“When Dad’s Alzheimer’s got worse, Mom would call frantically and sometimes I could hear him screaming in the background. His irritability soon became aggression, so the first time Mom called sobbing that he had hit her, I knew that this was going from bad to worse, a lot worse. My brother and I talked on the phone and explored all the options – senior home care, assisted living or a nursing home. After we researched the benefits and costs of all of our options, we talked to an assisted living facility admissions administrator who told us that Dad’s ‘history of aggression and violence’ made their facility a non- option. Dad wasn’t a good fit for a nursing home either. Nobody wanted dad.” “The senior home care agency was a blessing and our wonderful caregiver was excellent with dad - until he kicked her. It’s been downhill from there and when Mom died I knew he would have to come to live with me, or me with him. My brother would provide some financial and long distance emotional support, but in the end I was the only choice. And so, my life interrupted, humiliated and frustrated by Dad’s behavior, I live with my dad and terrific and patient caregiver sent by a Home Care Agency. I’m 58 years old and my life, as I knew it, is over.” That is a true story told to me by the loving daughter of an Alzheimer’s dad. While most people think Alzheimer’s is a “Memory Disease”, there are many neurological and psychiatric symptoms. Alzheimer's patients often develop delusions and are convinced their family is stealing things from them when they can’t find something or a family member uses the checkbook to help with the finances. Active aggressive behavior towards their spouse and family makes it difficult to remember that Alzheimer's aggression really has nothing to do with others and everything to do with their own shame, pain and frustration. Anger and aggression is common among Alzheimer's patients. There's swearing, screaming, hitting, kicking, grabbing, pushing, throwing things, scratching, biting and making strange noises. More than 5 million Americans are diagnosed with Alzheimer's disease every year and up to half can show some of these behaviors. Physically aggressive behavior is an issue with many dementia patients and those most in danger are the people with dementia themselves and their caregivers. Violent behavior presents a particularly distressing problem for families. They know their loved ones with dementia generally don’t intend to cause harm yet when confused, fearful, angry or in pain, they may kick, hit, bite, throw or shove. (If you have had experience with these behaviors, please give us your comments). The most common emotionally hurtful aggression is verbal, when they might swear at you, make threats, call you names or accuse you of doing things that you haven't done. Whatever type of aggression, it's frightening and upsetting. The first time it happens you may not know how to cope and will feel helpless and scared that it might happen again. People with dementia may become aggressive if they feel frightened, embarrassed or frustrated because they cannot understand others or make themselves understood. Sometimes it happens suddenly when you don't expect it. This is called an ‘over-reaction’ or a ‘catastrophic reaction’, when the person shouts or screams or becomes very agitated for no good reason. People with dementia usually use this behavior to communicate how they are feeling or to express themselves. Aggression may be one of the ways in which they are trying to communicate. It is important to know that the person is not being purposefully aggressive, as people with dementia are not in control of their behavior, thoughts or actions. It's up to you to control your anger, responses and expectations. Dad isn’t taking his anger or frustration out on you personally - it could have been anyone who happened to be there at the time and he will probably forget about it quite quickly. How to react when a Dad or Mom becomes aggressive: Stay calm and try not to show fear. Walk away, as losing your temper or arguing will make things worse. Do something to take your mind off what just happened. Fixing a snack or something for both of you to drink could also help things return to normal. If you start to lose your temper, stop. Relax, take a breather and don’t feel guilty. Give Dad or Mom space by standing a few feet away. If he or she feels that you are getting too close, they could lash out physically. Being punched, slapped, kicked or bitten will not make this better. If he or she does become violent, get out of the way as quickly as possible, leaving the room if necessary, and return once they have calmed down. Arguing with a person who has dementia will only frustrate both of you as she or he is not able to reason or understand why you are upset. Don’t try to reason with someone in this state. Concentrate on speaking in a calm, reassuring voice distracting them from whatever triggered the episode.
- Do not laugh or tease as it will make things worse.
- Do not punish them.