What to do with a violent dementia patient

What to do with a violent dementia patient

A violent dementia patient can be extremely dangerous and pose a serious threat to themselves and others.

Old people can get mean which often leads to a decreased quality of life for both the patient and caregiver.

Personality changes can be extreme and very unpleasant. 

The person may become agitated, confused, paranoid, and exhibit aggressive behavior.

The person’s behaviour may include hallucinations.

They often blame at family members and their caregiver for imagined threats to their safety.

It is important to seek professional help if you are caring for someone with dementia.

Their behavior may include throwing things which can lead to physical abuse and violence.

There are many support groups and resources available to help you deal with this difficult situation.

Unfortunately, dementia can be one of the most difficult illnesses to cope with.

It affects both the person who is diagnosed and for their loved ones.

One particularly distressing form of dementia is when patients act aggressively and are hostile.

They often become unrecognizable as the person they once were.

The spouse, usually the caregiver is left to cope with these changes.

 Know they too require physical and emotional support.

This can be an extremely difficult time for the caregiver, who may feel overwhelmed and unsupported.

The caregiver must receive both physical and emotional support to cope with this challenging situation.

Below are some strategies to help caregivers manage aggressive responses.

How to deal with aggressive patients with dementia as the caregiver

Dealing with aggressive patients with dementia can be a difficult task for caregivers.

It is important to understand the reason for the aggression and to try to diffuse the situation.

Just know that the behavior is not intentional.

This is usually a result of the disease process affecting their brain.

There are various ways to deal with aggressive patients with dementia.

Some tips to deal with aggressive patients are:

1. Remain calm and do not show anger or frustration

It is important to keep your own emotions in check.

The patient will be picking up on your energy and may become even more agitated.

The natural response even for the most gentle caregiver is to respond in kind.

Unfortunately, this will only make things worse and escalate the situation and cause future outbursts.

Use calming techniques to de-escalate aggressive dementia behavior

Some people suffering from dementia may experience combative dementia.

When someone who has a severe dementia condition has a hard time communicating with a caregiver.

They often react aggressively and lash out at everyone.

These violent outbursts are terrifying. 

Older adults may cry or curse, shout, throw things, punch, or hit something.

2. Identify what may be triggering the behavior

Identifying the underlying cause is a good first step.

This could be pain, hunger, thirst, or boredom.

Once you know what is triggering the behavior, you can try to address the issue.

Address any needs that may be causing the agitation

For example, providing food, water, pain medication, or engaging in activities that may be of interest.

Use distractions: a change in environment or a simple distraction like offering a favorite treat can be enough to diffuse the situation.

This could involve changing the subject, playing music (music therapy).

It may be showing photos that may trigger distant memories of more pleasant times in their lives.

3. Avoid arguing or confrontation

Arguing with a person with dementia will only aggravate them and is likely to lead to more aggressive behaviors.

Speak slowly

Stay calm and speak at a slower pace than you normally do.

This is a good technique when dealing with a patient with Alzheimer’s disease.

Aggression and agitation in Alzheimer’s Disease

A person with Alzheimer’s suffers from deteriorating cognitive function.

During the later stages of the disease, they can suffer memory loss and reduced comprehension levels.

This adds to feelings of frustration that are expressed as aggressive behavior or even escalate to violent behavior.

4. Provide a safe and comfortable environment for the patient

When caring for a patient with dementia it is important to create a safe and comfortable environment as part of daily living.

This means minimizing distractions and creating a calm atmosphere.

It is also important to keep communication simple.

Avoid asking the patient to complete complicated tasks.

Try to provide plenty of opportunities for stimulation and socialization.

These can help reduce agitation and behavioral problems.

It is also important to be aware of the patient’s preferences and accommodate them when possible.

If the patient prefers to sleep in a certain bed or wear specific clothing, make sure these needs are met.

It may also be helpful to have objects in the room that remind the patient of happier times.

It is also important to keep communication open with the patient and their family members.

This allows for updates on the patient’s condition and can help reduce any confusion or distress.

Thoroughly explain the changes that the patient is experiencing and help them to understand what is happening.

Make sure to answer any questions they may have honestly and openly.

It is also important to provide support to the family members as they deal with their feelings about the situation.

Also, be aware of the family dynamics and do not assume all family members are reading off the same page.

In some circumstances, some siblings don’t help with caring for elderly parents which can cause tension and resentment among other family members.

