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Dealing with Aggression

Learn how to deal with aggression often caused by Alzheimer’s or dementia.

It is estimated that in the UK there are over 700,000 unpaid carers for someone with Alzheimer’s or Dementia. What is often feared most by these carers is not forgetfulness or confusion but aggression.

Aggression is a symptom of both diseases (Alzheimer’s leads to dementia, and understanding the patient’s perspective is key to providing person-centred care. If immediate danger is present, ensure your safety and seek professional help. 

Identify and address the triggers

Aggression is often a sign of an unmet need or an inability to communicate. Keeping a log of when these episodes occur can help you identify patterns and anticipate potential triggers. Common causes of distress include: 

  • Physical discomfort: Rule out physical causes, such as pain, illness (like a urinary tract infection), hunger, thirst, or fatigue, by consulting a doctor.
  • Environmental factors: The person may feel overstimulated by loud noises, glare, clutter, or unfamiliar people. A space that is too hot or cold can also cause distress.
  • Routine changes: Upsetting the daily routine for meals, bathing, or sleep can cause confusion and frustration.
  • Confusion and frustration: Difficulty performing simple tasks, following conversations, or understanding surroundings can lead to angry outbursts.
  • Perceived threats: The person may feel threatened or have paranoia due to delusions or a misunderstanding of what is happening.
  • Caregiver stress: A patient can pick up on a caregiver’s frustration or impatience, which may worsen their agitation. 

De-escalate the situation

When aggression occurs, your response can either worsen or improve the situation.

  • Stay calm: Your calm demeanour can help soothe the patient. Take a deep breath and give them space.
  • Do not argue: Reasoning or correcting a person with advanced dementia will only increase their frustration. Focus on their feelings, not the facts.
  • Offer reassurance: Use a soft, patient, and loving tone. Acknowledge their feelings and reassure them that they are safe.
  • Use distraction: Gently shift the person’s focus to another object or activity, such as a favourite TV show, snack, or soothing music.
  • Slow down: If you are helping with a task like getting dressed, and they become agitated, step back and try again later. Rushing can make things worse.
  • Give space: Back away and remove yourself from the room if necessary to keep both of you safe. Ensure a clear path to an exit.

Prevent future incidents

Modifying the environment and routine can reduce triggers and promote a sense of security.

  • Create a routine: A predictable daily schedule for meals, activities, and sleep can minimize confusion. Incorporate soothing activities like listening to music, exercise, or spending time outdoors.
  • Reduce clutter: A simpler, less cluttered environment can decrease overstimulation and disorientation.
  • Address physical needs: Ensure the person gets enough rest, stays hydrated and nourished, and is a comfortable temperature.
  • Stimulate the senses: Gentle hand massages, aromatherapy, or repetitive, calming tasks like folding towels can be effective.
  • Improve communication: Speak slowly, use simple and specific language, and avoid open-ended questions. Maintain eye contact and use non-verbal cues like a smile or gentle touch. 

When to seek professional help

If aggressive behaviours escalate, medical intervention may be necessary.

  • Contact a doctor: See the patient’s doctor to rule out or treat any medical issues, review medications for side effects, and develop a management plan.
  • In case of an emergency: If the person becomes physically violent and you feel unsafe, call emergency services. Inform them that the person has dementia.

Prioritize self-care

Caring for a person with aggressive behaviours can be draining.

  • Use respite care: Utilize temporary respite care services to take a break and recharge.
  • Find support: Talk to family, friends, a counsellor, or a support group for caregivers. You can also contact a dementia helpline for advice.
  • Stay healthy: Maintain your own health with regular exercise, a balanced diet, and sufficient rest.

Aggression in an elderly person is heartbreaking, but it’s not hopeless. With calm responses, careful observation, and supportive tools, you can make things easier—for them and for you. The goal is safety, dignity, and a little more peace in the storm.

Learn how to spot the early signs of Alzheimer’s which can be key to coping with the disease.

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