Alzheimer’s Anger and Aggression

For people taking care of elderly parents with Alzheimer’s or dementia, one of the biggest challenges is dealing with outbursts of agitation and aggression.

Techniques for managing Alzheimer’s aggression such as re-directing the person’s attention or medication can certainly help. But Cindy Steele, an RN and Nurse Scholar for Copper Ridge, a residential care community, says the key is finding out what is causing the outburst. “Dismissing aggression as a normal behavior associated with Alzheimer’s doesn’t enable the caregiver to fix whatever is causing the outburst. Why do they seem to get upset? What causes it?” says Steele, who focuses on behavior management for Alzheimer’s and dementia.

She says agitation and aggression are typically caused by one or more of these five factors:

Cognitive Impairment

Sometimes caregivers overestimate what their parent with Alzheimer’s or dementia is capable of accomplishing. If a person with Alzheimer’s is asked to do a task, and they are not able to complete it, they get upset and frustrated, which results in an outburst. Caregivers must adjust their expectations to their parent’s capabilities. And remember that Alzheimer’s and dementia are degenerative diseases. Parent’s abilities will decline over time, which means expectations must be shifted continually.

Psychological Disorders

Steele says that 40% of people with Alzheimer’s develop depression, due to a neuro-chemical imbalance in the brain. Anxiety disorders and delusions also occur quite commonly in people with Alzheimer’s. Once these imbalances are identified and diagnosed, medication can be prescribed that has proved to help tremendously.

Physical Problems

Outbursts might be associated with physical problems. The person might have a headache, a rash, constipation, or fatigue. This means caregivers must be vigilant about watching their elderly parent’s physical well-being and noticing when changes occur. When people with Alzheimer’s have physical problems, they might be unable to tell the caregiver. The behavior – in the form of a tantrum – is their form of communication.

Environment

The person may be reacting to an uncomfortable environment. For example, a room may be too cold, too noisy, or too crowded. Their inability to clearly communicate their discomfort turns into an outburst.

Approach

People with Alzheimer’s react and respond to how a caregiver approaches them. Trying to rush them, or force them to do something they don’t want to do can result in agitation. How you approach the person with Alzheimer’s is key, Steele says. Use a gentle tone of voice, but don’t be condescending. Don’t rush them as they try to complete a task, even if they are moving at a frustratingly slow pace. Don’t demand that they do something or bark orders at them. Ask them. Use calming gestures and gentle touch.

Getting to the root cause of outbursts will help caregivers manage behavior more effectively and may lesson the frequency of agitation and aggression.

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