If necessary, use physical restraints safely and calmly

There is no definitive answer to this question as it depends on a variety of factors specific to each situation.

However, in general, physical restraints may be necessary in cases of severe dementia.

This is where the elderly patient is a danger to themselves or others.

For instance, if the individual is wandering around and getting lost, or if they are becoming agitated and violent.

Only then physical restraints may be needed to keep them safe and calm.

Also, ensure that there are no objects within reach that could be used as weapons.

Don’t attempt to physically restrain the patient if you are not trained to do so.

This could lead to further injury.

5. Keep communication open and positive

Use verbal commands sparingly and calmly.

This can be difficult when the person with dementia is being disruptive or difficult.

However, it is important to stay patient and understanding.

Instead of asking “why are you angry?” which can make the situation worse.

Instead try saying “I need you to calm down now.”

This sounds easier said than done especially when the behavior is difficult to manage.

Do not ask too many questions in one interaction. 

Reduce these conversations to short periods over the whole day.

Let the patient know that you are there to help and support them.

Acknowledge their emotions

Try to understand what they are trying to say, even if it is difficult.

It is important to remember that the person with dementia still has feelings and thoughts.

This is even if they may not be able to express them clearly.

Make sure that there is plenty of time for communication

Don’t expect the person with dementia to be able to carry on a long conversation.

This is especially important if they are feeling tired or agitated.

Try breaking conversations down into small chunks.

Allow for plenty of breaks and distractions in between.

If these tips are followed, communication can remain positive and open in even the most challenging situations.

6. Remove yourself from the immediate environment

Sometimes the only thing to do is to take a deep breath and leave the room.

The caregiver also needs their personal space.

 Removing themselves from the person with dementia is the best move they can make.

It can help manage the situation by providing some time for them to regroup and relax.

The caregiver can then return to the room with a fresh perspective.

They are then better equipped to handle the situation.

It also gives the elderly patient some privacy and can help reduce their anxiety.

Do not feel that as the caregiver you have to be there 24/7. 

This will only lead to caregiver burnout.

When is medical intervention appropriate?

There is no one answer to this question as each case of dementia will present differently.

Medical interventions are appropriate when a patient’s behavior becomes a danger to themselves or others.

Patients with Alzheimer’s disease and dementia can become agitated and violent, and difficult to manage.

In some cases, medication may be prescribed to help calm the patient and reduce their agitation.

Families should work with their geriatric specialists to come up with a management plan that works best for them and their loved ones.

If the patient’s behavior continues to be a problem, additional measures may be necessary.

These may include a referral to a nursing home or assisted living facility.

Summary

There are a few key things that a caregiver can do to manage a violent patient effectively.

1. Remain calm and try to avoid provoking the person.

2. Avoid arguing or trying to reason with them.

3. Try to establish and enforce boundaries with the person.

4. Make sure there is always someone else around when caring for the person, in case of an emergency.

5. Seek help from professionals if the behavior becomes too difficult to manage.

Frequently asked questions

What causes aggression in people with dementia?

People with Alzheimer’s disease and dementia can experience a wide range of symptoms.

They include changes in mood and behavior.

Aggression is one type of behavior that can often occur in people with dementia.

Several factors can contribute to aggression in people with dementia including:

1) The physical needs of the patient may not be met.

The patient may be in pain or physical discomfort, which can lead to agitation and responding in an aggressive way.

2) The person may be confused if their daily routine is not followed.

Their frustration at this unexpected break in their schedule can lead to upset, anger and aggression.

3) The person may be experiencing anxiety or fear, which can manifest as aggression.

4) Underlying factors such as a person’s environment may be contributing to their agitation and aggression.

They could be loud noises or overcrowding.

5) The person’s medication may be contributing to their aggressive behavior.

How many types of dementia are there

The most common type of dementia is Alzheimer’s disease.

Other types are frontotemporal dementia, vascular dementia and Lewy body dementia.

What are the signs of dementia getting worse

There are some general signs that dementia is getting worse:

1) The person has increasing trouble completing everyday tasks.

For example paying bills, using the telephone, or preparing meals.

2) There is a decline in memory, judgment, and decision-making abilities.

3) The individual experiences changes in mood or behavior. 

These include becoming agitated, paranoid, delusional or withdrawn and can turn violent.

4) There is a decrease in physical abilities and mobility.

5) The person’s health deteriorates overall.

6) They are unable to recognize familiar people or objects.