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Aggression

 

Anger reflects many feelings and occurs for reasons that aren’t clear.  We can try to figure out why but also we must respond to the behaviour.

Possible causes:

  • Fatigue or disruption of sleep pattern
  • Grief as his world becomes less and less familiar
  • Pain or physical discomfort
  • Sensory overload
  • Feeling lost, insecure or forgotten
  • Fear of a situation or a person he finds threatening
  • Dementia may lessen his control over emotions
  • As dementia progresses, he may struggle to express anger and will do so physically (hitting, biting, kicking) or verbally (shouting, name-calling).
  • May happen suddenly without any apparent reason or after a stressful event

Strategies:

    • Watch for a sudden increase in movement to indicate anxiety.
    • Respond in a supportive manner and reassure in a gentle voice.
    • Reduce noise.
    • Ensure that staff maintain a consistent routine.
    • Speak slowly and use repetition.
    • Break activities into manageable steps.
    • Distract him.
    • Approach slowly from the front at the same eye level.
    • Leave the room for a “time out.” Remember it is the disease, not the person.
    • Avoid arguing or expressing anger or irritation, verbally or non-verbally.

    Example: You are having dinner with your father in the residents’ dining room. You watch your father struggle to cut his meat and get the food to his mouth. You offer to help and begin to cut his food. He lets you for a minute, but then grabs your wrist and threatens to “smack you if you try that again!” Your father has never laid a hand on you and you are horrified that this just happened.

    Don’t:

    • Grab his hand and try to force him to let you go.
    • Yell in surprise.
    • Explain that you were trying to help.

    Do:

    • Remain calm and don’t react.
    • Let your arm go limp, apologize and distract him with conversation.
    • Once he lets go, give him space to cool down. Later on, think about what was behind his anger. Was he embarrassed? Could he have thought you were taking his food?

    Last Updated: 06/18/14
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