How to Deal with Aggressive Dementia Patients (4 Strategies)

1- Activities Ideas
2- What to say/do for specific Challenging Behaviors

Thanks for watching! In this video, we talk about 4 strategies (or levels) of approaches on how to handle a combative dementia patient and manage anger outbursts. I've this learned while working as a therapist (ie. not a nurse or doctor using meds) at a psychiatric hospital for elderly and mostly dementia patients.

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It is a week-long training experience with easy-to-follow steps to get 1 win with 1 challenging behavior so you can make caregiving easier (even if you're feeling stressed, overwhelmed, and at the end of your rope.)

Your 7 day experience will consist of:

20 minute Facebook LIVE trainings for 5 days on May 17, 18,19, 20, 22, 23 which you can attend live or watch the playback of later.

Each day you’ll get one bite sized action step to quickly apply lessons in the real world so you can experience results that help you get the peace and freedom you deserve.

A live Zoom workshop the following week available at two different times - 7:30 E.T. on Tuesday, May 24th or 7:30 E.T. on Thursday, May 26th - called “3 Ways to Make Challenging Dementia Behaviors Easier” where we’ll celebrate each others big & small wins, participate in role-plays, and answer any lingering questions (as long as you sign-up, playback will be available if you can’t make it live.)

Free printable cheat sheets that you can reference in a pinch to stop struggling and start living on your terms.

A Facebook community specifically for this training experience to connect with & get support from other participants, so you get more effective, easier caregiving no matter how challenging your situation is.
1st Thing to Try: Asking & Giving Choices

If you need your loved one or client to do something, first ask yourself, how important is it that they do what your asking and is there a way that you can ask them or give them a choice.
Especially with basic tasks, caregivers forget that being given commands day after day can wear on anyone especially someone with dementia.

2nd Thing to Try: Giving Space

If they are still getting aggressive, ask if you can do it later. Giving them some space if it is safe to do so to cool off will help avoid screaming or hitting and they will likely be able to actually hear what your asking when they are less upset.

3rd Thing to Try: Calling for Help

If intervening for immediate health and safety concerns has to be done, get someone to help you.
This cannot be overstated when it comes to health and safety. If you can, keep your distance to keep yourself and them safe and if you can't, in that moment, get them to safety as fast as you can
to minimize injury to yourself and them and get help ASAP. That someone could be hired help, a family member, friend or local services in your area like a doctor or even a hospital.

Bonus:
When Getting help when your loved one or client is getting violent and extremely verbally abusive out of nowhere as this could be a sign of medical issues that are happening at the same time
as the dementia that need to be addressed or a sign that your loved one needs medication to manage out of control moods.

Last Thing to Try
- Verbal abuse or violent behavior even after getting help
- could mean that it is time to place your loved one in a skilled nursing
- Or again at a hospital to get stabilized
- Getting help doesn't mean you've failed as a caregiver
- A lot of time, it is what is necessary to keep you and your loved one safe
- Just remember, no one can walk this path of dementia caregiving alone

Good News
- Thankfully, you can usually stop some warning signs before someone

[jhutch]

My best tips for aggressive behaviour:
1) Pick your battles - can you let this go and still be safe? If it is important but not urgent, wait until later and reapproach.
2) You can't win if the answer is a hard 'no', so stop trying in order to avoid inevitable escalation. Use a distraction or withdraw, and reapproach again later.
3) Have someone else reapproach. Sometimes a fresh face is a whole new ballgame. Don't take it personally.
4) Use what you know about their personality. Are they independent, do they have a sense of humour, are they shy, do they like fashion, do they like to flirt, do they like to go for walks or have cups of tea? There are a lot of individual motivations and techniques that might help. As soon we do 'x' then we'll have our tea /walk...
5) Instead of trying to take a sweater away (as in the example), talk about the weather. Are you comfortable? It sure is hot today! I had to take my extra sweater off - though it sure was cold this morning...
6) Give them an out /give them credit. I know you usually like that sweater - it looks so pretty on you. I can see why you put it on when it was cool earlier. Now that it is so much warmer, you probably want to show everyone that beautiful shirt you've been wearing underneath!
7) Play favourite music. Lively, soothing, sing-along, dance tunes... It lifts the spirts and can improve compliance. It helps to smile and sometimes to be a bit silly (joking), or soothing (it's going to be okay /give a hug).
8) Compliment, empathize and reassure. 'You always look great.' 'I can see this is is hard for you, but I promise I will make sure everything is okay.' Reasoning is most often a waste of time.
9) Say yes a lot. Yes, you look great in that sweater - I can see why you reached for it - it brings our your beautiful blue eyes! I could just hang it here so it stays nice for later when you need it again.
10) Aggression is a response. Find out what the trigger is. Fear, discomfort, confusion, hunger, fatigue, frustration... Addressing the cause of the problem will reduce the upset.
11) Spend quality time to build rapport. Don't make all interactions task oriented. Make eye contact, offer to hold a hand, be patient and listen.

