Aggressive behaviour may be verbal (shouting, name-calling) or physical (hitting, pushing). This behaviour can occur suddenly, with no apparent reason, or can result from a frustrating situation. Whatever the case, it is important to try to understand what is causing the person to become angry or upset.
Aggression can be caused by many factors including physical discomfort, environmental factors and poor communication. If the person is aggressive, consider the following:-
• Physical discomfort
• Is the person tired because of inadequate rest or sleep?
• Are medications causing side effects?
• Is the person unable to let you know that he or she is experiencing pain?
• Is the person overstimulated by loud noises, an overactive environment or physical clutter?
• Does the person feel lost?
• Are you asking too many questions or making too many statements at once?
• Are your instructions/suggestions simple and easy to understand?
• Is the person picking up on your own stress and irritability?
• Are you being negative or critical?
How to respond
• Try to identify the immediate cause. Think about what happened right before the reaction that may have triggered the behaviour.
• Focus on feelings, not the facts. Try not to concentrate on specific details: instead consider the person's emotions. Look for the feelings behind the words.
• Don't get angry or upset. Don't take the behaviour personally. The person isn't necessarily angry with you. Be positive and reassuring. Speak slowly in a soft tone.
• Limit distractions. Examine the person's surroundings, and adapt them to avoid similar situations.
• Try a relaxing activity. Use music, massage or exercise to help soothe the problem.
• Shift the focus to another activity. The immediate situation or activity may have unintentionally caused the aggressive response. Try something different.
• Decrease the level of danger. Assess the level of danger - for yourself and the person with dementia. You can often avoid harm by simply stepping back and standing away from the person. If the person is heading out of the house and onto the street, be more assertive.
• Avoid using restraint or force. Unless the situation is serious, avoid physically holding or restraining the person. He or she may become more frustrated and cause personal harm.
Remember that people with dementia can no longer make sense of the world around them. Try to imagine how they must feel especially if they can no longer communicate their wishes. Don't push things, if you are trying to make them do something they don't want to, just leave it and try again later, perhaps using a different approach.