Aggressive Behavior in Dementia

Dementia

Dementia is a loss of cognitive abilities that has behavioral components. It affects the memory and is usually irreversible and progressive. Dementia is found much more often in the elderly; it affects men and women roughly equally. There are several types of dementia, including Alzheimer's disease and vascular dementia. Patients with dementia sometimes become aggressive as part of the disease course.

Types of Aggression

Aggressive behavior in dementia patients may involve a verbal attack, an assault, a threat or self-inflicted aggression. An animal may be harmed or property may be damaged or destroyed. Aggression may be directed at anyone in reach or it may be aimed at one individual, often a caregiver.

Alzheimer & Dementia Care 

Causes

Aggressive behavior in a dementia patient may be linked to the underlying cause of the dementia. Alzheimer's disease, for example, causes structural and chemical changes in the brain that can lead to aggression. Some hostile behaviors can be linked to delusions and hallucinations, according to an article in "American Family Physician" titled "Behavior Disorders of Dementia." Other causes include dementia's negative effect on impulse control and the patient's inability to verbalize his needs. Additionally, he may feel frustrated at his growing inability to complete tasks. A dementia patient may become overstimulated by questioning or loud voices or noises. He may be uncomfortable or in pain and be unable to express it. Aggression can also stem from fear if he doesn't recognize his surroundings or anyone around him. Fatigue increases aggressive behaviors in an Alzheimer's patient, explains the text "Medical-Surgical Nursing."

Medical Treatment

Medication may be given to treat the psychosis that often accompanies dementia. Atypical antipsychotics, anti-convulsants and anti-anxiety medications may be prescribed, explains "Behavior Disorders of Dementia." Antidepressants may also reduce aggressive behaviors in dementia patients. Drugs used to treat aggression often have side effects that limit their safe use; therefore, they are often begun at a low dose to determine tolerability and effect. Some medications are taken on a regular basis while others are given only as needed for agitation or anticipated agitation.

Management of Acute Aggression

When possible, it is beneficial for the caregiver to avoid touching the dementia patient during an aggressive outburst as this can increase her fear or anger. The caregiver should not become upset, as this can increase the aggression, explains HelpGuide.org. Sometimes the individual can be distracted into an activity she enjoys. A soothing voice and a non-judgmental attitude may help defuse the situation. Confrontation during or after the incident isn't helpful as the patient lacks the ability to control her behavior or gain insight from the experience.

Prevention

Many aggressive episodes can be avoided by monitoring the dementia patient's behavior patterns. If he becomes aggressive when he tries to complete a task, the caregiver should find a way to break the task down into manageable steps. Keeping a routine of meals, activities and sleep also helps prevent aggression. Exercises such as walking, stretching, playing with a pet or rolling a ball between two people may be beneficial. The patient should have all the tools necessary for hearing and seeing well; an individual who needs a hearing aid should have it placed into the ear each morning and a person who needs glasses should be given clean glasses each morning. Being able to hear and see properly helps avoid misunderstanding the environment.

Read more: http://www.livestrong.com/article/185811-aggressive-behavior-in-dementia/#ixzz1FNVvvjCG