[oscardaone]

Honestly, I’ve have been approaching this on my own. Wish I had a team or an extra person helping me sometimes.

[nanolight]

Behavioral meds were the only way forward for our family. We finally got to sleep at night did not fear mom would harm us while we slept.

[mojojeinxs]

Medicate them. They cannot be held accountable for their actions because their brain no longer functions properly. The nurse's aide I don't feel that I should have to have the threat of getting my teeth knocked out because families refuse to medicate their loved ones. My mom was extremely combative and I tried different medications and it worked. These people are not going to get any better there only going to further decline. People need to stop being delusional. Frontal lobe dementia it's the worst to deal with deal with. I'm currently taking care of four residents diagnosed with that. I feel like a I am a cage fighter trying to get them ready for bed every night. One resident it takes four aids just to change a brief. If they were given medicine to calm them down their life would be more comfortable. When dementia eats at the frontal lobe of your brain you no longer have any empathy kindness or reasoning skills left. People live longer but not better. The best thing anybody can do when they get diagnosed with dementia become a DNR have a living will and go on hospice.

[ellensunden]

These are excellent tips for caregivers! Although, what if a loved one is exhibiting all these signs but refuses to get tested for Dementia/Alzehimers? My mother has most of the symptoms, along with being violent and aggressive. She refuses to allow me to speak at all. If I try, she screams "Shut UP! Go to Hell". It doesn't matter what I'm trying to say...if I even attempt speech, she lashes out at me. The last time I tried to speak to her, she got up out of her chair and started beating on me. After she was done, she sat back down and started to mock and heckle me. She would sneer and snicker at me, calling me "weak" among her many other insults and degrading comments, which are always personal attacks meant to hurt me, since she knows exactly what to say to hurt me the most. I ended up calling the cops. They documented the bleeding scratches she left on my right hand. She acted like a complete angel around the cop...I was gob-smacked! The cop said that he didn't see her as a threat and left. Mom is cruel to the service people she talks to on the phone, often abusing and belittling them as well. I have shut myself off from her physically, mentally and emotionally. I do not talk to or engage her in any way. It's impossible to try...I just get sneered at and get told to "Shut Up!" and "Go to Hell!. I should note that she is diabetic but does not take care of herself at all. She only sits and watches tv and eats only sugary foods and take-out. She will allow her blood sugar to plummet and expect me to revive her every time with a glucagon shot. Yet, when I revive her, she immediately begins her abuse all over again. I can't leave b/c she will die without someone to revive her, but living like this is really taking its toll. She refuses to get tested, and everyone that I ask for help says that they can't help me if she doesn't have a diagnosis. I've called the cops, Adult Protective Services, the Battered Women's shelter (for myself) and even her doctor. No one will help me if she doesn't have a diagnosis. Any and all advice would be greatly appreciated! Thanks!

[maryduplessis]

My personal experience was, upon walking into my mum in laws bedroom, it all depended on her mood. I would always enter with a smile and a cup of tea. If she scowled I would leave the tea with her and walk out, wait 10 mins and walk back in. Towards the end I was dealing with a person who kicked when you dressed her and would try to tear her clothing with her teeth and bit and scratched. I would calmly grab her hands and hold them on her lap where I would gradually release them. This action proved to be more effective when I sang her favourite songs and especially when bathing her. Patience is what is required and don't ever raise your voice or appear impatient. I would also play the distraction game. To stop her getting up out of her wheelchair I would ask her to hold her bible on her lap while I made her bed. In her youth she was very religious so this tactic worked. Afterwards I would read a small psalm or story. Yes, caregiving requires lots of stamina and patience but it has its rewards even on days where you end up the worse for wear 😂😂😂...

[sarahstrong]

If someone has picked something up & is waving it around in an aggressive manner, one thing that can be tried is to praise them for finding the item & being so helpful & say how much you appreciate them, at that point they may just let you take the item from them.

[TortureBot]

My 74 year-old mother that is usually very level-headed and does not have dementia just got out of the hospital for a horrible UTI that almost killed her. Her blood pressure had gotten down to about 64/42.

After a week in the hospital and days of confusion and irritability they got her kidney function back to normal and her blood pressure holding on its own without medications.

They sent her to a place for therapy that is basically a nursing home with a therapy wing.

She has only been there for about two days and has had two or three instances of what seems to be dementia and wanting to go home and such.

She lashed out at me tonight, her 51 year old son, and two nurses. They think her UTI wasn't completely healed or she might have another one.

