How to Manage Anger and Aggression in Alzheimer's Disease
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- Опубліковано 15 лип 2024
- How to Manage Anger and Aggression in Alzheimer's Disease?
“When older adults are acting badly, that is a sign of
an unmet need.”-Melissa Batchelor, PhD, RN, FNP-BC, FGSA, FAAN
Older adults with Alzheimer's disease can get angry or be aggressive. These types of behaviors, when associated with Alzheimer's disease, can be a challenge for care providers and family members alike. These behaviors should not be overlooked and should be taken into consideration of the context in which the behaviors occur to try to find a solution.
Join me for this episode of This Is Getting Old: Moving Towards an Age-Friendly World, where we'll talk about How To Manage Anger and Aggression in Alzheimer's Disease.
Part One of 'How To Manage Anger and Aggression in Alzheimer's Disease.'
Anger and aggression generally happen in response to some underlying trigger, resulting in the behavior(s) observed. Below are some of the underlying causes of anger and aggression for an older adult living with Alzheimer's disease and the best ways to respond as a caregiver.
Understanding The Underlying Cause(s) Or Trigger
Possible Cause 1: Brain Changes
As caregivers or family members, you need to understand what cognitive abilities remain intact versus what deteriorates. Alzheimer's disease is essentially “brain failure” - meaning memory ability is lost over time, and thinking and problem-solving become much more difficult. At a certain point, the person also loses the ability to use and understand language. However, one part of the brain that remains intact is the basic responses of Fight, Fright, or Flight. The Fight, Flight or Fright response may be what’s coming out as angry or aggressive behavior in the person with Alzhiemer’s disease, so we need to be mindful of this when interacting with a person. To make sure that they hear us and see us, before we touch them.
Possible Cause 2: A General Health Problem or Physical Discomfort
Another trigger for angry and/or aggressive behaviors are a general health problem or physical discomfort. You need to understand that when a person with Alzheimer's disease is experiencing pain or discomfort, they aren't going to be able to tell you what's hurting. They may hurt in their elbow or their hip, but they can't tell you exactly where they're hurting because they can’t localize pain (what this means is that when they feel pain all over - rather than in one specific spot).
To figure out if or where they are hurting, you will have to look at nonverbal behavior, such as facial grimaces or holding a specific part of their body. Look for any nonverbal behavior as the way the person will communicate with you - rather than just straight out telling you what's wrong when they can no longer use or understand words.
Possible Cause 3: Environmental Factors
The environment does have an impact on someone with Alzheimer's disease. If your home is generally quiet or you live by yourself when you have a little bit of cognitive impairment, if the whole family shows up and there are twenty-five people in the room, that is a totally different level of activity. The sudden change of environmental noise may be too much stimulation and this can create anxiety, which might drive angry and/ or aggressive behavior(s).
Possible Cause 4: Poor Communication
When a person living with Alzheimer's disease loses the ability to use and understand words, their only option is to use behavior to communicate with you. When you see someone acting badly, that is usually a sign of an “unmet need” - so trying to figure out what they may need will be the better strategy for managing the behavior.
Part Two of 'How To Manage Anger and Aggression in Alzheimer's Disease.'
Best Ways to Respond?
Response 1: Safety First
If you're dealing with someone that's very angry and they are being very aggressive, the first thing to do is to make sure to maintain their safety. Once you know they are safe, it would also be best if you back off and give them space to calm down. You may need to remove yourself from the room if the anger or aggression is directed towards you. Give them the time and the space they need to calm themselves down in a safe place.
Response 2: Become A Detective
After making sure the person is safe, the next best response is to become a detective. I usually teach what I call the 3CP Model. The 3C’s are: Change the person, Change the people, or Change the place. This is a simple way to think through identifying behavioral triggers and preventing or resolving problematic behaviors.
Read the full article here - melissabphd.com/podcast-blog/
My 90 yo father has AD. His aggression has gotten so bad, he won't even cooperate for a neurologist to do a thorough evaluation now. We need to move him to a more secure environment and cannot get him to cooperate or be less aggressive. We are afraid that if we manage to move him, he is going to be aggressive with staff and other residents.
