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Understanding Behaviors of Dementia: Anger and Aggression

Behavioral changes are common as dementia progresses, and these changes can be stressful or even frustrating for loved ones. As your loved one’s dementia progresses, it’s important that you anticipate these behavioral changes so you can deal with them more effectively.

Aggressive behaviors — verbal or physical — are common, and they can occur suddenly with no apparent reason. Witnessing your loved one’s aggressive behaviors can be difficult to cope with, but understanding he or she isn’t acting this way on purpose, and knowing the correct way to respond can help.

Triggers of Anger and Aggression

There are many factors that may cause your loved one to act out in anger or aggression, including physical discomfort, environmental changes and poor communication. Understanding the cause of the behavior will help you know how to best respond.

Physical discomfort — Is your loved one experiencing physical pain or not feeling well? It can be difficult for someone with dementia to articulate how they are feeling, often causing them to express it through aggression. Lack of sleep or side effects of medications may also cause aggressive behaviors.

If you suspect physical discomfort may be the cause of your loved one’s behaviors, especially if the symptoms appear suddenly, seek medical help.

Environmental factors — Overstimulation through loud noises, physical clutter or an overactive environment can be upsetting to someone living with dementia. Large crowds or being surrounded by unfamiliar people may cause your loved one to become angry or aggressive.

Most people function best at a certain time of day; activities and appointments should be scheduled during the time you know your loved one is most alert and able to process new information or surroundings.

Poor communication — Difficult instructions or information overload may also trigger aggressive behaviors. Be sure your directions are simple and easy to understand and avoid asking too many questions or giving too much information at once. If you, the caregiver, are stressed or irritable, your loved one may pick up on that and become irritable or upset.

Dealing with Anger and Aggression

The first step in dealing with aggressive behaviors is to identify the cause of the behavior. Think about what may have happened to trigger the behavior and rule out pain as the source of your loved one’s stress.

Here are a few techniques to help when your loved one displays aggressive behavior such as agitation and anger, yelling, searching, rummaging or being generally frustrated:

• Remain calm and maintain eye contact.
• Do not confront or correct the behavior.
• Be positive and reassuring.
• Listen and respond, speaking slowly in a soft, calm tone.
• Focus on how your loved one is feeling and attempt to redirect his or her focus to a more relaxing activity.
• Do your best to calmly diffuse the situation, avoiding using restraint or force unless the situation is serious.

For more tips on dealing with anger and aggression, visit alz.org.