Managing Anger and Aggression in Dementia

James Hourihan, Author

Dealing with the aggressive behaviour of people with dementia can be a challenging task, not only for the person affected, but also loved ones and staff. Outbursts of anger are often a common and distressing symptom of dementia that can lead to safety concerns and disrupt relationships. 

Understanding what triggers anger and aggression in dementia is crucial to handling these challenging behaviours, and responding appropriately during crisis situations. 

Causes of Aggression in Dementia 

While anger and aggression in dementia may seem unpredictable, it can happen due to various reasons and identifying the root cause is vital in supporting individuals affected by this condition. 

Physical Discomfort 

People with dementia may struggle to express basic needs like hunger, pain, and discomfort, which often leads to immense frustration and increased episodes of aggression.

Delusions & Paranoia 

Delusions and paranoia which are also common symptoms, particularly of dementia with Lewy bodies, can trigger aggressive behaviour as the person may feel threatened, mistrustful, and refuse to cooperate with staff and their relatives.

Loneliness & Boredom 

Loneliness and boredom are two other notable factors that can cause aggression in dementia. A lack of social interaction, exercise or activities can increase anxiety and frustration, contributing to aggressive outbursts.

Poor Communication  

Communication breakdowns arise when individuals with dementia struggle to comprehend staff instructions, or become disoriented due to jumbled memories or thoughts, leading to feelings of frustration and irritability. 

Environmental Triggers

Changes in routine, new or unfamiliar people, and over-stimulation by noise or clutter are all environmental triggers that have a profound impact on mood and behaviour, which can heighten anxiety levels and provoke aggression. 

Medication 

Additionally, medication side effects should not be overlooked, as they can cause adverse reactions like fatigue and loss of appetite in people with dementia, leading to feelings of agitation. 

How to Respond to Anger and Aggression in Dementia 

Responding to dementia-related anger and aggression requires patience and a willingness to adapt your approach as needed to prevent or minimise the frequency/severity of outbursts.

Remember that these behaviours are not the person’s fault, but rather a manifestation of the disease. With the right strategies in place, you can help create a calming and supportive environment.

  1. Appear Calm 

As difficult as it may be, it’s essential to appear calm when dealing with aggressive behaviour. Yelling or arguing in response only heightens the tension. Instead, practise deep breathing and stay composed while soothing the person to de-escalate the highly-charged atmosphere. 

  1. Give Space & Time 

If possible, create distance between yourself and the agitated person, giving them time to calm down. Leaving or stepping out of the room for a few moments can reduce their stress levels and make the situation more manageable. Remember, sometimes less interaction is the key to resolving a conflict.

  1. Avoid Using Restraint

Unless your safety or the safety of others is compromised, avoid using restraint when responding to anger and aggression in dementia. Grabbing or taking hold of the person could exacerbate the situation and increase their level of anger. Always seek assistance in emergency situations. 

  1. Acknowledge Their Feelings

Sometimes, all the person with dementia needs is for you to acknowledge how they are feeling and validate their experience. Be empathetic, listen to what they are saying, and respond with compassion, which could help you in figuring out what the underlying problem may be.

  1. Create a Relaxing Environment 

Creating a soothing environment can help to calm aggressive individuals with dementia. For instance, using soft lighting, playing gentle music, diffusing essential oils, or providing them with their favourite snack can make for a more comfortable atmosphere.

  1. Distraction & Redirection Techniques 

Redirecting conversations, changing the scenery, or offering activities are other forms of behaviour management to distract the person from their stressors. Playing a board game, working on a puzzle together, enjoying a walk outdoors or watching their favourite TV show provides a range of diversions to shift their attention and mood.

  1. Try Cognitive Stimulation Exercises 

Additionally, cognitive exercises are great for alleviating boredom and restlessness in individuals with dementia. Crossword puzzles, Sudoku, or reading a book together are just some examples of mental stimulation that can distract them from any feelings of frustration.

  1. Stick to Routine

Lastly, consistent routines can have a significant positive impact on dementia patients, helping them to feel more stable and less disoriented. This ultimately reduces the likelihood of aggressive behaviour and therefore it’s vital to establish regular meal times, activities, and bedtime.

Working with people suffering from dementia who exhibit aggressive or violent behaviour is not easy. However, implementing effective behaviour management strategies in your care approach can promote their sense of security and support, leading to an overall improvement in their quality of life.

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Timian empowers organisations nationwide to achieve more positive outcomes by utilising de-escalation techniques and non-restrictive interventions to support and aid the most vulnerable members of society.

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