How Should You Respond to Aggressive Behaviors in Dementia?



How Should You Respond to Aggressive Behaviors in Dementia?
An older man looks angrily at a younger man, who has placed a hand on his arm as he attempts to calm aggressive behaviors in dementia.

Remember the six R’s when responding to aggressive behaviors in dementia.

Of the many challenging behaviors common in Alzheimer’s, probably the most complicated to manage is aggression. A senior who has always been mild-mannered can abruptly lash out in outbursts that are truly alarming: hitting, cursing, kicking, yelling, biting, or throwing objects. How can you, as a family caregiver, safely help restore a sense of calm when confronted with aggressive behaviors in dementia?

To start with, remind yourself that the aggression is a consequence of the disease. It is not something the older adult can control, and it is not intentional. That said, it must be defused to keep both you and the senior safe from harm.

The 6 R’s of Managing Difficult Behavior,” developed by Dr. Peter Rabins and Nancy Mace in their book The 36-Hour Day, can be an excellent way to help. Read through and refer back to them so you’re equipped for the next burst of aggression.

The 6 R’s:

  • Restrict. Maintain a calm tone of voice and demeanor while you strive to help the senior withdraw from the behavior.
  • Reassess. Consider what might have provoked the incident. Triggers can include physical pain, distractions or noise in the room, fatigue, hunger, thirst, etc. Keeping a journal of what was taking place before and during each incident might help provide clues.
  • Reconsider. Empathize with the older adult by imagining yourself dealing with a disease that inhibits your ability to clearly communicate your needs and wishes, to complete tasks independently which were once easy, to feel confused and disoriented, etc.
  • Re-channel. Redirect the person to a task the individual takes pleasure in, or relocate to an alternative environment, for example, moving out onto the front porch or going into the dining room together for a snack.
  • Reassure. Let the individual know that everything is okay and that you are there. If the individual responds positively to touch, place your hand on their shoulder, offer a pat on the back or hug, or take their hand in yours.
  • Review. Make note in your journal what went well – or what did not – to help in utilizing the most effective response if the aggression arises again.

Knowing that aggressive behaviors in dementia may occur at any time, it’s beneficial to gauge the home environment and make a plan to make certain it really is as comfortable and calming as possible, for example:

  • Playing quiet music the senior enjoys in the background.
  • Placing familiar, comforting objects within easy access.
  • Avoiding TV shows that may display violence or other troubling images.
  • Opening the window shades during the day to allow natural light to stream in.

Hired Hands Homecare is here for you as well with specially trained dementia care providers who understand the nuances of the disease and how to most effectively manage the corresponding challenges. Reach out to us at (866) 940-4343 for more information on our in-home dementia care services for seniors. We’re here to help in Fremont, Napa, Rutherford, and the surrounding areas.





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