Some people living withAlzheimer’s diseaseor other types ofdementiaremain easy-going. Others develop intense feelings of anger and aggression.
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It’s normal to feel surprised, discouraged, hurt, or even angry when someone with dementia lashes out at you for no obvious reason.
It’s important to understand what causes anger in dementia. This will help you learn how to respond and cope in these situations.
This article looks at some of the reasons for anger and aggression in people with dementia. It also offers some coping tips for caregivers.
Angry Behavior in People with Dementia
When someone with dementia gets angry, they may:
Sometimes, there are warning signs. The person may raise their voice, scowl, or swing their arm at empty space.
Other times, you may not see it coming. This “no-warning” anger can be hard to cope with because it is unpredictable.
Anger and aggression are most likely to develop in themiddle stages of dementia. At the same time, there may be otherchallenging behaviorslike wandering, hoarding, and obsessive-compulsive behaviors.
6 Common Causes of Aggression
There are many reasons why people with dementia may become angry. Some are related to the disease itself. Others have to do with the emotional toll of dementia.
Loss of Recognition
People with dementia may not recognize their loved ones. This can cause fear, anxiety, and aggression.
For example, a wife with dementia may try to attack her husband. She may not do this out of anger but because she is afraid of the “strange man” in the house.
When Dementia Leads to Loss of Recognition
Paranoia, Delusion, and Hallucinations
People with dementia may also experience distortions of reality. For example, a person may have:
Not everyone with dementia has these symptoms. When they do, though, it can be difficult to handle.
People withlewy body dementiaare more prone to having these symptoms. They can occur in all types of dementia, though.
Coping With Paranoia and Delusions in Alzheimer’s Disease
People withfrontotemporal dementiamay become physically aggressive much sooner than people with Alzheimer’s. This is because people with Alzheimer’s have damage nearer to the back of the brain.
The frontal parts of the brain are responsible for:
The loss of these functions can lead to impulsive behaviors.
Poor Food Intake
Studies suggest poor eating habits and weight loss may be related to behavior problems in people with dementia.
In people without dementia, poor nutrition can affect mood, energy, and cognitive function. In people with dementia, it can fuel sudden outbursts and aggressive impulses.
Misunderstandings
Dementia affects communication. Someone with dementia may have trouble understanding what their caregiver is saying or doing.
The person you are caring for may not understand why you’re trying to help. They may feel like you’re just bossing them around. This can lead to conflict.
Caregiver Overload
As a caregiver, it’s natural to have strong feelings from time to time. You may feel frustrated, angry, or impatient. Even if you aren’t verbalizing those feelings, the person you are caring for may pick up on them. Sometimes they may reflect those feelings back to you.
Monitoring yourself forcaregiver burnoutand overload is important. This will help improve your own quality of life and also your loved one’s.
8 Tips for Coping
One of these strategies may help you face the anger or aggression of the person you’re caring for. Which one you choose will depend on the situation.
Give Space
Give the person a little space. Their resistance may be because they feel their personal space has been invaded and they don’t know why.
Don’t Argue
Arguing with someone who was dementia almost never works. This is true even if you think you have a clear point.
If you argue, you may just make the person angrier. You won’t “win,” and the situation may become worse.
Give Time
If you’re helping the person complete a task and they become angry, back off for a few minutes. Make sure the person is safe to leave alone and give them some time.
You may find that trying the same task 20 minutes later will produce a completely different result.
RecapIt can help to give the person you’re caring for some time and space. Avoid arguing with them and practice patience.
Recap
It can help to give the person you’re caring for some time and space. Avoid arguing with them and practice patience.
Use Distraction
Music can be a good distraction. Try playing some of your loved one’s favorite songs. It may help lighten the mood and get the person in the right frame of mind to accept help.
One-on-One Interactions
Change Caregivers
People with dementia often benefit fromroutines. They may prefer a consistent caregiver. Sometimes, though, a different face can bring a different result.
If you’re working in a care home and there are other staff present, try switching caregivers.
RecapTry not to overwhelm the person with too many caregivers at once. If you are working in a care home, it may even help to switch caregivers.
Try not to overwhelm the person with too many caregivers at once. If you are working in a care home, it may even help to switch caregivers.
Find the Cause
Look for a cause. Environment andphysical factorscan affect behavior. Pain, fatigue, hunger, or too much stimulation can trigger anger and aggression.
Look for patterns in behavior. For example, the person may tend to getangry in the evening.
Think about what happened before the outburst. Was there noise? A lot of visitors? Certain events or activities that triggered the reaction? The more triggers you can identify, the easier it will be to avoid them.
Ask the Doctor
Sometimes, dementia can provoke so much aggression and anger that the person and those around them are no longer safe. If this happens, it’s time to call a doctor.
Medicationshould never be the first choice in dealing with challenging behaviors. There are times, though, when it may be needed. A doctor can evaluate this.
Summary
People with dementia sometimes become angry and aggressive. As a caregiver, you’ll find it helpful to understand why this happens.
People with dementia may not recognize their loved ones. They may also have feelings of paranoia or hallucinations. These things can contribute to aggressive behavior.
Other factors like poor food intake, problems with communication, and caregiver overload can also play a role.
There are a few strategies that can help you cope with these situations. Give the person space and time, don’t argue, and try to find distractions.
Don’t overload the person with too many caregivers at once. It may also help to change caregivers.