[roamingnomeRV]

I know the largest factor for us dealing with my father in the 10 years of his diagnosis was that one, single episode where he was combative (after an hospital visit and they hadnt fed him). Once the hospital put "Combative" on his record we could no longer get him into any home anywhere. This ended up a blessing for us, as we got a live in nurse to help us at home until his death almost 2 years later. But I dont think he would have received the level of care he did had we been able to put him in a home. I know there are people who are unable to make the choice we did. But I was able to quit my job and we cut or income so that I could be at home to help my mother with my fathers care all day. I think we had it easy as my father was a lifelong firefighter, but a "Gentle Giant" as far as personality. He was rarely angry, but he did have agitation in the form of "singing" (which was actually him just making loud noises) and fidgeting.

[dianaleal]

I remember when I started taking care of clients with aggressive behavior this lady told me don't bother her and that I was not to come out of my room. Her daughter just left and she said just make sure to check her during the night I was assigned to a sleep over. I did check on her and told her to let me know if she needed help. I was kind to her she was agitated because she thought she didn't need Care. Her daughter was very nice. I did make something in the morning for her and she seemed better. Caregiver for 24 years and still working at 72. I like my job

[michelemoline]

This is 100% my mother. I literally just went to the Dr and had a broken and sprained thumb.

[dianamarella]

The problem with all these solutions is that there are many types of dementia and the aggresive patients do not understand communication, so in theory these are good suggestions but when you cant even get close enough to care for a patient without being attacked these are not helpful. Also she said "call the doctor for more help" lol there are no doctors in site, only aides and nurses. The doc gets called by the nurse after a situation is over. I guess all im saying is i appreciate what she is saying in the video, its just not real life.

[onthehill]

Keep in mind if you call a paramedic, they will send the police as well if it has to do with aggressive behavior. My aunt with dementia got aggressive with her husband and she was arrested! They sort it out later. This made the situation even worse.

[yocelin]

Thank you! I had just gone through this with my loved one, and this video was suggested for viewing. I could not believe it. It’s just what I needed. Very informative.

[DreamsOfFinland]

My option: CBD oil for daytime, and THC cbd at night. About $40/month, no side effects except calming and being able to think.
Now there are edibles, life changing easy treatment of severe anxiety and rages. I got stuck in a bad bout, could not stop myself, was given some Purple Kush in a pipe. 2 minutes later my heart opened, I apologized to my family, totally calm.

[DementiaSurvivor]

Just like every other time I've tried to get help, I clicked on the link and it just isn't there. Just like there isn't any help and we are definitely on our own. God bless us all.

[Bellalovesyouever]

My problem as an aide is my patient is 94 and still has a lot of motor skills so she’s capable of pushing you out of the home. Her daughter believes she should tell her mother when she forgets things and makes my patient agitated and in turn my patient later on with lash out on me. There has been more recently and when I asked the daughter if she was taking her medication she told me that it makes her mother tired and didn’t want her on it. This is my main patient I see 10am-5 pm 5 days a week, and I’m honestly not sure whether to ask for a different patient as I believe I’ve done what I can to help just don’t think I’m the right caregiver for her. I have bruises from the last time she lashed out and have had them before from previous times
I honestly have no idea what to do

[maryjames]

my grandma suffers from dementia. What she does next is based on her thoughts start speaking random things of people who aren't present at this moment and when we corect her there's nothing like that. She gets even more loud as to prove she's right. She will keep repeating and irritating my mom...my mom who's is taking care of her throught the day...my mom can't step out of the house to go for a walk because as soon as she sees my mom change into clothes to go outside she will suddently happen to have a headache or stomach ache. If her water or food delays by a minute she will suddently have a spinning headache.
She will simply go again and again to toilet even after mom reminding her that she had just gone to pee few minutes before. If she doesn't allow her to go ( bcz it's only a memomry loss thing) She becomes loud ...repeats saying it again and again so that we get irrtitated and tell her to just go!....I have seen so many grandma's staying with kids...none are like her. What to do? how to take caree of them without us being loud as her.

[jennkerry]

My mother is probably a stage 3-4 angry dementia with sociopathic and narcissistic personality disorder. Talk about an extremely hard combo to deal with. She’s 68, my father just passed in October’23 and we’ve found that her condition exploded after he died. We don’t know what to do with her other than have the cops called for her to be hospitalized. My sister lives with her, but she’s done. She’s moving out and coming to live with me. My mother will be utterly alone. She’s isolated herself due to her personality. She’ll refuse to pay bills and the bank will take the house. I believe there’s also another underlying mental illness at play. But we feel that there’s nothing we can do because she’ll fight every step of the way. It’s hard when your hands are tied

[marketgarden]

Hey, your videos are great and have helped me a lot with my job. I've seen a lot of the behaviours from your guide videos and your impressions really nail it. Keep it up and thank you!

I've seen a little bit more confrontational behaviour lately, I think the coronavirus rules right now have upset a few of our people because the visors and face masks can be a bit scary and confusing, they want you away from them asap.