How to Deal with Aggressive Dementia Patients (4 Strategies)

Download 2 FREE dementia cheatsheets at this link: dementiasuccesspath.com/yt-cs
1- Activities Ideas
2- What to say/do for specific Challenging Behaviors
Thanks for watching! In this video, we talk about 4 strategies (or levels) of approaches on how to handle a combative dementia patient and manage anger outbursts. I've this learned while working as a therapist (ie. not a nurse or doctor using meds) at a psychiatric hospital for elderly and mostly dementia patients.
Join our mini-series event starting May 17,2022 at 7:30pm EST Get 1 Win with 1 Challenging Behavior in 7 Days Experience.
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It is a week-long training experience with easy-to-follow steps to get 1 win with 1 challenging behavior so you can make caregiving easier (even if you're feeling stressed, overwhelmed, and at the end of your rope.)
Your 7 day experience will consist of:
20 minute Facebook LIVE trainings for 5 days on May 17, 18,19, 20, 22, 23 which you can attend live or watch the playback of later.
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A live Zoom workshop the following week available at two different times - 7:30 E.T. on Tuesday, May 24th or 7:30 E.T. on Thursday, May 26th - called “3 Ways to Make Challenging Dementia Behaviors Easier” where we’ll celebrate each others big & small wins, participate in role-plays, and answer any lingering questions (as long as you sign-up, playback will be available if you can’t make it live.)
Free printable cheat sheets that you can reference in a pinch to stop struggling and start living on your terms.
A Facebook community specifically for this training experience to connect with & get support from other participants, so you get more effective, easier caregiving no matter how challenging your situation is.
1st Thing to Try: Asking & Giving Choices
If you need your loved one or client to do something, first ask yourself, how important is it that they do what your asking and is there a way that you can ask them or give them a choice.
Especially with basic tasks, caregivers forget that being given commands day after day can wear on anyone especially someone with dementia.
2nd Thing to Try: Giving Space
If they are still getting aggressive, ask if you can do it later. Giving them some space if it is safe to do so to cool off will help avoid screaming or hitting and they will likely be able to actually hear what your asking when they are less upset.
3rd Thing to Try: Calling for Help
If intervening for immediate health and safety concerns has to be done, get someone to help you.
This cannot be overstated when it comes to health and safety. If you can, keep your distance to keep yourself and them safe and if you can't, in that moment, get them to safety as fast as you can
to minimize injury to yourself and them and get help ASAP. That someone could be hired help, a family member, friend or local services in your area like a doctor or even a hospital.
Bonus:
When Getting help when your loved one or client is getting violent and extremely verbally abusive out of nowhere as this could be a sign of medical issues that are happening at the same time
as the dementia that need to be addressed or a sign that your loved one needs medication to manage out of control moods.
Last Thing to Try
- Verbal abuse or violent behavior even after getting help
- could mean that it is time to place your loved one in a skilled nursing
- Or again at a hospital to get stabilized
- Getting help doesn't mean you've failed as a caregiver
- A lot of time, it is what is necessary to keep you and your loved one safe
- Just remember, no one can walk this path of dementia caregiving alone
Good News
- Thankfully, you can usually stop some warning signs before someone

[@jhutch1681]

My best tips for aggressive behaviour: 1) Pick your battles - can you let this go and still be safe? If it is important but not urgent, wait until later and reapproach. 2) You can't win if the answer is a hard 'no', so stop trying in order to avoid inevitable escalation. Use a distraction or withdraw, and reapproach again later. 3) Have someone else reapproach. Sometimes a fresh face is a whole new ballgame. Don't take it personally. 4) Use what you know about their personality. Are they independent, do they have a sense of humour, are they shy, do they like fashion, do they like to flirt, do they like to go for walks or have cups of tea? There are a lot of individual motivations and techniques that might help. As soon we do 'x' then we'll have our tea /walk... 5) Instead of trying to take a sweater away (as in the example), talk about the weather. Are you comfortable? It sure is hot today! I had to take my extra sweater off - though it sure was cold this morning... 6) Give them an out /give them credit. I know you usually like that sweater - it looks so pretty on you. I can see why you put it on when it was cool earlier. Now that it is so much warmer, you probably want to show everyone that beautiful shirt you've been wearing underneath! 7) Play favourite music. Lively, soothing, sing-along, dance tunes... It lifts the spirts and can improve compliance. It helps to smile and sometimes to be a bit silly (joking), or soothing (it's going to be okay /give a hug). 8) Compliment, empathize and reassure. 'You always look great.' 'I can see this is is hard for you, but I promise I will make sure everything is okay.' Reasoning is most often a waste of time. 9) Say yes a lot. Yes, you look great in that sweater - I can see why you reached for it - it brings our your beautiful blue eyes! I could just hang it here so it stays nice for later when you need it again. 10) Aggression is a response. Find out what the trigger is. Fear, discomfort, confusion, hunger, fatigue, frustration... Addressing the cause of the problem will reduce the upset. 11) Spend quality time to build rapport. Don't make all interactions task oriented. Make eye contact, offer to hold a hand, be patient and listen.

