How Do I Manage Combative Behavior in My Loved One with Dementia?

Arizona Dementia CareMom doesn’t have a mean bone in her body, but recently, that sweet elderly woman who’s been known for her gentle demeanor throughout her life has been exhibiting combative and aggressive behaviors, courtesy of Alzheimer’s disease or another form of dementia. How can the family members who love and care for this senior cope with these new challenges?

It’s important to note that once your loved one experiences an episode of dementia-related aggressive and combative behavior, the likelihood of it occurring again is high. The staff at Nightingale Homecare understand that the best way to manage combative behavior is to prevent it.

Proper management can significantly decrease aggressive incidents. Body language, appearance and tone of voice that convey kindness and calmness are probably the most important tools to utilize when approaching a combative person. Perform tasks gently, and avoid hurrying or pressuring your loved one. Giving the appearance of impatience or annoyance may trigger a combative reaction. Provide a predictable, calm environment and ensure that your loved one’s needs for food, rest, comfort, and social interaction are met. You may have to remind your loved one who you are frequently, to avoid anxious or aggressive reactions with a possible mistaken identity.

Evaluating and understanding some important factors about your loved one’s aggressive episodes is crucial to circumventing future occurrences. It may be helpful to document for other caregivers and family members the answers to these questions:

  • What triggers the aggressive behavior?
  • What early signs of aggression does my loved one display?
  • Does my loved one’s behavior progress to physical violence?
  • What helps my loved one to calm down?

When working with an aggressive/combative loved one, it is important to maintain a constant awareness of your loved one’s mood and affect. Even subtle reactions, like clenched jaw and fists or a stiffening of the body will give you some clues that the loved one may have difficulty coping and is feeling anxious.

Signs of escalating aggressive behavior may include:

  • Raised voice, yelling with possible cursing, or sexualized language
  • A frightened or angry look in the eyes
  • Tensing of the body, such as clenched fists
  • Increased respiration
  • Flushed face
  • Pacing or repetitive behavior with agitation
  • Removal of clothing, bandages, NG tube, oxygen tubing or IV lines
  • Threats to family or caregivers
  • Paranoid ideation
  • Aggressive use of objects in the environment: grabbing, pulling and throwing things
  • Hitting, pinching, spitting, pushing, kicking

Should your loved one become combative, remember that your goal is to de-escalate or “bring down” the reaction. It is important to verbally acknowledge your loved one’s distress by showing concern and avoiding an authoritarian or harsh tone. It is also important to project a calm, yet attentive, facial expression. Your loved one is likely to become more agitated if you react by becoming agitated too.

Verbal de-escalation skills can be learned through training and practice. The specially trained dementia care staff at Nightingale Homecare can assist you in learning these techniques. Give us a call at 602-504-1555 and we’ll arrange a time to meet with you to offer tips on helping your beloved senior remain calm and to feel at peace. Our Arizona home care services for those with Alzheimer’s  are also an invaluable resource for families, providing the compassionate, expert dementia care needed to allow family caregivers a chance to catch their breath, relax and enjoy some much-needed downtime. Contact us any time to learn more.