Some persons with dementia may display or experience some levels of agitation and aggression towards their family members or caregivers at some point. They can be defined as below:

Agitation

is a set of behaviours that involve a person with dementia experiencing verbal or motor anxiety.

Aggression

is a further level of agitation in which the behaviours can be expressed through verbal abuse, threats, damaging property, physical violence towards another person or over-reacting to minor setback or criticism.

Agitation and Aggression may be caused by:

  • Disease progression of dementia causing loss of control over behaviour.
  • Physical discomfort such as pain, fever, illness or constipation.
  • Fatigue due to sleep deprivation.
  • Defensive behaviour when independence and freedom are threatened.
  • Frustration due to inability to cope with daily tasks.
  • Fear of surroundings or people as the person with dementia can no longer recognise them.
  • Adverse reaction to medications.

Tips on Managing Agitation and Aggression

Dealing with aggressive behaviour is not easy. It is always useful to identify what triggers the aggression and find effective ways to manage it.

It is important to know that it can be a form of communication depending on how a person with dementia behaves. If we can establish what he/she is trying to communicate, it may prevent them from feeling frustrated and acting aggressively.

Below are some ways to manage such behaviour:

  • Identify or be aware of signs or behaviour indicating agitation or aggression. Distract the person with dementia early with appropriate activities before his/her outburst.
  • Ensure the environment is safe by keeping away dangerous items such as scissors, knife or any sharp objects.
  • Stay calm and do not get into an argument. A heated response from you may make the situation worse.
  • Approach your loved one slowly; reassure him/her and acknowledge that he/she is upset.
  • If the person with dementia gets agitated/aggressive when you are caring for him/her,
    • Explain your actions, in short, simple sentences such as “I am going to help you remove your shirt” or “We are here to help you”.
    • Ask yourself if what you are doing for the person really needs to be done at that moment.
    • Give him/her some time and space and return in a while to try again gently.
  • If the person with dementia gets physically abusive
    • Make some space between you and the person with dementia (at least one arm-length) to prevent yourself from getting physically injured.
    • Do not try to restrain or restrict the outburst of anger unless he/she is causing harm to him/herself or others.
    • Call for help if needed.
  • Ensure your loved one’s needs are met, such as hunger, thirst, sufficient sleep.
  • Try to maintain consistency in their daily routines, environment and carers.
  • Ensure the medical conditions and medications of the person with dementia are reviewed regularly by the doctor.

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