Alzheimer’s aggression

Alzheimer’s aggression most often flares up during the later stages of Alzheimer’s disease. The person may become easily agitated, angry and abusive - often for no apparent reason. The person may swear, hurl insults and scream. Though verbal assaults are more common than physical assaults, a person with Alzheimer’s disease may throw things or resist care by pushing and hitting.

Why does Alzheimer’s aggression occur?

No one really knows why Alzheimer’s patients become aggressive. Aggressive behaviour often occurs in the later stages of Alzheimer’s disease. Aggression may be a symptom of Alzheimer’s disease itself, perhaps due to changes in the area of the brain controlling emotion. It may also be a reaction to actions of others or to the environment around the person with Alzheimer’s disease. For example as the person loses insight and understanding of what is happening to them they may become frustrated by their situation or misunderstand what others are trying to do for them.

Understand the triggers of Alzheimer’s aggression

Alzheimer’s aggression can flare up without warning. There may not be an obvious cause. However, often there are triggers that carers can look for. By knowing the triggers, you may be able to lower the frustration level of the person with Alzheimer’s disease. This can lower the number of aggressive outbursts. Here are some common triggers of Alzheimer’s aggression:

• Discomfort caused by lack of sleep, side effects from medication or pain that the person is not able to describe.
• The surrounding environment such as loud noises, busyness around the person or clutter.
• Confusion caused by being asked too many questions at once, trying to understand complex instructions or feeling the stress of carers.

Tips to reduce Alzheimer’s aggression

Once you understand the types of triggers for Alzheimer’s aggression, you can take steps to prevent it. Try these suggestions:

• Anticipate situations in which the person with Alzheimer’s may be uncomfortable, over-stimulated or confused.
• Avoid asking too many questions at once, giving overly complicated instructions and speaking negatively. That way, you are less likely to confuse and agitate the person.
• Limit the amount of loud noises, frenetic movement and clutter.
• Don’t contradict. Those with Alzheimer’s disease see a different reality than you do. Rather than challenge that reality, sit and listen. Ask questions about it.
• Focus on the past. Alzheimer’s affects short-term memory. It’s often easier - and less stressful - for someone with Alzheimer’s disease to recall and talk about distant memories than it is for them to remember what they watched on TV the night before.
• Use memory cues. As the disease progresses, remembering to do - and how to do - everyday tasks like brushing teeth or getting dressed becomes more difficult. Reminder notes placed in key locations can help to prevent frustration.

Caregiver stress and Alzheimer’s aggression

It’s not easy to care for a person with Alzheimer’s disease. The burden of round-the-clock care takes an emotional toll. Add to it the frustration of watching a loved one deteriorate. It’s not surprising that carers may feel isolated and depressed. Left unrelieved, these feelings can lead to abusive behaviour toward the person with Alzheimer’s disease, from insults to physical injury.

If you are a carer, do yourself and the person you care for a favour. Try to take regular breaks so that you have time for yourself. Seek help for yourself if you notice signs of depression, anxiety, sleeplessness, exhaustion or irritability. Taking care of yourself will help you take better care of others.