[@Nothanks450]

Thank you for simple recap, 27/7 caregiver here, no time for long drawn out video

[@jhutch1681]

Those are my tips besides what's in the video. I watched the clip on fast speed :) All the best to you. @@Nothanks450

[@oscardaone]

Honestly, I’ve have been approaching this on my own. Wish I had a team or an extra person helping me sometimes.

[@OkamiKaiza]

I wish you much strength in your journey of taking care of your loved one.

[@gimilama]

I can relate

[@Nothanks450]

24/7 caregiver here. He has dementia/Alzheimer’s, she can’t speak and is paralyzed right side. They have many other medical issues between them, last 24 hours has been tough for all, dementia really bad today and combative…. Better days ahead….

[@mojojeinxs9960]

Medicate them. They cannot be held accountable for their actions because their brain no longer functions properly. The nurse's aide I don't feel that I should have to have the threat of getting my teeth knocked out because families refuse to medicate their loved ones. My mom was extremely combative and I tried different medications and it worked. These people are not going to get any better there only going to further decline. People need to stop being delusional. Frontal lobe dementia it's the worst to deal with deal with. I'm currently taking care of four residents diagnosed with that. I feel like a I am a cage fighter trying to get them ready for bed every night. One resident it takes four aids just to change a brief. If they were given medicine to calm them down their life would be more comfortable. When dementia eats at the frontal lobe of your brain you no longer have any empathy kindness or reasoning skills left. People live longer but not better. The best thing anybody can do when they get diagnosed with dementia become a DNR have a living will and go on hospice.

[@dianamarella8939]

I am also a nurses aide and I your words are so true! Medications are very effective for the PTs comfort, alot of people don't know what we truly go through and although this videos helps with higher functioning PTs it is of no help for the PTs we deal with. I feel your pain. I wish providers and families would see the positives of medicine therapy.

[@nancyracies8824]

Agreed. I advocate for CBD gummies/edibles. Very mild and calming. Ask the families to talk to their doctor so that you have permission to administer.

[@Carmen-11211]

And what would hospice do ??

[@nanolight4337]

Behavioral meds were the only way forward for our family. We finally got to sleep at night did not fear mom would harm us while we slept.

[@ellensunden2778]

These are excellent tips for caregivers! Although, what if a loved one is exhibiting all these signs but refuses to get tested for Dementia/Alzehimers? My mother has most of the symptoms, along with being violent and aggressive. She refuses to allow me to speak at all. If I try, she screams "Shut UP! Go to Hell". It doesn't matter what I'm trying to say...if I even attempt speech, she lashes out at me. The last time I tried to speak to her, she got up out of her chair and started beating on me. After she was done, she sat back down and started to mock and heckle me. She would sneer and snicker at me, calling me "weak" among her many other insults and degrading comments, which are always personal attacks meant to hurt me, since she knows exactly what to say to hurt me the most. I ended up calling the cops. They documented the bleeding scratches she left on my right hand. She acted like a complete angel around the cop...I was gob-smacked! The cop said that he didn't see her as a threat and left. Mom is cruel to the service people she talks to on the phone, often abusing and belittling them as well. I have shut myself off from her physically, mentally and emotionally. I do not talk to or engage her in any way. It's impossible to try...I just get sneered at and get told to "Shut Up!" and "Go to Hell!. I should note that she is diabetic but does not take care of herself at all. She only sits and watches tv and eats only sugary foods and take-out. She will allow her blood sugar to plummet and expect me to revive her every time with a glucagon shot. Yet, when I revive her, she immediately begins her abuse all over again. I can't leave b/c she will die without someone to revive her, but living like this is really taking its toll. She refuses to get tested, and everyone that I ask for help says that they can't help me if she doesn't have a diagnosis. I've called the cops, Adult Protective Services, the Battered Women's shelter (for myself) and even her doctor. No one will help me if she doesn't have a diagnosis. Any and all advice would be greatly appreciated! Thanks!

