7 Ways to Reduce Aggressive Dementia/Alzheimer Behaviors

Brain damage caused by dementia and Alzheimer’s disease can sometimes cause people who have never been violent in their lives to begin displaying aggressive behavior. These older adults can begin to throw things, scream, push, grab, kick, hit, curse, or even bite, sometimes with no apparent reason and without provocation. This aggression can be both frightening and difficult for caregivers to handle.

It’s important to remember that these individuals aren’t consciously behaving this way, or doing it to be hurtful. They may not even realize what they’re doing. Their actions are simply due to the deterioration of their brain health.

While you as a caregiver or family can’t necessarily prevent these angry outbursts, you can adopt effective ways to minimize their chances of occurring, reduce your own stress, and keep everyone safe. Here are ways to reduce and prepare for aggressive dementia episodes:

1. Notice signs of an upcoming outburst. Occasionally (although not always) there are warning indications that an aggressive outburst is brewing. If you know your older adult particularly well, you can likely sense when something seems “off.” You may be able to tell that they’re grappling with heightened confusion, frustration, anger, agitation, or minor outbursts. Some of the best ways to dissipate approaching storm clouds are distracting the individual with a soothing activity they enjoy, changing the environment if it’s too stimulating, providing extra comfort and support, or offering a favorite beverage or snack. (Be aware, however, that some aggressive episodes come out of nowhere, so you may not always have an advance warning.)
2. Stick to a regular daily routine. Creating and adhering to a regular daily routine for your senior helps to minimize stressful or unexpected events, both of which can contribute to unwanted aggression. Keep in mind that dementia has been causing them to slowly lose control over their physical and cognitive abilities, as well as take away much of their independence. This causes them to be faced with a greater amount of unpredictability and unknowns, which can be frightening and stressful. Providing structure to their days so they have some idea of what to expect can go a long way toward reducing the anger and anxiety that often fuel aggressive dementia behavior.
3. Create a calm living environment. When an environment is distracting or makes it difficult for someone with dementia to complete basic tasks, it can quickly increase their agitation or frustration levels, triggering aggression or outbursts. On the other hand, creating a relaxing environment helps to minimize agitation and confusion, calming the individual and allowing them to concentrate on necessary daily tasks.
4. Be mindful of nonverbal communication. We don’t always realize that the nonverbal messages we’re sending with our facial expressions and body languages speak louder than our actual words. You can reduce agitation and confusion in your senior by consciously using body language and facial expressions that they can clearly and easily understand. This will also encourage them to cooperate more readily with essential tasks.
5. Get rid of all potential weapons. Your older adult with dementia could hallucinate that someone was breaking into the house, or have a delusion that you are a burglar. As a result, they might find anything that could be used as a weapon and attack you with the intention of protecting themselves, you, or other family members. To keep everyone safe, remove all potential weapons. (Besides obvious items like knives, guns, and sharp objects, this also includes regular household objects that could be weaponized, such as scissors, matches and lighters, tools like screwdrivers, glass bottles, or rolling pins.)
6. Create a safe place for yourself. In some cases, the wisest response in an aggressive situation is to remove yourself from the area until your senior calms down or forgets they were upset. Consider setting up a safe place for yourself, such as a secure room or a path outside. You may also want to keep a phone and security tools (like a doorstop wedge or security bar) in the room. Having a plan in place for when things get out of control can keep you safe and reduce your stress levels.
7. Prepare emergency responders to keep things from escalating. If called to your home, emergency responders (fire, police, EMTs) could mistake dementia aggression for intentional aggression. They would most likely respond with force, intending to protect you, but this would only make the situation worse and possibly result in injuries, jail, or involuntary psychiatric hospitalization. To prevent this from happening, communicate with emergency responders when you’re not in an emergency situation. Call the non-emergency number for fire, police, and EMTs, and ask if they can place a notification on your address or phone number to let responders know your older adult has dementia. Advise them as to how they could best de-escalate a potential future situation to protect all involved. If they use Smart911, you could sign up and add your personal information. (Smart911 is a free service that allows individuals to create a Safety Profile with detailed information that can be accessed during an emergency. This profile can include information such as medical conditions, emergency contacts, household members, pets, and access information, which can be crucial in situations where the caller may be unable to communicate effectively or provide this information verbally.)

While you may not be able to prevent all aggressive outbursts caused by dementia, following these suggestions can go a long ways towards minimizing the chances of their occurrence, or towards de-escalating the situation if they do occur.