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Anger or aggression

What to do if the person becomes angry or aggressive

Dealing with mood swings and sudden changes in a person with dementia can be a challenge. However, it’s important to understand there is usually a reason for the change. It could be emotional or physical. Here’s a quick summary of some of the physical reasons why mood changes can occur:

  • Fatigue – the person may have had a bad night’s sleep.

  • Boredom or loneliness – lack of stimulation or company can cause frustration. See if the person is interested in going out for a walk or helping with a task that gives them a sense of purpose.

  • Pain – the person may be in pain and unable to tell you about it. Signs of pain can include a change in gait (walking), grimacing, gripping their stomach, being pale or sweaty or having a high temperature. Speak to the person’s GP.

  • Discomfort – has the person been sitting still for too long? Are they stiff? Is the room too hot or too cold?

  • Thirst or hunger – the person may be hungry or thirsty and unable to tell you. Ask yourself when they last had something to eat or drink, and give them some food and water

  • An infection – urinary tract infections (UTIs) can cause increased confusion and should be treated immediately, as they can escalate and result in a hospital admission that could have been avoided. <Link to UTI article>.

  • Side effects of medication – if they have changed medication or started taking additional medication combined with what they were already taking, then it may be impacting them. Speak to their GP if you are concerned.

  • Feeling anxious – the person may be anxious at a certain time of day when it’s time for you to leave and perhaps fearful of being left alone. Reassure them you will be back and let them know that someone else will be on hand to help. Don’t announce that you’ll be leaving too far in advance, as it will give them time to think about you going, which may cause them to get stressed out. Announce you’re going just before you depart.

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Dealing with anger

  • Firstly, accept that you are the person who needs to change. The person with dementia won’t be able to control their emotions in the same way as you.

  • Try to understand what may be causing the person to feel angry or upset. There may be another reason if it doesn’t appear to be due to a physical cause.

  • Don’t overcompensate. Aggression can often be caused by a person feeling frustrated at their inability to do the things they used to do. Are you doing too much for them? Try not to take over and do everything for them. Encourage the person to do what they can.

  • Don’t talk to the person loudly or as if they were a child. Always be respectful of the person. Raising your voice won’t help them understand you unless they have hearing problems.

  • Don’t take it personally if they say something unpleasant. Don’t try to challenge them or contradict them, as this can make things worse.

  • Use distraction techniques. Change the subject, even if it’s simply offering the person a cup of tea or playing some music that may alter the person’s mood.

  • Try to find the source of the person’s anger or aggression. Certain triggers may occur, such as occurring at roughly the same time of day or following a relative’s visit. If you understand those triggers, you can adapt.

  • Medication may help to calm the person if they are often aggressive. Encourage the person’s family to speak to their GP if they are often angry.

 

BOX OUT

Protect yourself

As a carer, you have a right to work in a safe environment, so be clear on what you feel isn’t tolerable. Tell the person in a factual and unemotional tone that it is unacceptable for them to swear at you or try to hit you if this happens.

Never allow yourself to be at risk. If you need to, hide car keys or sharp objects if you are worried the person will become physically aggressive or try to go out and drive. Move away from the person if they are swinging at you. If the person is having delusions frequently and you feel they are likely to harm themselves or you are at risk, always seek medical help. Call 999 and explain that the person with you has dementia if you are in any immediate danger.

 

 

Sources:

The Essential Carer’s Guide To Dementia, Mary Jordan, Hammersmith Health Books

Alzheimer’s Association

https://www.alz.org/help-support/caregiving/stages-behaviors/suspicions-delusions

Dementia Help

https://dementiahelpuk.com/sign-up-for-your-free-guide-to-challenging-behaviour/