One of our goals at Nightingale Homecare is to place caregiving tools in the hands of those struggling to provide senior care to a beloved family member suffering from dementia, knowing how difficult it can be to know where to turn when challenges seem insurmountable. We’ve previously shared some tips on how to recognize and diffuse the combative, aggressive outbursts that Alzheimer’s patients sometimes exhibit, and we have a few more tips to help caregivers de-escalate these challenging behaviors.
And so, for the next time you find yourself confronted with an aggressive episode, we offer you the following steps to help restore a sense of calm and peace:
- Avoid aggressive signals, such as clenching fists or crossing arms.
- Maintain caring eye contact, while trying not to stare aggressively at your loved one.
- Breathe slowly and deeply.
- Stand at a slight angle, at least two arm lengths away, avoiding fully-facing the agitated person to protect the chest and abdomen if he or she suddenly hits or kicks.
- Keep the nearest door open, and position yourself between the loved one and the door, so that he or she is not blocking the exit if you will need to leave quickly.
- If possible, position yourself so that there is a piece of furniture between you and your loved one, for further protection.
- Speak in a firm, calm voice.
- Watch the tone and volume of your voice. Keep it low, as most people tend to raise both their tone and volume when excited or threatened, resulting in high-pitched yelling.
- Say something that helps your loved one to know that you understand his feelings: “Mom, I can see that you’re really upset, and I want to help.”
- Treat your loved one with dignity and respect, and never threaten or belittle the person for the behavior.
- Don’t argue or try to reason with your angry loved one, such as saying, “I do not always forget your newspaper.”
- If possible, try to “undo” whatever has made the person agitated. For example, if combative behavior resulted when you approached your loved one to give him a bath, back off and leave him alone for awhile.
- Distracting him with his favorite activity can also be effective: “Dad, your favorite TV show is on now, would you like to watch?”
- When trying to de-escalate a loved one’s behavior when more than one caregiver or family member is present, it is helpful if only one person talks, to avoid confusing or frightening the loved one.
Safety is the top priority when dealing with a combative loved one. If family or caregiver safety is threatened, you should leave the area immediately, and get any other persons to safety, if needed. If the situation is extreme enough that you cannot effectively handle it, the police should be promptly called to assist.
Nightingale Homecare’s dementia care program, “Connections,” has helped numerous families and patients succeed in living safely at home with Alzheimer’s and other dementias. We provide innovative, empathetic, and thoughtful care that has real impact in the lives of those living with Alzheimer’s.
When it comes to choosing an Arizona home care company for your loved one, trust the agency that trains its clinical professionals and caregivers in the “Alzheimer’s Whisperer” program, implemented and guided by Dr. Verna Benner-Carson, a national dementia care expert. For expert home care based on deep understanding of those living with dementia, call Nightingale at 602-504-1555 or contact us online to speak with a dementia senior homecare specialist today.
Mom 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.