What Are the Causes of Aggression in Dementia Patients?

Aggression in dementia or Alzheimer's patients takes many forms, including pushing, hitting, shouting, cornering or making threats. Aggressive behaviors can come without warning, which often makes it difficult for caregivers or other patients and is often the primary reason a loved one is placed in a care facility. Someone with dementia may start to swear, scream, throw objects at others and attempt to resist care. Although verbal assaults are more common than physical threats, both hostile behaviors are possible.

Stress

• Avoiding sources of stress, fear or alarm can help to diminish aggressive behavior. Many dementia patients do not like loud or sudden sounds because the sounds create fear. A calm environment is important to avoid aggressive reactions. People with dementia often have high stress levels because they do not remember the people around them and--if they are in a new environment--find their environment to be strange. As dementia progresses, there can be misunderstandings of why they are in an new environment, which can be frightening.

Aggression Over Social Interaction

• When you approach someone with dementia, the person may not recognize you, even if he saw you five minutes before. Approach the person slowly and calmly and speak in a soft tone. Talk to the person using her name, and speak in simple sentences. Try to maintain a peaceful environment without many distractions to decrease stress. Although the feeling of touch can be calming, some dementia patients do not like to be touched and they do not like the feeling of being restrained, as it increases anxiety.

Physical Illness and Depression

• Those with dementia may have difficulty dealing with illness or depression and may not be able to express themselves, causing them to react aggressively because of the pain or discomfort. Not being able to verbalize their feelings and feeling trapped often makes a dementia patient act aggressively.

Disruption to Privacy and Routine

• For many dementia patients, having personal space is of utmost importance. If a dementia patient feels as if his personal space has been invaded, including during hygienic assistance, he will most likely misinterpret the action as an invasion and react with aggression. Maintaining a routine for dementia patients can also help avoid potential conflicts and reduce agitation, as they will not feel rushed or hurried.

Lack of Choice and Dementia

• Some dementia patients begin to have difficulty when they feel like they do not have control or choices over their environment. A patient with dementia might become upset when he feels like he has no choice over what to eat or wear. Caregivers may limit the choices while still encouraging dementia patients' independence in order to reduce aggression.

Identifying Triggers and Reacting

• It is important for a caregiver to identify triggers of aggression to try to eliminate the cause and modify behavior to reduce aggression. Caregivers should react in a calm manner and try to redirect a dementia patient to a new activity. The way that the caregiver reacts can either perpetuate the hostile behavior or calm the person down. By finding out what a person's triggers are, it is possible to intervene earlier and avoid those situations.