Recently I met with two sisters to discuss housing options for their mother with dementia. Mom was living with one of the sisters in a two bedroom apartment. The other came one day per week to spend time with mom and give the caregiving daughter a break. They do live in a town which is what I would say is focused on a senior population. Mom is still pretty functional, but wants to go out and cruise around the neighborhood. This is a real hardship for the daughter who has physical and mental limitations herself. During our conversation we discovered that she would try to reason with her mother, when this kept re-occurring she of course would get irritated. Turns out she doesn’t understand that you do not reason with a person with dementia. We hope we got that message through to her to make her life somewhat easier until we find a new home for mom.
So far there hadn’t been any major aggressive behavior from mom but this leads into how to deal with aggressive behavior in a person with dementia.
What is aggression?
It’s a destructive or hostile action or behavior directed toward oneself, other people or objects.
What can trigger aggression in a person with dementia?
Pain, physical illness, dehydration, depression, anxiety, not enough sleep, drug changes or the wrong one, and it can be as simple as being constipated. Or just being frustrated – feel that they are not understood, not able to communicate how they feel, the list can go on. Maybe they just don’t understand what they are being asked to do something.
How to deal with aggression.
Try to identify if there is a pattern to the person’s aggressive behavior, then take steps to hopefully prevent it in the future. Do this by keeping a written account/diary of these events, noting if there is a pattern, then figuring out how to avoid the triggers. For example if you find that these outbursts occur when they are asked to do something, maybe the request can be simplified or made more specific: instead of saying “dress yourself”, say “put this shirt on”.
What about medication for aggression?
Sometimes behavior modification isn’t enough to help control aggressive behavior. Currently there are no drugs specifically approved for treating aggression in dementia, but research does show that a number of medications may be helpful. These include antidepressants, antipsychotics, and anti-anxiety drugs. Be sure to discuss this their doctor.
In review, steps to take to diffuse aggressive behavior in a person with dementia:
Stay calm and stop whatever it is you are trying to get the person to do.
Give them space so they do not feel threatened.
Do not argue, make degrading comments or punish the person physically or psychologically.
Remember they will most likely not recall the event or be able to learn from it.
Get support, e.g. contact the Alzheimer’s Association for caregiver support groups and training programs for caregivers.
Submitted by Anita Oberhelman of Anita’s Senior Referrals
Anita has been helping Seniors and their families find housing and care when they no longer can live independently since 1991. Anita and her husband have lived in Portland area since 1975, raising 3 sons and 1 daughter outside of Hillsboro. Now there are 7 grandchildren to spoil and enjoy. She continues to enjoy helping Seniors and their families find the best care and housing, her motto has always been would I place my own parents there.