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How do you deal with someone with Dementia has physical aggression? Physical Aggression is defined as hitting, biting, scratching, spitting and otherwise lashing out. Seeing these signs from a person with dementia is not uncommon if they are in the later stages. Keep in mind your loved one is not doing this on purpose, but it is very important to learn how to control them when they are having an episode. There are two reasons why your loved one can turn violent. One is personality changes, this is caused by the disease which makes them lose control. Two is emotional or physical discomfort. They might feel insecure, angry, embarrassed or unable to communicate their emotions. Below you will find some tips we found on dailycaring.com on how to prevent and respond when your loved one is physically lashing out.
How to prevent aggression
- Try to keep the person calm, secure, and comfortable. Make sure the person is dry (if he or she wears adult sanitary products) and is neither hungry nor thirsty. People with Alzheimer’s forget to eat and can’t always tell you what they need.
- Keep to basic household routines. Ideally, sleep and meals happen in a predictable way every day. Ideally, the person with Alzheimer’s gets fresh air (weather permitting) every day and/or gets a little exercise, even if it’s just walking through the house.
- Keep a written log of what was happening just before violent outbursts. Try using the ABC method to understand Alzheimer’s behavior. You may soon see a pattern. If bathing tends to spark violence, for example, can you tell what seems most upsetting about it? If it’s being cold, maybe you can turn up the heat, shut the bathroom door, and run towels and a robe in the dryer before you begin.
- Prepare the person for triggers as best you can. Obviously, you can’t preempt every upset – if a substitute care helper shows up, you still need the help of that person even if the new face is upsetting to the person with Alzheimer’s. But while it’s not usually productive to rationalize with someone who has dementia, telling them about an upcoming change is considerate and may offer a little preparation. Keep your tone calm and upbeat – letting your own frustration show through words or body language will only make your loved one tense and more on edge.
How to respond in the heat of the moment
- Try to stay calm. Don’t fight back or raise your voice. Even cues that you’re nervous might get picked up by someone with Alzheimer’s, and that can increase the aggression. Leave the room if you need to pull yourself together.
- Stay safe. Obviously, you don’t want your charge to fall or hurt herself, but your own safety needs to be paramount. Step back if the person is out of control, rather than stepping in to restrain or overpower.
- Don’t argue. Make it your goal to avoid escalating the behavior, not to get your way or prove yourself right.
- Resist the temptation to punish. The notion of cause and effect is beyond the cognition of someone with serious dementia. Issuing consequences (no snack, a lecture) will only add to the person’s upset, and to the violence.
- Try breaking the mood by stopping and starting again in 15 minutes. Change to a new activity, or even just move to a new room. If bathing has gotten off on the wrong foot, for example, switch to something you know your loved one enjoys – listening to music, having a snack. Then get back to the bath later, taking care to eliminate or soften the trigger if you can. (Maybe you play the favorite music in the bathroom this time.)
- Self-soothe in healthy ways. After a troubling incident, take care of yourself, too. Call a friend or reach out to an online Alzheimer’s forum. Do not isolate yourself physically from others (a common practice, since caregivers grow afraid to have others see their loved one “this way”).
Let’s say that you have tried out the tips listed above, and nothing is working out. It might be best to consult with your loved one’s doctor in regard to their aggression. Your loved one can have a urinary tract infection, may be in pain, or their doctor might be able to prescribe antidepressants or antipsychotics which are used to reduce physical aggression. If the medicine prescribed does not help either, you might want to keep an open mind and search into a new living situation. Your primary goal should be to do what is best for you and your loved one.