How to Cope With the Physical Aggression of Alzheimer's
Physical aggression -- hitting, biting, scratching, spitting, and otherwise lashing out -- is not uncommon in someone in the later stages of a dementia illness such as Alzheimer's disease.
There are two main reasons why people with dementia may turn violent:
Personality changes brought on by the disease include loss of inhibition and self-control. A mild-mannered individual may do things he or she never would have previously.
Emotional or physical discomfort is the top trigger for physical aggression. The person feels insecure, threatened, angry, tired, embarrassed, humiliated, or otherwise vulnerable but lacks the ability to communicate these emotions in a socially acceptable way.
How to prevent aggression
Try to keep the person calm, secure, and comfortable. Make sure the person is dry (if he or she wears adult sanitary products) and is neither hungry nor thirsty. People with Alzheimer's forget to eat and can't always tell you what they need.
Keep to basic household routines. Ideally, sleep and meals happen in a predictable way every day. Ideally, the person with Alzheimer's gets fresh air (weather permitting) every day and/or gets a little exercise, even if it's just walking through the house.
Keep a written log of what was happening just before violent outbursts. Try using the ABC method to understand Alzheimer's behavior. You may soon see a pattern. If bathing tends to spark violence, for example, can you tell what seems most upsetting about it? If it's being cold, maybe you can turn up the heat, shut the bathroom door, and run towels and a robe in the dryer before you begin.
Prepare the person for triggers as best you can. Obviously you can't preempt every upset -- if a substitute care helper shows up, you still need the help of that person even if the new face is upsetting to the person with Alzheimer's. But while it's not usually productive to rationalize with someone who has dementia, telling them about an upcoming change is considerate and may offer a little preparation. Keep your tone calm and upbeat -- letting your own frustration show through words or body language will only make your loved one tense and more on edge.
