What's the Best Way to Handle Someone With Alzheimer's Who Gets Angry and Violent?

1 answer | Last updated: Sep 24, 2016
A fellow caregiver asked...

What's the best way to handle someone with Alzheimer's who gets angry and violent?

Expert Answers

Kathryn Pears, who has a master's in public policy and management, has been involved in dementia care for 30 years. She was a caregiver for her father, who had early onset Alzheimer's disease, and cared for him at home until his death in 1991. She was director of Public Policy and Education for the Alzheimer's Association, Maine chapter, until June 2011, when she left to create Dementia Care Strategies, where she provides consulting and training services to family and professional caregivers about all aspects of caring for someone with Alzheimer's disease or a related dementia. In addition, she has led multiple legislative initiatives in Maine to improve care for individuals living with dementia, including passage of a Silver Alert program to track missing people with dementia as well as special care unit disclosure.

Behavior in general is almost never random. It is how the person with Alzheimer's communicates when they are unable to verbalize their needs or concerns. Anger and agitation in particular are the result of the person being unable to make sense of their environment or interactions. The confusion they feel results in stress which, if left unchecked, can quickly escalate into anger and violent or catastrophic reaction.

The best approach is to take a step back and look at the big picture"¦what was happening before the person became angry? For example:

"¢ Were they trying to complete a task that was too complex for them?

"¢ Was there a frustrating interaction with another person?

"¢ What was going on in the environment? Was it unfamiliar, too loud, too many people?

"¢ Does the behavior usually occur at a certain time of day?

"¢ Could the person have an undiagnosed medical problem, such as a urinary tract infection or other illness that is causing them discomfort?

"¢ Is there any evidence they might be having hallucinations?

"¢ Is it triggered only by certain individuals?

If you can figure out what is triggering the behavior you are well on your way to preventing or minimizing it.

Watch for subtle changes in the person's physical demeanor. If you observe them starting to look restless or stressed that is the time to intervene. Don't wait until the lid blows! Change the topic, guide them away from what is upsetting them, take a walk, play some quiet music, anything that will take their focus off of what is causing them to get angry.

You may have to do some experimenting before you find the right combination of triggering event and intervention but keep at it. A little detective work will go a long way to resolving this problem.