Of the many challenging behaviors typical in dementia, possibly the most complicated to manage is aggression. A senior who has always been mild-mannered can abruptly lash out in outbursts which are truly terrifying: hitting, cursing, kicking, yelling, biting, or throwing things. How can you, as a family care provider, safely help reestablish a sense of calm when managing dementia and aggression?

To start with, remind yourself that the aggression is a result of the disease. It’s not something the senior can control, and it is not deliberate. That being said, it must be diffused in order to keep both you and the senior safe 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, can be an excellent way to help. Go through and refer back to these techniques so you’re equipped for the next burst of aggression.

The 6 R’s:

  • Maintain a calm tone of voice and demeanor as you strive to help the individual withdraw from the behavior.
  • Think through what may have provoked the incident. Triggers could include physical pain, a lot of distractions or noise in the room, hunger, thirst, fatigue, etc. Maintaining a journal of what was happening before and during each occurrence often helps provide clues.
  • Empathize with the older adult by picturing yourself fighting a disease that suppresses your ability to clearly communicate your needs and wishes, to complete tasks independently which were once very easy, to feel disoriented and confused, etc.
  • Redirect the person to a hobby the senior enjoys, or move to another type of environment, such as moving out onto the front porch or going into the dining area together for a snack.
  • Let the individual see that everything is okay and that you are there. If the individual responds positively to touch, place your hand on their shoulder, offer a hug or pat on the back, or take their hand in yours.
  • Make note in your journal what went well – or what didn’t – to help in using the most effective response if the aggression arises again.

Understanding that aggression may occur at any time in a senior with dementia, it’s helpful to gauge the home environment and take steps to ensure it is as calming and comfortable as possible, for instance:

  • Playing relaxing music the older adult enjoys in the background.
  • Placing comforting and familiar objects within quick access.
  • Staying clear of TV shows that may display violence or any other distressing images.
  • Opening the blinds during the day to allow plenty of natural light to stream in.

Charter Home Health is here for you as well with specially trained dementia caregivers who understand the intricacies of the disease and how to most effectively manage the related challenges. Reach out to us online or by phone at (215) 935-6321 for a free of charge in-home consultation and for more information about our professional services for dementia home care in Philadelphia, PA and the surrounding areas.