[@sarahstrong7174]

If someone has picked something up & is waving it around in an aggressive manner, one thing that can be tried is to praise them for finding the item & being so helpful & say how much you appreciate them, at that point they may just let you take the item from them.

[@maryduplessis2510]

My personal experience was, upon walking into my mum in laws bedroom, it all depended on her mood. I would always enter with a smile and a cup of tea. If she scowled I would leave the tea with her and walk out, wait 10 mins and walk back in. Towards the end I was dealing with a person who kicked when you dressed her and would try to tear her clothing with her teeth and bit and scratched. I would calmly grab her hands and hold them on her lap where I would gradually release them. This action proved to be more effective when I sang her favourite songs and especially when bathing her. Patience is what is required and don't ever raise your voice or appear impatient. I would also play the distraction game. To stop her getting up out of her wheelchair I would ask her to hold her bible on her lap while I made her bed. In her youth she was very religious so this tactic worked. Afterwards I would read a small psalm or story. Yes, caregiving requires lots of stamina and patience but it has its rewards even on days where you end up the worse for wear 😂😂😂...

[@roamingnomeRV]

I know the largest factor for us dealing with my father in the 10 years of his diagnosis was that one, single episode where he was combative (after an hospital visit and they hadnt fed him). Once the hospital put "Combative" on his record we could no longer get him into any home anywhere. This ended up a blessing for us, as we got a live in nurse to help us at home until his death almost 2 years later. But I dont think he would have received the level of care he did had we been able to put him in a home. I know there are people who are unable to make the choice we did. But I was able to quit my job and we cut or income so that I could be at home to help my mother with my fathers care all day. I think we had it easy as my father was a lifelong firefighter, but a "Gentle Giant" as far as personality. He was rarely angry, but he did have agitation in the form of "singing" (which was actually him just making loud noises) and fidgeting.

[@dianaleal5183]

I remember when I started taking care of clients with aggressive behavior this lady told me don't bother her and that I was not to come out of my room. Her daughter just left and she said just make sure to check her during the night I was assigned to a sleep over. I did check on her and told her to let me know if she needed help. I was kind to her she was agitated because she thought she didn't need Care. Her daughter was very nice. I did make something in the morning for her and she seemed better. Caregiver for 24 years and still working at 72. I like my job

[@yocelin1087]

Thank you! I had just gone through this with my loved one, and this video was suggested for viewing. I could not believe it. It’s just what I needed. Very informative.

[@TortureBot]

My 74 year-old mother that is usually very level-headed and does not have dementia just got out of the hospital for a horrible UTI that almost killed her. Her blood pressure had gotten down to about 64/42. After a week in the hospital and days of confusion and irritability they got her kidney function back to normal and her blood pressure holding on its own without medications. They sent her to a place for therapy that is basically a nursing home with a therapy wing. She has only been there for about two days and has had two or three instances of what seems to be dementia and wanting to go home and such. She lashed out at me tonight, her 51 year old son, and two nurses. They think her UTI wasn't completely healed or she might have another one.

[@michelemoline5984]

This is 100% my mother. I literally just went to the Dr and had a broken and sprained thumb.

[@TadSanDiego]

Thank you for this video. Very helpful!

[@gaillevine3188]

Such good info. Thank you.

[@dementiasuccesspath2239]

Share in the comments if you've seen aggressive behavior in dementia.

[@siddheshsawant2079]

Hi my father suffering in dementia... He is very aggressive and loud Yell, plz help me for how to treatment.. plz contact me in my below mail I'd [e-mail]

[@dianamarella8939]

The problem with all these solutions is that there are many types of dementia and the aggresive patients do not understand communication, so in theory these are good suggestions but when you cant even get close enough to care for a patient without being attacked these are not helpful. Also she said "call the doctor for more help" lol there are no doctors in site, only aides and nurses. The doc gets called by the nurse after a situation is over. I guess all im saying is i appreciate what she is saying in the video, its just not real life.

