How Do You Know What To Do With A Violent Dementia Patient?
While general society may know that dementia can cause problems with memory and cognition, some people may not know that this condition can lead to aggression in some cases. Individuals with dementia may sometimes experience violent outbursts, even toward loved ones.
Violent behaviors can present significant challenges related to safety, as well as emotional challenges due to a sense of being attacked by someone you love. Caregivers of those with dementia may benefit from learning more about the condition, possible reasons for aggressive behavior, and how to support a violent dementia patient.
What is dementia?
When some people think of dementia, they may think of Alzheimer’s disease. While Alzheimer’s is the most common form of dementia, it is not the only type. The term dementia refers not to a single disease but to a set of symptoms that can have various causes. Other types of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia, among rarer variants.
Vascular dementia is often caused by a lack of blood flow to the brain, and Lewy body dementia is related to deposits of the protein alpha-synuclein in the brain. Frontotemporal dementia is typically caused by the loss of nerve cells in the frontal and temporal lobes of the brain.
While some symptoms of dementia may vary depending on a person’s dementia type, there are often standard symptoms in those living with dementia. Symptoms can vary at different stages, but the following are some of the symptoms that individuals living with dementia may experience:
- Difficulty remembering words
- A tendency to lose items
- Trouble concentrating
- Challenges with understanding thoughts
- Difficulty recognizing people
- Loss of interest in activities
- Trouble speaking
- Problems with balance
- Inability to practice hygiene and get dressed
Dementia and violence
Some people with dementia become frightened or annoyed when they hear loud noises or when there is too much noise in their environment. Other causes of violence may also occur, and each individual is different. When facing aggressive behaviors, it may be helpful for loved ones to look at the underlying cause and consider seeking support.
What to do when a person with dementia becomes violent
When a loved one is the target of a violent outburst from someone with dementia, they may have conflicting emotions. They may have empathy and understand that their loved one is not acting aggressively on purpose. However, they may also experience frustration when exposed to aggressive behavior while trying to help.
In these situations, individuals may first think about safety. If you don’t consider your safety, you could become injured, which could, in turn, affect your ability to care for your loved one. If the person becomes violent, you might try to put some physical distance between you and them. If you are not in danger, consider finding a way to ensure that your loved one cannot harm themselves. You might consider calling for assistance to ensure both of your safety.
A violent dementia patient may be confused, making reasoning with them difficult. If they become confrontational but are not in danger, it may help to leave the room temporarily and stay outside the door to ensure their safety. If you enter again a few minutes later, they may be ready to engage more calmly. Do not leave them with items they could use to hurt themselves.
Below are a few strategies that may help individuals avoid or de-escalate confrontation with a person with dementia:
- Provide concise, one-sentence explanations while speaking slowly.
- Remain calm and repeat your explanations verbatim.
- Allow the person extra time to comprehend your responses.
- Avoid arguing.
- Don’t tell them that they have forgotten something.
Regarding the last point, it may help to gently go along with what the person with dementia tells you. For example, if they tell you they hate a meal they just requested, reminding them of their request may lead to further confrontation. Instead, you might say that you forgot. Doing so doesn’t mean that you have to accept a loved one’s behavior when they are abusive, but understanding minor comments may help you avoid confrontation.
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
Strategies to foment a calm environment
In addition to the above strategies for confrontation, it may help you prevent such moments to promote a calm environment. The following are some strategies that may help:
- Place pictures or familiar items around the house.
- Play soft music or songs that the person enjoys.
- Limit the number of visitors one sees at a time.
- Try to avoid loud noises.
- Maintain an organized home environment.
- Maintain a regular schedule for meals and sleep.
Despite your efforts to create a calm, pleasant environment, a person with dementia may experience moments of frustration and become aggressive. At times, this response may be due to an unmet need. For example, they may have physical discomfort from a need to use the bathroom, or they may have wet or soiled their undergarments (possibly in the later stages of dementia). At other times, their needs might not be so obvious. For example, they may feel frustrated that they cannot carry out everyday activities or believe they have been left out of a decision-making process.
During moments of tension, consider what the individual needs at the exact moment and try to meet that need as much as possible. If they are still upset, consider taking a few moments yourself. For some caregivers, a few moments of deep breathing or mindfulness exercises may serve as effective self-care measures that protect their own mental health and well-being.
Getting help as a caregiver of someone with dementia
The loved ones of someone with dementia often experience unique emotional challenges. Their lives can seem to be uprooted by caring for someone who can’t live independently, especially in the later stages of dementia. Family members may find it helpful to speak with a counselor about the challenges involved with caregiving.
Individuals who don’t have time for in-person therapy due to caregiving responsibilities may benefit from online therapy through a platform like BetterHelp. With online therapy, caregivers can connect with a therapist from anywhere via phone, video, or live chat. With some online therapy platforms, they can also contact their therapist via in-app messaging, and their therapist can respond as soon as possible. This feature may be helpful after experiencing a violent outburst from a loved one with dementia in between sessions.
Numerous peer-reviewed studies have demonstrated the effectiveness of online therapy. One study published in 2017 found that online cognitive-behavioral therapy (CBT) was effective in managing a number of disorders, including depression, which may be common among caregivers of people living with dementia. A therapist may also be able to help caregivers navigate complex decisions, such as exploring memory care communities for their loved one.
Takeaway
Learning how to manage aggression can be emotionally draining for family members, who may feel frustrated as they try to help their loved ones. To handle these challenging emotions, it may help to speak with a licensed therapist. If your caregiving responsibilities make leaving your loved one alone challenging, you might also consider online therapy.
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