immediately clear. Therefore, it is important to take steps that have been shown to reduce anger and aggression in a wide variety of situations. The Alzheimer’s Association article, Treatments for Behavior, offers useful coping tips including:

  • Check on their personal comfort -- Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation that can cause agitation, anger or aggressiveness. Maintain a comfortable room temperature.
  • Stay calm and create a calm environment for your loved one -- Avoid noise, glare, insecure space and too much background distraction, including television. These types of annoyances can increase stress, anxiety and agitation that can also lead to anger and aggression.
  • Don’t be confrontational or argumentative – Go with the flow! For example, if your loved one with dementia wishes to visit a parent who died years ago, don't point out that the parent is dead. Instead, try saying, "Your mother is a wonderful person. I would like to see her too."
  • Focus on their feelings not their actions – Trying to rationalize with a person with dementia will not be successful. Instead, recognize that their discomfort is real, even if the reason for it seems irrational. Try to redirect their attention away from their source of anger
  • Take a break – If you can’t reduce their anger or aggression during a particular outburst, and they are safe in their environment, walk out of the room. Take a short break to gather yourself and let them try to do the same. Also, give your loved one with dementia sufficient downtime between stimulating events to reduce their stress and the potential for anger and aggression.
  • Provide a security object – A favorite personal security object can also reduce stress and anxiety and reduce the chances of your loved one with dementia becoming angry or aggressive.
  • Ensure your safety – If you feel that your loved one with dementia could harm themselves or you, call for help immediately. Inform the first responders that the person has dementia.
  • Don't take their behavior personally -- Always remember that the anger or aggression you observe is the fault of the dementia and not your loved one.  Treat them with a calm, understanding approach that reassures them of your love and minimizes their stress

Dementia care experts advise that if the episodes of anger and aggressiveness get worse, you should seek medical advice. As a last resort, they say, antipsychotic medications can help to keep the person safe from injuring themselves or others.

We invite you to read our other timely articles on current caregiver subjects and dementia care topics posted on our website.

We Would Love to Hear from You!

If you have comments or questions about our blog on How to Respond to Anger and Aggression in a Loved One with Dementia, we’d love to hear from you. We also encourage you to share any of your caregiving experiences in our comments section.

Engaging Days. Meaningful Moments.

Loved ones with Alzheimer’s disease or other memory impairments require specialized care and support.

They also deserve a lifestyle rich in dignity and fulfillment. Impressions Memory Care at Bryn Mawr provides residents with Engaging Days and Meaningful Moments that emphasize individual abilities, encourage socialization and promote the highest level of independence possible. We offer a complete continuum of leading-edge programs, services and amenities that address the total physical, emotional and social needs of residents in a caring setting that offers individual suites with large private baths and the comfort of home. Our memory care community touches hearts and changes lives.

Helping Families Be “Family” Again

Memory loss caused by Alzheimer’s disease, dementia or another form of memory impairment doesn’t only affect the person who has it – it affects the entire family.

If you have a loved one with early- to mid-stage memory loss, you know how challenging it can be to provide the care that’s needed while trying to maintain balance in your life. As care needs increase, you may not be able to meet them physically or emotionally. It’s often difficult to be available to care for your loved one’s health and well-being around the clock.

If and when the time comes to seek additional help, place your trust in Impressions Memory Care at Bryn Mawr. We lift the stresses and worries of being a caregiver from your shoulders, enabling you and your family to enjoy time with your loved one again.

For more information, please call Sharon at 484.380.5404 or contact us online.

Disclaimer: The articles and tip sheets on this website are offered by Impressions Memory Care at Bryn Mawr and Main Line Senior Care Alliance for general informational and educational purposes and do not constitute legal or medical advice. For legal or medical advice, please contact your attorney or physician.