[@nancyracies8824]

It certainly is real life but as you stated, there are many types of dementia so there are many types of situations. When she said, "call the doctor" I took it to mean that she might need a sedative. Some doctors will prescribe one PRN (as needed) for the caregiver to have available to administer if needed. Naturally, the doctor will come on the scene much later so if there is a sedative available it will help the situation for the time being. Personally, I advocate for CBD gummies pre-emptively with patients who are aggressive.

[@user-uk3ym6fv9d]

good video

[@jennkerry]

My mother is probably a stage 3-4 angry dementia with sociopathic and narcissistic personality disorder. Talk about an extremely hard combo to deal with. She’s 68, my father just passed in October’23 and we’ve found that her condition exploded after he died. We don’t know what to do with her other than have the cops called for her to be hospitalized. My sister lives with her, but she’s done. She’s moving out and coming to live with me. My mother will be utterly alone. She’s isolated herself due to her personality. She’ll refuse to pay bills and the bank will take the house. I believe there’s also another underlying mental illness at play. But we feel that there’s nothing we can do because she’ll fight every step of the way. It’s hard when your hands are tied

[@DeanneCecelia]

Great Channel

[@DreamsOfFinland]

My option: CBD oil for daytime, and THC cbd at night. About $40/month, no side effects except calming and being able to think. Now there are edibles, life changing easy treatment of severe anxiety and rages. I got stuck in a bad bout, could not stop myself, was given some Purple Kush in a pipe. 2 minutes later my heart opened, I apologized to my family, totally calm.

[@onthehill3381]

Keep in mind if you call a paramedic, they will send the police as well if it has to do with aggressive behavior. My aunt with dementia got aggressive with her husband and she was arrested! They sort it out later. This made the situation even worse.

[@DementiaSurvivor]

Just like every other time I've tried to get help, I clicked on the link and it just isn't there. Just like there isn't any help and we are definitely on our own. God bless us all.

[@maryjames9988]

my grandma suffers from dementia. What she does next is based on her thoughts start speaking random things of people who aren't present at this moment and when we corect her there's nothing like that. She gets even more loud as to prove she's right. She will keep repeating and irritating my mom...my mom who's is taking care of her throught the day...my mom can't step out of the house to go for a walk because as soon as she sees my mom change into clothes to go outside she will suddently happen to have a headache or stomach ache. If her water or food delays by a minute she will suddently have a spinning headache. She will simply go again and again to toilet even after mom reminding her that she had just gone to pee few minutes before. If she doesn't allow her to go ( bcz it's only a memomry loss thing) She becomes loud ...repeats saying it again and again so that we get irrtitated and tell her to just go!....I have seen so many grandma's staying with kids...none are like her. What to do? how to take caree of them without us being loud as her.

[@raindancer3330]

You notice when you're trying to have a conversation with someone else they try to get the attention? Or if you're watching a movie with the pt and client because the clients daughter wants you to see a movie, the pt will get up to pee a lot. I swear demons come into these people just to mess with you. I'm not going today, I think I had enough, I can't deal with the behavior and the daughters bad moods and indirect jabs at me.

[@maryjames9988]

@carolina i didn't get you. what do you mean? atleast i know a thing that's it not some demons in my grandma . i realise it's a age thing. but i still wanted to know how to calm down my grandma from getting so anxious and irritated

[@raindancer3330]

@@maryjames9988 I'm not saying your grandma does. My patient just freaks me out. Girl her eyes even change. She does know how to get attention and when she wants things her way and her daughter is trying to enjoy being around other family, if her mom doesn't want to be there she will act horrible. All you can do is say, hey let's fix our hair and put some lipstick on so we can have some fun. Can you help me do this, compliments. Sometimes it's just not gonna be a good day. She's declined more the last 4 months.

[@lorimiller4301]

Its true, there really are demons that mess with people. Its very subtle so you can miss it but you see a certain gleam in their eye, a nasty look on their face or a snarl in the lips. People dont realize but its true. They are subtle and most people arent paying that much attention. If youve dealt with them you know.

