Alzheimer’s Disease and Violent Behavior

Alzheimer's Disease and Violent Behavior

One of the major challenges in caring for a loved one with Alzheimer’s Disease can be coping with the personality changes that often occur, and these changes can include aggression and violence.  Alzheimer’s aggression most often flares up during the later stages of the disease, many times for no apparent reason. This behavior can include mistrust and paranoia/delusions, yelling, screaming, and cursing, and hitting, grabbing, pushing, kicking, scratching, throwing objects, and even biting.  Alzheimer’s aggression is one of the main reasons most people put their loved one in a nursing home. No one knows for sure why some patients with Alzheimer’s lash out and become aggressive, while others do not, but there are “triggers” that that caregivers can look for. By recognizing these triggers, caregivers can lower their loved one’s frustration level, and reduce the number of outbursts.Possible triggers for aggressive/violent behavior:

  • Hunger, thirst, too hot, too cold, or being in pain, with the inability to convey or explain it
  • Medication side effects
  • Something feels threatening or uncomfortable in their environment
  • Frustration with themselves for forgetting names, faces, where they put things
  • Baths, showers, getting undressed for bathing
  • Being in a crowd for fear of getting lost
  • A loud, busy, confusing environment
  • A new, unfamiliar environment
  • Lack of sleep
  • Lack of a regular routine
  • Confusion caused by being asked too many questions at once
  • Visual and auditory hallucinations

Knowing and recognizing the above triggers can help a caregiver understand and possibly avoid a violent episode.  If your loved one does become aggressive and violent, here are some tips on how to handle it:

  • If what you are doing is causing them to react, stop doing it, and step away
  • Redirect them to another activity, distracting them with a pleasurable activity
  • Validate their feelings, telling your loved one it’s okay to feel frustrated
  • Use soft, gentle tones when speaking, and always smile.  
  • Do not initiate physical contact during an angry outburst – this can trigger physical violence
  • Give them space to play out the aggression, but make sure that both you and your loved one are safe
  • If the aggression is turning violent, and you are your loved one are at risk for harm, call 911
  • After an incident is over, learn how to debrief and try to identify what caused it, so the trigger can possibly be avoided.  

Fortunately for many patients, Alzheimer’s aggression and violent behavior seems to fade over time. While the dementia itself is not reversible, the aggression does seem to subside.  In home caregivers in Maryland and elsewhere can provide respite help so that family members can take a break to get rest and refreshment.

Here are links to some Alzheimer’s resources:

Alzheimer’s Behavior Management
Alzheimer’s Association



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