It is estimated that about 50 percent of Alzheimer's patients are verbally or physically aggressive towards friends, family members and caregivers. Often, the aggression occurs suddenly and appears to be without reason. This is one of the most difficult aspects of the disease for loved ones and caregivers to deal with. Consider the following tips for how to handle aggression with Alzheimer's:
1. Identify common triggers.
In some cases, the aggressive behavior has a cause, though it may not be obvious. Common triggers may include the following:
Physical discomfort
Inadequate sleep
Medication interactions
Hunger
Difficulty communicating
Overstimulation
Particular times of day
Be sure to analyze the senior’s environment carefully. Remember, since many Alzheimer's patients have lost the ability to communicate the fact that they are in pain or that noise levels are too high, they may act out with aggression instead of trying to communicate their needs.
If you can identify a common cause for the aggressive behavior, you can work to minimize the frequency of outbursts. For example, if the aggression often occurs late in the day, schedule appointments or activities for mornings. Having a quiet period during that time of day may reduce the episodes of aggression.
2. Stay calm.
Although it is difficult, remaining calm is one of the most important strategies for dealing with Alzheimer’s aggression. Speak loud enough to be heard, but use a reassuring tone and make short, calming statements. Speaking slowly and steadily while exhibiting calm, cool behavior will prevent the aggression from spiraling out of control. When appropriate, try to smile or offer a calming touch. Through your actions, let the patient know that everything will be okay.
3. Offer relaxing activities.
Both art and music have been found to have soothing effects on Alzheimer's patients. When the aggressive behavior starts, turn on relaxing music or a favorite song from the past. Some caregivers find that playing music at the same time each day can prevent aggression that occurs regularly.
Consider providing the Alzheimer's patient the opportunity to create art to head off any aggressive signs. Art can be an appropriate outlet for frustration or intense feelings—just be sure to offer the activity to prevent outbursts, rather than to diffuse one already in progress.
4. Change direction.
If you are not sure why the aggressive behavior started, assume it might have something to do with the current situation. Change the activity. By trying something different, you may be able to shift the focus and stop the unwanted behavior.
5. Get a medical evaluation.
Talking about the issue with a doctor many help determine if a medication side effect is to blame. It is also possible the patient’s behavior is caused by pain, which could be prevented with the right medication. A physician can help determine if underlying pain exists and how to resolve the issue.
6. Support her feelings.
Let the Alzheimer's patient know it is okay to be frustrated and upset. Having those feelings are normal. If your loved one exhibits uncharacteristic or unwanted behavior, try not to make her feel ashamed. This will only lead to feelings of guilt and the desire to defend herself. For example, if the patient is becoming upset about a lost item, use logic instead of accusations in order to locate it.
7. Maintain a routine.
For someone who has trouble communicating, not knowing when daily activities will occur—like when dinner will be served—can be stressful. Try to stick to a regular routine so that the patient can anticipate each day’s order of events. Most importantly, keep bedtime on a regular schedule, to ensure an adequate amount of rest.
Dealing with aggression in an Alzheimer’s patient can be difficult and overwhelming. If you would like help coping with this and other changes, please contact us.