How can we calm an abusive dementia patient?

A fellow caregiver asked...

Are there any protocols or calming techniques for a belligerent agitated dementia patients?
My dad has dementia and is being cared for by a team of caretakers 24/7. Recently he wakes he thinks his overnight caretakers (weekend and weekday) are his enemies. He gets belligerent and says hurtful things to them. They realize that he is delusional but it still has an impact on them. He is not this way all the time. We are trying to keep him in his home as long as possible.

Expert Answer

Merrily Orsini, MSSW, was a pioneer in the business of providing geriatric care managed in-home care. She currently serves on the board of the National Association for Home Care and Hospice and is Chair of the Private Duty Homecare Association. She holds a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care.

There are really many techniques for calming an abusive dementia patient. To calm an agitated person with dementia, most techniques revolve around the caregivers being trained on a) the disease itself, b)how to approach the person prior to speaking or interacting, and c) how to react when there is some belligerence. Other items to try are soft music (whatever he liked when he was younger, but played to sooth him), soft lighting, but enough for him to see when he awakens so he knows where he is. Some communication basics are to always be calm and quiet. Never question the "reality" of the patient, rather just go with it. If there is agitation, leave the room (make certain he is safe) and return in 5 minutes with a good, calm, reassuring greeting and announcement that clearly states who the person is, and starts fresh. When your father awakens he may be disoriented and scared. He does not know who these people are as his memory does not allow that retention. That makes him belligerent. So, understanding that, the caregivers just need to learn techniques to deal with him that are specific to the Alzheimer's patient, and work with him. Here are some resources that you might find helpful to make certain that all are trained in how best to work with your father. Resources: The classic book on how to work with, speak to, and interact with a person with Alzheimer's is Mace and Rabins book the 36 Hour Day which can be bought really cheaply online as a used paperback. Dr. Verna Carson writes some excellent training manuals on what she calls becoming an Alzheimer's Whisperer. You can access information on those here: