Understanding and Managing Alzheimer’s Aggression Behaviors

Caring for a loved one with Alzheimer’s or dementia is already a labor of love. As the disease progresses into later stages, your caregiving role may become more challenging as the person’s needs change. In addition to the increased need for care, individuals with Alzheimer’s or dementia may exhibit difficult, new behaviors, such as physical aggression. Nightingale Homecare has compiled some helpful tips for family caregivers to consider for managing Alzheimer’s aggression.

Causes of Aggressive Behaviors

An individual with Alzheimer’s or dementia may exhibit signs of physical aggression, such as biting, hitting, or violently acting out. The older adult isn’t behaving this way on purpose; the disease can cause people to have sudden changes in behavior. It can help to identify if there’s a cause for the violent outburst, in order to prevent or reduce the cause in the future. Some common causes that may trigger aggressive behaviors include:

• Communication difficulties. Since a decline in communication skills is common in individuals with dementia, an inability to communicate effectively can be frustrating for the individual. They may also feel frustrated if you do not use helpful communication methods, such as speaking calmly, using simple steps, and asking few questions, while caregiving. These frustrations may result in the use of physical aggression as a means of communication.
• Physical discomfort. The person may feel physically uncomfortable due to pain, illness, or injury, but have no effective way to communicate those feelings except through aggressive behavior.
• Environmental issues. Being in an uncomfortable setting with loud noises or large crowds can feel upsetting to someone with dementia. Even being at home, where the person feels safe, can make them feel insecure if there’s a lot of household clutter or too many visitors stopping by.

How to Respond to Aggressive Behavior

It can be scary when a loved one starts acting out aggressively toward you. It’s helpful to remember that the person isn’t choosing to behave this way and may be reacting violently because it’s the only way they can communicate as the disease progresses. Even though it’s difficult, there are steps you can take as a family caregiver to help deescalate the situation or to prevent it from getting worse. Here are some ways to respond when managing Alzheimer’s aggression behaviors:

• Be safe. Do not put yourself or your loved one in danger. If needed, step away from the senior exhibiting aggressive behavior. If they are unable to calm down, seek help from nearby family or friends. If there is an emergency, call 911, and notify the operator that the person’s aggressive behavior is due to Alzheimer’s, so they understand that it isn’t a criminal situation.
• Stay calm. Try not to escalate the situation by getting upset, raising your voice, or arguing. Speak calmly and softly.
• Calm the room. A noisy environment may trigger aggressive behavior. Try lowering the volume on the TV or music or asking people to step out of the room.
• Take a break. Go into another room for a few minutes if you need to compose yourself or to give the older adult some space to calm down. Make sure the room is safe for the person you love before you leave.
• Identify the cause of the behavior. Notice if something happened, or if the individual is uncomfortable or in pain, that may have caused a change in behavior. There may be something you can change or address quickly to help reduce the aggression.
• Find a distraction. If the current activity is too overwhelming, try something different, or try a change of scenery. Moving to another room or switching to an activity the senior enjoys may help to calm the situation. Consider relaxing activities, like listening to music, too.

What to Do After an Aggressive Episode

When you aren’t dealing with a current aggressive episode, there are some things you can do to try to prevent or reduce future outbursts. It can help to take a little time to calm down first before thinking more about the situation. Here are some things to try:

• Document the episode. Keep a journal of each aggressive episode and the events leading up to it. You may notice a pattern forming during certain activities or at particular times that can help you make changes to prevent an incident next time.
• Get support. Caring for a loved one with dementia can bring up a lot of difficult emotions, and that’s especially true after an aggressive incident. It can help to talk with loved ones, or reach out to a therapist, clergy, or support group to discuss your situation.
• Stick to a routine. Having a daily routine for meals, activities, and rest time throughout the day can make the day more comfortable. Consistency also makes the day feel more predictable and may reduce the chance of incident due to surprise.
• Practice self-care. Make sure to take care of yourself, especially after a challenging incident occurs. Find ways to make sure your needs for rest, nourishment, and exercise are met.
• Communicate. Calmly communicate the next part of your routine or any changes to the senior.
• Consult the doctor. It may help to discuss the loved one’s aggressive behavior with a physician to see if any medications may be helpful.
• Arrange for additional help. If you need a break from caregiving, an in-home caregiver can provide you with respite while assisting the older adult you love. Nightingale Homecare provides compassionate caregiving services in Phoenix, AZ and the nearby area.
• Consider alternate housing. If safety concerns make home care feel like it may no longer be an option, it may be time to consider an assisted living option.

Understanding and managing behaviors like Alzheimer’s aggression may feel too challenging at times. Nightingale Homecare is available to provide additional tips and assistance through our Connections dementia care program. Our innovative program includes training for family caregivers and interventions to help the individual with Alzheimer’s continue to receive care safely at home. Contact us today at (602) 504-1555 or through our online form to learn more about our compassionate and professional caregiving services in Phoenix, AZ and the surrounding areas.