Responding to Agitation and Aggression in persons living with Dementia

Agitation and Aggression- Individuals with dementia frequently become restless, anxious, or upset you may see a resident pacing, moving furniture or objects, talking to themselves, yelling or swearing. These behaviors can escalate to aggressive behaviors like, threatening or causing harm to another by pushing or hitting, cornering another resident or staff, or even throwing objects or food. And unfortunately, aggression among people with dementia can happen suddenly and seemingly without warning.

I am here to let you know if you pay attention you may be able to diffuse the situation or even prevent it.

Things to try to decrease agitation and aggression:  First thing to do is remind yourself to stay calm, it can be very very difficult but by reassuring your resident you are offering them security and creating a safe environment.

Our job is to figure out What they are trying to tell us?? remember all behaviors stem from something. So, we are going to listen to our resident as they verbally and maybe physically express their frustrations. They may not make much sense to you but sometimes a good detective can figure it out and ease the person agitation.

Possible triggers:

So, what are possible triggers:  Pain, discomfort, like being too hot, too cold, hungry, needing to use the bathroom, etc.). Perhaps they may be frustrated or overstimulated.

Environmental triggers: turn down the tv/radio, decrease noises that are loud and startling, move the resident to a smaller dimmer area, play soft music, hold their hand if they will let you and continue to reassure them you want to help.

Do Not: scold them or tell them things like “you know better”  “stop that” “ don’t touch that” that’s not yours” “ this is not acceptable. Because it is not going to help, in fact, it may make things worse.  Get yourself into their reality they are only trying to meet their needs.

Your Behaviors: It is also very important to reflect on your behavior in response to the person. If you are not already doing so, reassure the person that you are there to provide assistance and comfort. If it seems like the person needs something to do, try redirection to an enjoyable activity. Refer to a social history if there isn’t one accessible talk to your manager.

Behavior charting:  when charting on a behavioral incident or when filling out a behavior flow sheet, it is helpful to use specific, concrete words that clearly describe what a resident is doing so you can truly track whether the interventions/changes the environment work to decrease the behavior

Remember: no person is the same so not every intervention will be successful and what works for one may not work for the other. When you do find something that works, share it with your coworkers and manager.

Emmy Kaczmarksi, RN is a Master Trainer for AGE-u-cate® Training Institute, Dementia Educator, Behavioral Specialist and lives in Hudson, WI.