Understanding how to deal with an angry dementia patient is challenging for many reasons. But it’s important to keep in mind that the anger they’re displaying is often a response to the confusion or discomfort they’re experiencing. Coping with aggressive behaviors can be emotionally taxing for caregivers and loved ones. However, understanding that those with dementia are not acting this way on purpose can be a comfort.
What Is Dementia?
Dementia is a term used to refer to changes in the brain(Opens in a new window) that cause:
- A decline in memory
- An inability to think rationally, problem-solve or make decisions
- Difficulty with coordination and communication
- Confusion, disorientation and a lack of spatial and visual awareness
In dementia, these symptoms worsen over time. When they become severe, they interfere with one’s daily functions, relationships and abilities.
Common signs of dementia include(Opens in a new window):
- Getting lost in a familiar neighborhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Inability to recall old memories
- Difficulty communicating or paying attention
- Problems with reasoning, problem solving or completing tasks independently
While these symptoms are common in people with dementia, some conditions, such as traumatic brain injuries (TBI), thyroid problems, chronic infections, and brain tumors, can present similar symptoms. Certain medications can also cause reactions that mimic dementia symptoms. It's important to see a doctor to get an accurate diagnosis and rule out other conditions that may not be dementia-related.
Understanding the Underlying Causes of Anger
Dementia is caused by damage to or loss of nerve cells and their connections in the brain. It causes the brain to function differently. As a result, certain behaviors may present as anger and aggression.
When caring for someone with dementia, they may lash out at you because they feel confused or anxious. Mistrust and defiance are natural reactions when a person is disoriented or frustrated. While it can be hard not to take it personally, try to keep in mind that this is not intentional or malicious but a symptom of dementia. It is important to understand what may be causing the anger in each situation so you can address the cause.
Dementia changes the way a person thinks and feels. As the syndrome progresses, the cognitive and emotional changes that occur can cause the person to display anger as a response.
These changes include:
- Increased confusion, anxiety and agitation
- Loss of impulse control
- An inability to control emotions
- Less awareness of time
Understandably, as people with dementia experience a significant loss of control, increased confusion and an inability to function as they once did, angry outbursts can become more frequent. But as a caregiver, it’s important to respond with empathy and compassion.
What Triggers Anger in a Person with Dementia
Anger can often be triggered by pain, discomfort, confusion or frustration. If you’re dealing with outbursts when caring for a loved one with dementia, consider if these factors might be a cause.
Discomfort
Physical discomfort(Opens in a new window) is a common cause of anger for those with dementia. Assess if they may be:
- In pain
- Fatigued
- Constipated
- Hungry or thirsty
- Wearing soiled underwear
- Suffering from an infection
- Experiencing unpleasant side effects from their medication
Confusion
Dementia often causes people to feel confused or disoriented(Opens in a new window) day after day. This can be exhausting and overwhelming for them. Check to see whether they may be:
- Overwhelmed by loud noises or physical clutter
- Unable to process information, such as remembering a common object’s function, answering a question, or recalling a name
- Confused about the day, time, or place
- Unsure of who you are — or other people around them
Frustration
Becoming agitated or anxious(Opens in a new window) because you can’t do or change something is hard for anyone. This is an everyday reality with those living with dementia. Your loved one may be frustrated by:
- Misplaced objects
- Not understanding instructions
- Being asked questions repeatedly
- Not being able to do what they once could
- Feeling lonely, forgotten, or anxious
- A caregiver’s agitation
Recognizing triggers can help you be more prepared when unwanted behaviors arise. It’s important to be patient, respectful and empathetic when dealing with someone with dementia who becomes angry. It will help you keep the situation from escalating.
Managing Triggers and De-escalation Techniques
Dementia changes the lives and behaviors of those affected — patients, caregivers and loved ones — in ways they can’t control. What you can try to control, however, are certain aspects of your loved one’s environment and your response to their behavior. These are crucial for managing triggers(Opens in a new window) and de-escalating emotional situations.
Change the Environment to Change the Behavior
Assess your loved one’s home and social environment. Try to see them through the eyes of someone with dementia. What may not seem like a big deal to you may be triggering for your loved one.
Consider these caregiver’s tips(Opens in a new window):
- Reduce Stimulation: Environmental triggers such as certain noises in and outside the home, smells, glares, and tastes can cause frustration or confusion. For example, your loved one may become disoriented or even hallucinate(Opens in a new window) after hearing voices on a TV program or smelling a certain scent. Try to maintain a neutral, innocuous environment.
- Encourage Physical Activity: Increasing daytime activities(Opens in a new window), particularly physical exercise they enjoy, can help reduce things like restlessness, agitation, disorientation, and other troubling behavior. Try to discourage inactivity and napping during the day.
