Of the many challenging behaviors typical in dementia, perhaps the most difficult to manage is aggression. A senior who may have always been mild-mannered can unexpectedly lash out in outbursts which can be truly frightening: hitting, cursing, kicking, yelling, biting, or throwing things. How can you, as a family caregiver, safely help restore a feeling of calm?
To start with, emphasize to yourself that dementia aggression is due to the disease. It is not something the individual can control, and it is not deliberate. That being said, it needs to be diffused to keep both you and the older adult protected from harm.
“The 6 R’s of Managing Difficult Behavior,” developed by Dr. Peter Rabins and Nancy Mace in their book, The 36-Hour Day, may be an ideal way to help. Go through and refer back to these tips, so you’re equipped for the next burst of aggression.
The 6 R’s:
- Restrict. Maintain a calm tone of voice and demeanor while you work to help the person disengage from the behavior.
- Reassess. Think through what may have provoked the incident. Causes can include physical pain, noise or other distractions in the room, fatigue, hunger, thirst, etc. Maintaining a journal of what was taking place before and during each incident might help provide clues.
- Reconsider. Empathize with the older adult by imagining yourself struggling with a disease that suppresses your ability to clearly convey your wishes and needs, to complete tasks independently that were once so easy, to feel disoriented and confused, etc.
- Rechannel. Redirect the person to an enjoyable task, or move to another type of environment, such as stepping out onto the front porch or going into the kitchen together for a snack.
- Reassure. Let the senior know that everything is okay and that you are there. If the person responds positively to touch, place your hand on their shoulder, offer a hug or pat on the back, or take their hand in yours.
- Review. Take note in your journal of what went well – or what did not – to aid in using the most effective response if the aggression arises again.
Understanding that dementia aggression may occur at any time, it’s helpful to evaluate the home environment and take steps to make certain it is as calming and comfortable as possible, for instance:
- Playing relaxing music the senior enjoys in the background.
- Placing comforting and familiar objects within quick access.
- Avoiding television shows that may show violence or any other distressing images.
- Opening the curtains during the day to allow an abundance of sunlight to stream in.
JFS Care is here for you as well with specially trained dementia care providers who understand the intricacies associated with the disease and how to most effectively manage the related challenges. Email or call us at (213) 383-2273 for more information on our in-home care in Santa Monica. Please visit our Service Area page to learn about all of the communities we serve.