My Grandpa has always been so sweet, but for the last 2 years living with him, his new aggressive attitude is prominent 24/7, and it’s been really frustrating for having to deal with him.. And although we’ve been giving him top notch hospitality, he’s been having accumulating episodes of him aggressively complaining to my mom, and since he’s been raising his voice at my mom, i’ve come to the point of disowning him in our relationship, even telling him that I hate him. He’s recently threatened to call “Elderly Abuse” on me, just because I don’t talk to him anymore and it’s getting real out of hand.. this vid has helped a lot, so thank you🙏🏽😹and i hope i can find the strength to keep up with him
Dealing with someone with Alzheimers is probably the hardest thing ive ever done. My 84 yr old Mother has this disease. Im her 57 yr old son. Ive left my job to stay with her and take care of her and its put me in a financial crunch. My credit is in the dumps, my personal life doesnt exist and it seems like every day something new comes up. Sometimes I truly feel IM loosing my mind. Sometimes I dont even want to get out of bed. It takes tremendous patience to not snap back sometimes but im sure we all cope how we can. I would have never believed this happened in life but it does and did. Whats really difficult is, my Mother has BCBS Medicare. The more I read, the more I realize "if she isnt on Medicaid, theres no chance of getting paid as a caretaker, like so many think." So, i cant work and leave her alone, she doesnt want ANY strangers coming in and Im getting deeper and deeper in debt. This is a very tough position to be in. We all need to hang in there. Ive been told theres a special place in Heaven for people like us.
@@bigmoneygrip6561 You're a great son, and I'd say just remember what she was to you before the disease, and especially remember what she's always wanted for you.. So don't forget to put care into yourself first as well🤍🙏🏽 much love bro
I am 30 my dad is 63 with alzehimer I just wake up he was shouting at me telling me to bring his money back! My heartbeat was rocket flying I gave him a glass of water and couple of oranges.he do have a social service helpers in the day.but during the weekend we stay with him.my mom hates him she humilate him when he watch girls in bikini on youtube and throw some insults on him. There is no relationship between them at all, he always calling me during the day not because he loves me but because i bring him all what he needs.no body in my family accomidate him like me.@@bigmoneygrip6561
Thank you for the advice. I have a client with Alzheimer’s and it’s really hard when she has ‘off days.’ But everyone needs to remember to always treat them with respect and empathy is the best approach. They do not understand what is happening so focusing on their good times is key
My 94 year old mother has stage 5 Alzheimers and lives on her own. She has carers twice a day, 6 days a week and has no recollection of them. Mother has a care package under Adult Social Care Services which includes regular health and safety assessments. She has a cleaner, hairdresser and chiropodist weekly. Mother is deaf and refuses to wear hearing aids in her home. She will not consider wearing a safety pendant or bracelet because she says she does not need it. She refuses to use a walking stick on her one outing a week for shopping with my brother. Mother takes the stick reluctantly and uses it like a water diviner. She rings my sister constantly asking for a.car parked outside her bungalow to be removed. It is not her car. She rings asking for her boiler light to be turned off and writes endless shopping lists which are useless. We have only recently got her to wear incontinence underwear thanks to her carers. Mother causes us, her family, a great deal of concern over her relentless denial issues and we are the ones who become agitated and angered by her attitude. Mother only becomes angry when we tell her that due to her inability to maintain herself and her bungalow, she will be moving into a Care Home. Then we see a real change in her. Loud,verbally abusive, foul tempered and in total denial. For another day. Until the next time.
S
during my Darling husband's sundowning, he was extremely agitated, combative and angry...he scared me...he always wants to fly for a business trip and when the staff won't let him out....he becomes fearless...what amazed me, I just tried to comfort him and walk with him as he yelled at everyone...then I asked him if we could pray...amazingly, he was willing to return to his room and we sat down and he started to pray....what a transformation...our Faith saved us that day...he apologized...a moment of kindness and clarity...I will always remember that moment of a beautiful man coming through...
Thanks for this it was very helpful. My Father-in-law has dementia and COPD and Heart Failure. His dementia is not clearly diagnosis but he is on Hospice and his primary care doctor felt he could not handle the tests. This has helped me greatly because he has aggressive moments especially at night when he sundown's.
Wow. This is so hard. Thank u for your wisdom.