- Maintain a Routine: Regular morning or evening routines can be especially helpful for those who experience sundowning(Opens in a new window). Focus on one activity at a time and try to structure routines so that certain things happen in the same order. This can help provide predictability, direction and control.
- Make It Safe: Remove hazards and clutter from the home that could be distracting, confusing or dangerous. Add safety features(Opens in a new window), especially in bathrooms, kitchens, stairs and entry ways, to help give the person more freedom to move around independently and safely. Ensure there is proper lighting throughout the home.
- Monitor personal comfort: Check for pain, hunger, thirst, constipation, a full bladder or fatigue. Maintain a comfortable temperature and make sure clothing and shoes fit properly. Be sensitive(Opens in a new window) to fears, threats and difficulty expressing what they need.
Your Response in the Moment to an Angry Outburst
No matter how much you adjust the environment, angry outbursts will still happen. Here are some tips to get you through those moments.
- Validate Their Feelings: Don’t try to ground them in reality; that may only confuse them further.
- Always Lead with Compassion: Remind them that they’re safe and that you’re there to help them.
- Manage Your Own Feelings: Take some deep breaths and remind yourself that their reaction is not personal. If you need to, step out of the room and take a break for a few minutes.
- Take a Deep Breath: Soften your tone and slow down your physical movements.
- Get Help If Needed: If things are beyond your control, seek out a medical professional to help you.
Communication Strategies That Work with Dementia
Communicating with a person with dementia (Opens in a new window)can often be challenging. Caregivers and loved ones are likely to experience frustration when they can’t get through to the other person.
Dementia can make it hard to:
- Find the right word
- Follow a conversation
- Hold a thought until they can speak it
- Understand the meaning of words
- Remember social norms and manners
- Be appropriate
A person with dementia may become frustrated(Opens in a new window) when communicating and hypersensitive to your tone or how loudly you speak.
8 Tips for How to Communicate with a Dementia Patient
- Be patient; communication is often beyond the control of someone with dementia.
- Use simple, clear language. Avoid figures of speech, sarcasm or exaggerations.
- Make eye contact and call them by their name.
- Use a gentle tone of voice and speak in a warm, matter-of-fact way.
- Your body language should be non-threatening; sit down beside them instead of looming over them; smile to show warmth.
- Use gentle, physical touch as appropriate, but beware not to agitate, as some people do not appreciate being touched.
- Validate and respond to their feelings; encourage them to keep talking even if you’re not completely on the same page.
- Avoid confrontation. If they become frustrated, stop what you’re doing and offer a distraction.
Remember that words are only one part of communicating. It’s important to be aware of your actions, eye contact, tone of voice and body language.
Caregiver Support and Resources: Getting Help For Yourself Too
If you’re feeling overwhelmed, that’s a completely normal response. Caring for someone with dementia(Opens in a new window) can be a lot to handle. Being a caregiver can feel like a full-time job, and you may start to feel lonely, angry and defeated. There’s no shame in seeking professional help for yourself. Having someone to talk to is a great outlet. Ultimately, it may make you a better caregiver.
Here are three ways to make sure your needs are also being met:
Take Care of Yourself
- Consider talking to a counselor about your feelings and experiences.
- Eat nutritious, whole foods like fruits, vegetables, whole grains and protein.
- Get regular physical activity.
- Spend time with friends or family.
Manage Stress
- Look for ways to take short breaks every day.
- Practice breathing exercises(Opens in a new window).
- Prioritize sleep; if possible, try to get seven to nine hours every night.
- Meditation, soothing music, stretching and aromatherapy can help alleviate anxiety and promote better sleep.
Ask for Help
- Friends, family or a faith community can often provide support.
- Join a caregiver’s support group(Opens in a new window), either in person or online.
- Talk to your doctor or a social worker about local resources for dementia care.
- Consider respite care. Many home care agencies can offer in-home support for an evening, a weekend or longer.
Navigating Dementia Symptoms with Compassion
Anger is a strong, volatile emotion that can trigger an immediate response in all of us.
When caring for a loved one with dementia who becomes angry, it’s important to understand the cause of their anger and avoid taking it as a personal attack. Seeking to understand, rather than react, can help you manage triggers, de-escalate the situation and communicate more effectively.
Caring for a loved one can be rewarding, but it doesn’t come without its challenges. To avoid burnout, make sure your needs are also being met and seek professional help and support if you’re struggling.
Let BrightStar Care® Help You Care for Your Loved Ones
BrightStar Care® can help make caring for a loved one with dementia easier. Whether you're looking for in-home care services or assisted living for your loved one or a reliable medical staffing partner for your organization, our experienced local care team members are ready to help. Find a location near you, contact us online or call (866) 618-7827 to learn more about how BrightStar Care® offers A Higher Standard®.