[@nancyracies8824]

Let her pee! Who cares? Talk to her doctor about CBD gummies/edibles. It's very mild and calming

[@marketgarden7337]

Hey, your videos are great and have helped me a lot with my job. I've seen a lot of the behaviours from your guide videos and your impressions really nail it. Keep it up and thank you! I've seen a little bit more confrontational behaviour lately, I think the coronavirus rules right now have upset a few of our people because the visors and face masks can be a bit scary and confusing, they want you away from them asap.

[@dementiasuccesspath2239]

MarketGarden thank you for your kind words! I’ve gotten some hate on the impression but hey, when you don’t have actors and you want to give an example of what someone might realistically see what are you to do? Lol I’ve noticed that too with my patients. I do my best to give reassurance and comfort through the PPE. Not fun as I’m sure it hasn’t been for you as well.

[@marketgarden7337]

@@dementiasuccesspath2239 I definitely find it more valuable seeing the impressions, very recognisable. It would be difficult to explain a lot of these behaviours adequately by just saying someone is "agitated" or "upset". It's good to show anyone who might not have seen certain behaviours before. Hopefully you and your people are all getting through this virus well enough.

[@dementiasuccesspath2239]

MarketGarden Thank you! I hope your folks are getting through great as well!

[@ImBless-sj1kl]

Bless❤

[@koreyb]

Does Medicare insurance cover a long stay in a psychiatric hospital for an advanced dementia patient?

[@rosefletcher6253]

See the pod casts of Dr. Tam Cummings. She explains the different types and has helped me understand the disease. Her approach is wonderful.

[@Diddy45.]

My mom refuses to change the diaper she pooped dont like to pee in the toilet no dont like to shower above all of that she is abusive and calling me bad names

[@cherylhoskins1533]

May our good Lord have mercy on these people, 🥀 hugs 🥀 4 you

[@nancyracies8824]

Talk to her doctor about CBD gummies/edibles. Mild and calming

[@a.blakelee8807]

my loved one does things not done before. Pick nose and sprinkle on floor,ugh! any questions about anything,,,the response will be the exact opposite of mine even though there is no way it should be! i.e. what color are the clouds? answer green! refuse to cover coughs, unless i am looking, have bathroom accident and say no I didn't,, what would you suggest?

[@dementiasuccesspath2239]

Sadly you aren’t going to convince them that they did what they clearly did. As far as the bathroom accidents, adult diapers could help with that or assisting with the bathroom. As far as the answers being out there goes, it’s hard to transition from them being one way for so long and drastically changing. The random answers are part of the disease. Injecting humor or asking more about it and kind of playing an improv game of yes and can make that go from distressing to a way you can make the changes a little lighter

[@nancyracies8824]

Having too many expectations will get you frustrated. Assuming/expecting they will pee on the floor or they will resist your help will keep you from being shocked and sad. Take away their underwear and only buy the disposables. They will likely resist at first but in time, they will forget.

[@joescheller6680]

my wife gets very aggressive when i try o include her in grocery shopping, will start to throw stuff if i correct her actions of picking up wrong things

[@dementiasuccesspath2239]

I’m sorry you’re going through that my friend. In my experience, correcting doesn’t do much. If I were in your shoes, I would first see if there is a trigger at the grocery store or what the feelings are behind the actions. Is she frustrated at not doing a task, is she unable to tell you she needs the bathroom? A simple, what’s wrong or how can I help you usually starts down the path of figuring out the root cause of the behavior. If it’s possible for you to leave her home when grocery shopping that might be better if it triggers her that much.

[@joescheller6680]

@@dementiasuccesspath2239 she forgets that we have the item in cart already and when I show it to her she will say I didn't put it there. Have a helper that does cooking and wife gets mad fir putting items in basket. Wife says get your own basket and pay for your own stuff keep telling her its our stuff doesn't sink in

[@dementiasuccesspath2239]

Joe Scheller It sounds like reasoning with her hasn’t worked. I think the grocery store for now may not be her thing or maybe having her grab the items may help.

[@joescheller6680]

@@dementiasuccesspath2239 I try to include her by suggesting she pick out some bread eggs mist everything we get but if I spend too long reading a label she will be grabbing other items we don't need.

