Dementia and aggressive behavior: Causes and prevention tips

Some dementia patients may start exhibiting aggressive behavior as the disease progresses. There are different causes for behavioral changes in dementia which don’t necessarily revolve around the disease itself. For example, behavioral changes may be associated with some sort of difficulty brought on by dementia, side effects of medications, changes in environment, social interactions, habits, and mental and physical health.

Aggressive behavior can be verbal or physical. In verbal aggressive behavior, patients may swear, scream, shout, or make threats. Physical aggressive behavior is when the patient hits, pinches, scratches, bites, or pulls hair.

Aggressive behavior may stem from the patient’s behavior prior to diagnosis, or it can develop as the disease progresses even if the patient wasn’t aggressive before.

Dealing with aggressive behavior can be quite challenging for a caregiver and at times scary because they may feel threatened or worry about their own and the patient’s safety.

Causes of aggressive behavior in dementia

Some dementia patients have trouble revealing or understanding their needs or wants, so in order to express themselves, they may exhibit aggressive behavior. Causes of aggressive behavior may be biological, social, or psychological.

Biological causes of aggressive behavior include:

• Pain
• Side effects of medications
• Environment unsuited for their needs
• Poor eyesight or hearing
• Hallucinations
• Physical effects of dementia affecting judgment and self-control

Social causes of aggressive behavior include:

• Lack of social contact
• Loneliness
• Boredom
• Different caregivers
• Not liking or trusting a particular carer
• Hiding their conditions from others

Psychological causes of aggressive behavior include:

• Feeling ignored
• Frustration due to inability to complete tasks
• Misunderstanding of carer’s intentions
• Difficulty understanding the world around them

Tips to prevent and manage aggressive behavior in dementia

The first step in managing and preventing aggressive behavior in dementia is to try and understand the patient’s needs or wants and ensure they are being taken care of. This means responding to hunger, thirst, tiredness, boredom, or other frustrations the patient may have. Here are some tips to help caregivers prevent and manage aggressive behavior.

• Make changes to how you approach situations
• Do not approach aggression with more aggression, try to be as calm as possible
• Avoid showing fear, anxiety, or alarm
• Avoid shouting and physical contact
• Reassure the patient and acknowledge their feelings
• Try not to take the behavior personally
• Maintain eye contact
• Uncover the cause
• Distract the patient’s attention
• Improve your communication skills
• Have the patient listen to their favorite music
• Create social interaction and stimulation for the patient
• Have the patient reminiscence about the past they remember
• Have the patient exercise

If these tips are unsuccessful and you are finding that the aggressive behavior is worsening, you may want to speak with the patient’s doctor with regards to medications that can help control the behavior.