Dementia and Aggressive Behaviour

People living with dementia can sometimes exhibit behaviour in ways that can be aggressive. Whether that’s physical or verbal, the actions of the person can be distressing for them and those around them. The nature of the behaviour can lead to friends and family agreeing that their loved one would benefit from professional support such as home care or dementia care.

What is Aggressive Behaviour?

Aggressive behaviour includes:

• Verbal – screaming, shouting, swearing and making threats.
• Physical – biting, hitting, hair-pulling, pinching, scratching.

Dementia and anger outbursts can be linked to how the person behaves before the illness developed, however, it has been known for people to develop aggressive behaviour who have never shown such behaviour before in their life.

What Causes Aggressive Behaviour?

Dementia causes pain for the person going through it which brings a need from them to feel comfortable. They also want to talk to people around them, feel engaged and feel well. However, dementia can make it difficult for people to understand their needs and their way of expressing what they want is through violent actions. There are various needs they may have for their aggressive behaviour.

Physical Needs

• They might be in pain, unwell or discomfort.
• Side effects of medication – drowsiness can lead to communication issues.
• The environment is too busy, overwhelming or too hot or cold.
• Poor eyesight or hearing causes misconceptions.
• Hallucinations lead to aggressive behaviour.
• Dementia affects judgement and self control.
• Lack of understanding for their behaviour.

Social Needs

• The person may feel lonely and not included or valued.
• They might be bored with not much to do.
• The person might not like their care professional.
• They could be hiding their condition from others.

Psychological Needs

• A feeling of their needs and rights not being respected or are being ignored. This can be down to their own misperceptions, memory difficulties or problems.
• A feeling of being stopped from doing what they want.
• Frustration with being unable to complete simple tasks.
• Depression or other mental health issues.
• Misunderstanding of why they have a person caring for them. They could feel that the carer is invading their space.
• Finding it difficult to accept that carers are helping them with intimate tasks such as washing, dressing and going to the toilet.
• Feeling threatened by a strange or unfamiliar environment.
• Lack of understanding of the world around them.

How to Deal with Aggressive Dementia Patients

It’s difficult to respond to aggressive behaviour, but you must take time to think of your loved one and why they might be behaving aggressively. It’s likely they aren’t doing it on purpose and reasoning with them is unlikely to lead them to change their behaviour.

Here are tips for things you can do and avoid doing while the person is behaving aggressively.

During the Aggressive Episode

• Don’t react straight away. Take a breath and give the person space and time. Leave the room until you’re both feeling calmer.
• Stay calm. Meeting aggression with an angry response will make the situation worse.
• Ensure your safety. Never tolerate violence against yourself.
• If they are being physically violent, try not to show any fear, alarm or anxiety. Walk away from the situation and call for help.
• Reassure the person and acknowledge their feelings.
• Don’t take aggressive behaviour personally as this is likely their way of trying to communicate with you of an issue they may have. Listen to what they have to say and mirror their body language if possible.
• Keep eye contact with the person to explain why you are there. Encourage the person to openly communicate with you.
• Are you supporting the person with a task? Does it need to be completed now? It’s good to stop, give them space and try again later when you’re both calmer.

After the Episode

It’s easy to blame the person for their aggressive behaviour but they are unlikely to have done it on purpose. If you treat your loved one differently, they will not understand why you are. Carry on as normal and be reassuring to them. You must remember to focus on the person and not their behaviour – they’re still the person you care about.

If you’re struggling with the emotions of dealing with an aggressive episode, talk to friends, family or even your GP or counsellor. The professional carers at Sova Healthcare are also happy to discuss your feelings with them if need be. Without this support network, you can focus on the behaviour and not the person you care for.

Managing Aggressive Behaviour

Aggressive behaviour can be prevented in those suffering with dementia by following a few steps:

1. Identify the problem – Consider all factors for their behaviour from the environment to the situation you’re in.
   
2. Analyse the situation – Where and when does the problem happen? Is it usual for them to act this way? Are visitors involved?
   
3. Focus on how the person feels when behaving aggressively – Are they unwell, uncomfortable or in pain? Tired? Delusional? Bored?
   
4. Identify what the person is reacting to – Are they reacting to a bad incident? Are they scared of something? Has something changed? Has a memory returned to them?
   
5. Have a behaviour management strategy – Develop a range of techniques that will keep the behaviour down to a minimum. Try different things to work out what is best for you and them.

Aggressive behaviour shown by a loved one going through dementia is difficult to contend with emotionally, but with the right strategies and support around you it will be okay. Sova Healthcare can provide a fresh approach to home care services. With various options available for your loved one – including domiciliary care – we can help with taking care of your loved one with specialist dementia care services. For more information, get in touch with us today.