Excellent professional advice and thoughtful techniques. Your calmness and intelligent approach is refreshing. The world is a better place with this kind of mentality. Thank you for sharing this. 👍🇨🇦
Great advice and tips
Very helpful
thank you
That was really good is there a part 2?
Now I understand some of the things my momma is going through. Be blest😘
Adding my mite here - sometimes aggressive behaviour can suddenly occur when there is an infection. Usually a UTI.
Thank you for being helpful.
Happy to help!
Thank you for your reply.
Would this also apply to episodes where they are agitated and thinking incorrectly? For instance, my mom would not get out of the car to go into the grocery store with my sister because she said she wouldn't support my sister "shop lifting". She said my sister stole things in the previous store. My sister has never shop lifted and we were both baffled. My mom was really angry and agitated.
It is so hard hard to get appts for things like eyes, ears, etc. If my mother refuses to go to audiologist, for instance, to get her aides fixed, it can take months to reschedule.
I get angry at my mom she fights me and I have been losing my temper with her. I am ashamed. The way she acts has been different me crazy. I hate myself
I'm sorry to hear that and I feel your frustration. I would recommend NEVER arguing!!! For your sake and your mother's.... No matter how bizarre the request, concern, etc... GO ALONG WITH IT. Say "oh, yes, I will fix that." I know this isn't easy but you will see the difference...
Never try to reason or be the one who is right, the one who is going to "explain things" so that they make sense. They will not make sense to your mother and your efforts will be for nothing. She may argue if the sky is blue. Change your perspective to focus on feelings versus thought/logic and respond only to the emotions. Do not try to make sense out of nonsense... This takes great patience but I know you can do it.
And please don't be ashamed! You're resilient and brave for talking on this responsibility and seeking proactive ways to ease the burden of this horrible disease. Take time for yourself to RELAX and don't feel bad distancing yourself when you need to. God bless
Same here…. It’s a difficult test, but we’ll get through it💪🏽
Thanks the advice. What if someone is incontinent and flat out refuses to wear their pads?
I can understand wanting a different shirt or not being hungry right now.
But that’s a hygiene issue.
Good question! I wish I had an answer... I'm a caregiver and one of my clients used to strip and remove all clothing. Reminders to keep clothes on didn't work so I would have to physically put her pants back on (gently) and tell her that we can remove the pants at bedtime or when using the bathroom, etc. Also being considerate of side effects from meds (ex: maybe she is hot and trying to cool off?)
Instead of referring to the pads as "pads"-- I would refer to them as just part of the underwear. Maybe say, "we're going to keep your underwear on for now (meaning pad) so that your pants stay clean. I know she is probably not concerned about cleanliness but it's worth a try. 🥺
I care for a woman now who is bed-bound and I refer to the diaper as her underwear. I never say diaper as I imagine it not feeling as dignified to her. I know it can be difficult and sometimes nothing works which can be extremely frustrating. I wish you well ❤️
I say, it’s my job. I need to keep you dry and clean. If that doesn’t work, I leave the room for a little while (1-2 hours) and try relocating him/her to a chair to work on the wet linens.
It is emotionally difficult for me because, both my mother + aunt, who used to be great people, have developed these symptoms, and I have almost no logical communication with them anymore, and I’m afraid that my spouse will be hurt by this also. I don’t know what to do to make it better.
How can I deal with an Alzheimer's client who throws her food at me everytime I feed her?
You’re not “feeding” her, you’re assisting her to enjoy her meal: just slow down, if she’s able, then let her hold the spoon with you helping her to move it towards her mouth. If you get a colleague to blindfold you and “feed” you in a hurry with food which may not be your preference , you’ll feel how your client might feel. If you’re stressed when you assist, she’ll feel it too. If someone has been impatient with her before, she’ll be frightened or upset every time it’s mealtimes. Slow and steady try friendly chatting and eating with them as that might help. Good luck!
Wait what did I watch?
Sorry if this sounds trivial but as you can see, like you, I have curly hair, and yours looks fantastic! Any tips? Where are you based? I want to go get my haircut wherever you go! :) Thanks.
Reminds us of angry Joe Biden.
DUH????
that's what I said
What's duh ? Please explain