Of the many difficult behaviors typical in dementia, possibly the most difficult to manage is aggression. A family member who may have always been mild-mannered can abruptly lash out in outbursts that can be truly frightening: hitting, yelling, cursing, kicking, biting, or throwing objects. How can you, as a family caregiver, safely help reestablish a sense of calm?
To begin, remind yourself that the aggression is caused by the disease. It’s not something the person can control, and it is not intentional. That said, it must 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, could be an effective way to help. Read through the 6 R’s as a reminder, and use them as a reference as needed so you will be prepared for the next burst of dementia aggression.
The 6 R’s
- Restrict. Maintain a calm tone of voice and demeanor while you strive to help the person withdraw from the behavior.
- Reassess. Consider what may have provoked the incident. Triggers could include physical pain, an excessive amount of distractions or noise in the room, fatigue, hunger, thirst, etc. Keeping a journal of what was happening before and during each incident will help identify triggers.
- Reconsider. Empathize with the senior loved one by picturing yourself fighting a disease that suppresses your ability to clearly communicate your wishes and needs, to complete tasks independently which were once so easy, to feel disoriented and confused, etc.
- Rechannel. Redirect the person to an activity the individual takes pleasure in, or relocate to a different environment, for example, moving out onto the front porch or going to the living room together for a snack.
- Reassure. Let the older adult see that everything is all right and that you are there. In the event that 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.
- Review. Take note in your journal what went well – or what did not – to help identify the most reliable response to produce the best outcome if the aggression arises again.
Understanding that aggression may happen at any time in an individual with dementia, it is helpful to evaluate the home environment and take steps to ensure it is as comfortable and calming as possible, for example:
- Playing quiet music the senior enjoys in the background.
- Placing comforting and familiar objects within an easy reach.
- Avoid TV shows that may display violence or any other distressing images.
- Opening the window shades during the day to allow plenty of sun light to stream in.
Golden Harmony can help by providing highly-trained dementia caregivers who understand the nuances associated with the disease and how to best manage the corresponding challenges. Reach out to us at 919-426-7522 to learn more about our in-home dementia care in Raleigh and surrounding areas. See our full service area.