Among the many challenging behaviors the caregivers of Alzheimer’s patients may experience, those of aggression and agitation may be the most upsetting and scary. Although it can be difficult to cope with, it is often helpful for caregivers to understand that the person with Alzheimer’s is not behaving this way on purpose, and that there are ways to help identify the cause and manage these behaviors.
Aggressive and agitated behaviors may exhibit physically or verbally and can come on suddenly, with no obvious reason. Due to the loss of cognitive function, those with dementia are unable to articulate or adequately identify their discomfort or frustration, and instead attempt to communicate with agitation or aggression. Some likely causes of this behavior may be physical discomfort, poor communication, or environmental factors, but whatever the cause, when caregivers are prepared, they can more easily identify the precipitating events, and work towards managing the behavior.
Possible Causes of Aggression
- Physical discomfort or pain
- Thirst or hunger
- Incontinence or soiled underwear
- Depression or loneliness
- Too much noise or confusion
- Inadequate sleep or rest
- Sudden change in place or routine
- New or multiple people in the environment
- Pressure to complete a task
- Frustration with not remembering
- Too many questions or instructions aimed at the patient
- Medication reaction or interaction
Ways to Respond
When you begin to notice signs your loved one is feeling agitated, like pacing, restlessness, sleeplessness or yelling, here are some ways you can respond to the behavior before it escalates:
- Try to identify the cause; think back to what occurred right before the agitation. Try to rule out pain as the cause as soon as possible.
- Focus on feelings, not the patient’s words, when you communicate. Look for the feelings behind the words.
- Reassure the patient while listening and speaking calmly to address concerns and frustrations.
- Keep a routine as much as possible, while building periods of activities and quiet time into the day.
- Keep the house filled with familiar objects, pictures and keepsakes which can help the patient to feel secure.
- Limit clutter, noise and unfamiliar people.
- Minimize distractions. Assess the patient’s surroundings and adapt them to avoid similar reactions in the future.
- Slow down your movements and relax around the patient; do not get upset. Be positive and reassuring.
- Shift the focus to another activity. Try using music, massage or exercise to help soothe the patient.
- Take a break. If the patient is in a safe place and you are able to walk away and take a deep breath and a moment for yourself, do it.
Physically Violent Behaviors
When you are a caregiver on the receiving end of an outburst or physically aggressive behavior, your safety as well as that of the patients are top priority. When violent aggression is directed at you, keep a safe distance, putting a large piece of furniture between you and the patient. Continue to remain calm and speak in a soft, slow tone, using reassurance. If it is necessary to protect yourself and the patient from hurting himself or herself, or another person, call 911.
If you do call, be sure and notify responders that the person has dementia which causes him or her to act aggressively.
If you are unable to find the cause of agitation, it is occurring more frequently, or you need more solutions for the behaviors, get help from the senior’s physician or health practitioner. A medical exam to discover the reasons behind the agitation and aggression may be in order. Ask the senior’s health practitioner if he or she recommends a medication to prevent or reduce the behavior.
Take Time for You
Being a caregiver for a patient with Alzheimer’s can be challenging in the best of times, but when your loved one has moments of aggressive behavior, it can be highly stressful. In the aftermath of these moments, do not overlook your own health, and the need to retreat, reflect and decompress. Such self-care time will give you a chance to refuel and continue to provide the important work you do for your loved one.
Nightingale Homecare is always on hand to provide trusted and highly specialized care for those with dementia, allowing family members to take a much-needed break. Our Dementia Connections Care Program offers a unique approach to better managing the unique challenges of Alzheimer’s through certified Alzheimer’s Whisperers® who not only work to make life as comfortable as possible for the person with dementia, but provide training to family members so they can apply the same strategies themselves.
Contact Nightingale Homecare, top providers of professional in home care Paradise Valley, AZ seniors need, any time by calling (602) 504-1555 to schedule a free in-home consultation to learn more, or to request additional resources related to effective care for those with dementia.
