Whose Fault Is Violence In Dementia? How To Decrease Their Aggression And Your Stress Level

A big stressor while caring for someone who has dementia is when that person becomes verbally or physically aggressive.  Both professional and family caregivers find this unexpected, scary and extremely stressful.  But frequently when a person with dementia becomes violent it is actually our fault. While it may feel uncomfortable to cast blame on a well-intentioned professional or family member, it is likely what we are doing that can cause an aggressive or even violent response from a person with dementia.

For example, if a person with advanced dementia is asking for dinner and we repeatedly tell her she just ate, it is likely she will become frustrated, angry and possibly even physically aggressive.

It’s important to focus on preventing the aggressive behavior to begin with.  Arguing with a person who has advanced dementia is a no win situation.  When the patient asks about dinner after she just ate, a better response is to put out a snack, redirect the patient to a fun activity or even just talk about dinner.  Dinner is clearly on the person’s mind.  Sometimes just having a conversation about “your favorite dinner foods” can appease her if she’s asking when dinner will be served.

Another trigger for violent behavior can be hallucinations, delusions and illusions.  If the patient thinks his son is an intruder, he might attempt to attack his son.  This can sometimes be prevented by family and professionals slowly and gently approaching the patient from the front and even re-introducing themselves if they’ve been away from the patient for even a short period of time.  Apologies are often helpful too–but many professional and family caregivers are resistant to this concept.  If Dad thinks you’ve stolen his money, it might soothe him if you say “I’m so sorry.”

Aggressive and violent behavior is a way that the patient with dementia is communicating with his or her caregivers.  It’s important to take a step back and ask, “what is she trying to tell me right now with this behavior?”  When aggressive behavior occurs, we need to course correct in the way we approach the patient. Of course if caregivers have attempted these non-pharmaceutical strategies and are still struggling, it’s a good idea to talk to the doctor about possible medication interventions.  But often aggressive behavior in dementia can be minimized or even completely eliminated when we change our approach to the patient.