Caregiver Insights
Dealing with Challenges
Dealing with Aggressive Behavior
Most people with Alzheimer’s will have aggressive or angry behavior occasionally. Some are aggressive frequently. The disease can trigger violent mood swings and outbursts at any time. The reasons for this behavior are widespread, including personality changes, brain damage, anosognosia, and physical pain. This article will focus on how to deal with aggressive behavior, rather than delving more deeply into its causes.
Recognize that aggression is symptomatic of the disease and will likely occur even if they love you. You may never be able to predict why or when aggression will happen. So, it is wise to always be prepared to manage the situation as well as you can.
Your first defense is a good offense. Be positive whenever you approach your loved one. Show that you are happy to see them. Smile. Set the tone. Be gentle. Avoid anything negative or accusatory. This will not always work, but every time it does, you will have avoided a negative experience. Whenever possible, approach them from the front. This avoids disruptive surprises and increases your chances of setting a positive tone.
At the first sign of aggression, understand it is probably not personal. Recognize that this is the disease acting out, not the rational actions of the person you have loved in the past. Be understanding. Communicate calmly and refuse to argue. Avoid showing frustration. Step out of the room or take deep breaths and count to ten if you feel yourself getting upset.
When aggression surfaces, stop whatever is happening, and divert their attention in either of two ways:
Option One (if they are verbal): Change the conversation and get them talking about something they are comfortable with (“Let’s talk about something that will make us both happier…”) Pick from a list you maintain of their favorite subjects or stories, like:
People who inspired them, including their children and grandchildren.
Successes they had when they were younger,
Things that they love or that make them laugh,
Team sports or activities they enjoyed,
The most memorable family activities or events.
Option Two: (whether they are verbal or not): Change the mood by changing whatever activity is going on (“I can tell you’re upset, and I’m sorry. But I bet you would rather be doing something more fun. Let’s…”)
Go get ice cream or a cookie,
Go for a walk or sit on a porch,
Watch something on TV,
Listen to some of your favorite music,
Look at old photos,
Play a game or do a puzzle.
When aggression recurs, realize you are not alone! Reach out for help from family members, friends, neighbors, support groups, or professionals. Whenever your loved one is exhibiting harmful aggressive behavior, move to a safe distance. Keep objects that can harm oneself or others (like keys or other sharp objects) out of reach.
Under the best of circumstances, dementia caregiving is challenging. But aggressive behavior makes it doubly so. While you are committed to being a good caregiver, never forget that your life matters too. You need time to yourself so you can relax and recharge. One of your most important jobs as a caregiver is to find a way to make this happen.
Finally, be aware that federal laws exist to delay or prevent nursing home placements, encourage aging in place for older adults, and provide preventive health services. These include caregiver education, counseling, and respite care. The services are free and are typically provided by county governments.
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