Changes in personality and behavior are very common in people living with dementia. But although common, they are not easy for caregivers – especially when changes involve angry outbursts and aggressive behaviors such as shouting and verbal outburst, throwing things, or attempts at physical aggression.
One of the keys to responding to aggressive behaviors is to understand why they are happening. By understanding the reasons for dementia related behavior we can help prevent the behaviors from happening again, and make coping a bit easier.
Why do aggressive behaviors occur?
Dementia can cause individuals to experience confusion, disorientation to time and place, as well as inability to recognize family members and caregivers. This can cause the individual to feel fearful, anxious, or even threatened. Dementia also damages the part of the brain where self-control, expression of feeling, and reasoning are controlled. This can cause the person living with dementia to experience – and then in turn, express – unpredictable emotions.
As difficult as it may be, it is important to not take the behavior personally. The person living with dementia is not behaving this way intentionally, and the challenging behaviors you experience are communication of a need or distress that they cannot express through words.
How to respond
Use dementia aware approach. Stay out of the individual’s personal space. Not only will this help to keep you safe, but it will also help the individual to not feel threatened. Do not touch the individual without first making a connection and ensuring that your touch is welcomed.
Try to identify the cause. Check for physical causes first; pain, hunger, thirst, illness or discomfort and restroom needs can all be triggers for anger and aggression in the person with dementia.
Agree with the person. Avoid using corrective phrases like “stop that” or “calm down.” These are rarely effective and can cause the person living with dementia to escalate even more. Agree with them and assure them you are on their side and you are there to help.
Join the reality of the person living with dementia. Even though they may be expressing things that are not true, it is true to them. Don’t correct them, scold them, shame them or argue with them. Validate their words and feelings.
Ensure the environment is calm. Loud and noisy environments can trigger or escalate the individual.
Redirect the person or shift their focus. Distraction can help take a person’s mind off what triggered the behavior, such as confusion or a distressing thought. Things you can try to redirect the individual:
- An activity they enjoy
- A change of scenery or going for a walk
- A snack/beverage they enjoy
- Playing music
- Prayers or deep breathing
- A phone call to a friend or family member
- Sensory stimulation – heat or cold, a massage, a weighted blanket or cool washcloth
- Asking them to help with something
By identifying not only triggers but things that are calming to the individual you can help to create and enhance their care plan, and create consistency for the individual and their caregivers.