[@dementiasuccesspath2239]

Joe Scheller ah I see. I guess it depends on the purpose of the trip. If you need to get in and out, probably don’t bring her. If you’re wanting to enrich her life then I suppose telling her you need 2 things to shorten the trip might accomplish that goal

[@Joyfulminimalist]

Unfortunately, my mil was a bit aggressive after her last and final stroke. I helped the aids get her back in bed, step by step with conversation and simple requests. I was there for her daily.

[@dementiasuccesspath2239]

JoyfulMinimalist I’m sorry you had to go through that. That’s a god strategy

[@vandanasabharwal147]

Hi, i am vandana from india, my father is suffering from Dementia, i am in some other city from my parents, my mother is alone to look after my father. We have kept an attendant who comes twice a day for him but rest of d time my mother take care of him. The major problem he creates is not going to pee n bath, we put him diaper but he pee’s in it totally n it starts smelling n not willing to to go to washroom, he uses abusive language n started hitting also, can you advice something to ease down in these matters, it will be really helpful for us to manage him? Looking for your revert, thanks

[@Bellalovesyou4ever]

My problem as an aide is my patient is 94 and still has a lot of motor skills so she’s capable of pushing you out of the home. Her daughter believes she should tell her mother when she forgets things and makes my patient agitated and in turn my patient later on with lash out on me. There has been more recently and when I asked the daughter if she was taking her medication she told me that it makes her mother tired and didn’t want her on it. This is my main patient I see 10am-5 pm 5 days a week, and I’m honestly not sure whether to ask for a different patient as I believe I’ve done what I can to help just don’t think I’m the right caregiver for her. I have bruises from the last time she lashed out and have had them before from previous times I honestly have no idea what to do

[@kristinamullen4066]

If they won't give you space what to do? i have very little patience left with a partucular person who is continually abusive in a memory care facility.I am not a direct care giver.but activity person.I am concerned for my physical safety.But upper management isn't concerned.

[@ps398632]

i am a son and, i am not sure if we are starting down dementia path for mom.

[@nancyracies8824]

If so, have her tested right away. There are meds that can slow the symptoms down (aracept, namenda, etc). Tell your mom all about it so she's not scared. Start baby proofing the house. Take the car keys. We would "help" our mom look for the keys and then after a few minutes, we'd say, "well, I can take you anywhere until we find those darn keys". In time, she was very comfortable with someone else driving

[@colleenfitz-gerald9749]

How do we sign up?

[@dementiasuccesspath2239]

Hey there, we are actually having our workshop starting tomorrow sign up here:dementiasuccesspath.com/may-2022-workshop

[@keiracurro8407]

Damn these people (carers) are tolerant, everyone i know try to avoid these individuals at all costs but you learn not to listen to the individuals who hve dementia because they are not in a right frame of mind its understandable no one will help them when they refuse, i would never be a carer to that level, only if you're happy with abusive relationships. 🐻sad that family financially take advantage take their pensions.

[@andrewbennett7756]

Help my mum is being so nasty its killing me love her so much 😮😮😮😮

[@nancyracies8824]

There are meds that can help such as Aracept and Namenda. Also, ask your doctor about CBD gummies/edibles

[@andrewbennett7756]

@@nancyracies8824 thank you so much for that I will do that my mum since the 60 to the late 90 was alway trying to 4 out of thre she was a great business woman and sucssful but to see her to day omg it's a terrible desise thank you so much for getting back to me bless you thank andy

[@abowling5759]

@@nancyracies8824thank you!….I am going to ask about those for my dementia person

[@michelemoline5984]

Yes- uti and possibly low blood sugar can cause my mom to be mean and nasty

[@user-zq3li3ih4d]

Not helpful at all. I have tried all of these things and now he's at the point of threatening to murder me i have to sleep with my bedroom door locked. He imagines seeing all sorts of things and tries to sneak out of the house. We had to buy extra locks so he can't get out. He uses fowl language and this is a man who would never swear before. I'm at my wits end.

[@starpunk2283]

Police is a no unless they have a weapon and you're in immediate danger.

[@cadaverdog1424]

Please correct your misspelling of ‘approaches’： your grammar is much harder to endure than dementia violence _____________________________

[@happilyartstudio732]

Oh wow, yours must be a really sad case to lash out over grammatical mistakes.

[@lukebeakum1316]

Grammar nazi

[@bren.k.2163]

Quit being a jerk.

[@SamanthaYelena]

You need help. And not with dementia.