It’s important to determine the cause of an angry outburst. In some cases, you may need to ask a doctor for help.
A Word From Verywell
When your loved one gets angry, it can be hard to know how to respond. If you understand why it might be happening, you may find it easier to deal with.
Remember that your loved one is feeling anxious and distressed during this time. Patience and understanding will help you manage and respond to these challenging situations.
Frequently Asked Questions
Some of the most common signs are:AgitationAggressionAnxietyDepressionPsychosisThese symptoms affect about 90% of people with dementia.
Some of the most common signs are:
These symptoms affect about 90% of people with dementia.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Huang SS.Depression among caregivers of patients with dementia: Associative factors and management approaches.World J Psychiatry. 2022 Jan 19;12(1):59-76. doi:10.5498/wjp.v12.i1.59Cerejeira J, Lagarto L, Mukaetova-Ladinska EB.Behavioral and psychological symptoms of dementia.Front Neurol. 2012;3:73. doi:10.3389/fneur.2012.00073Alzheimer’s Association.Hallucinations, delusions and paranoia.Tzeng RC, Tsai CF, Wang CT, Wang TY, Chiu PY.Delusions in patients with dementia with Lewy bodies and the associated factors.Behav Neurol. 2018;2018:6707291. doi:10.1155/2018/6707291Liljegren M, Waldö ML, Englund E.Physical aggression among patients with dementia, neuropathologically confirmed post-mortem.Int J Geriatric Psych.2017;33(2):e242-8. doi:10.1002/gps.4777Johns Hopkins Medicine.Brain anatomy and how the brain works.Hillis AE.Inability to empathize: brain lesions that disrupt sharing and understanding another’s emotions.Brain. 2014 Apr;137(Pt 4):981-97. doi:10.1093/brain/awt317Sebastian A, Jung P, Krause-Utz A, Lieb K, Schmahl C, Tüscher O.Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder.Front Hum Neurosci. 2014;8. doi:10.3389/fnhum.2014.00698Fostinelli S, De Amicis R, Leone A, Giustizieri V, Binetti G, Bertoli S, Battezzati A, Cappa SF.Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment.Front Nutr. 2020 Dec 16;7:604488. doi:10.3389/fnut.2020.604488Collier S.What’s the best way to manage agitation related to dementia? Harvard Health Publishing.UCSF Weill Institute for Neurosciences. Memory and Aging Center.Behavior & personality changes.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Huang SS.Depression among caregivers of patients with dementia: Associative factors and management approaches.World J Psychiatry. 2022 Jan 19;12(1):59-76. doi:10.5498/wjp.v12.i1.59Cerejeira J, Lagarto L, Mukaetova-Ladinska EB.Behavioral and psychological symptoms of dementia.Front Neurol. 2012;3:73. doi:10.3389/fneur.2012.00073Alzheimer’s Association.Hallucinations, delusions and paranoia.Tzeng RC, Tsai CF, Wang CT, Wang TY, Chiu PY.Delusions in patients with dementia with Lewy bodies and the associated factors.Behav Neurol. 2018;2018:6707291. doi:10.1155/2018/6707291Liljegren M, Waldö ML, Englund E.Physical aggression among patients with dementia, neuropathologically confirmed post-mortem.Int J Geriatric Psych.2017;33(2):e242-8. doi:10.1002/gps.4777Johns Hopkins Medicine.Brain anatomy and how the brain works.Hillis AE.Inability to empathize: brain lesions that disrupt sharing and understanding another’s emotions.Brain. 2014 Apr;137(Pt 4):981-97. doi:10.1093/brain/awt317Sebastian A, Jung P, Krause-Utz A, Lieb K, Schmahl C, Tüscher O.Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder.Front Hum Neurosci. 2014;8. doi:10.3389/fnhum.2014.00698Fostinelli S, De Amicis R, Leone A, Giustizieri V, Binetti G, Bertoli S, Battezzati A, Cappa SF.Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment.Front Nutr. 2020 Dec 16;7:604488. doi:10.3389/fnut.2020.604488Collier S.What’s the best way to manage agitation related to dementia? Harvard Health Publishing.UCSF Weill Institute for Neurosciences. Memory and Aging Center.Behavior & personality changes.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Huang SS.Depression among caregivers of patients with dementia: Associative factors and management approaches.World J Psychiatry. 2022 Jan 19;12(1):59-76. doi:10.5498/wjp.v12.i1.59Cerejeira J, Lagarto L, Mukaetova-Ladinska EB.Behavioral and psychological symptoms of dementia.Front Neurol. 2012;3:73. doi:10.3389/fneur.2012.00073Alzheimer’s Association.Hallucinations, delusions and paranoia.Tzeng RC, Tsai CF, Wang CT, Wang TY, Chiu PY.Delusions in patients with dementia with Lewy bodies and the associated factors.Behav Neurol. 2018;2018:6707291. doi:10.1155/2018/6707291Liljegren M, Waldö ML, Englund E.Physical aggression among patients with dementia, neuropathologically confirmed post-mortem.Int J Geriatric Psych.2017;33(2):e242-8. doi:10.1002/gps.4777Johns Hopkins Medicine.Brain anatomy and how the brain works.Hillis AE.Inability to empathize: brain lesions that disrupt sharing and understanding another’s emotions.Brain. 2014 Apr;137(Pt 4):981-97. doi:10.1093/brain/awt317Sebastian A, Jung P, Krause-Utz A, Lieb K, Schmahl C, Tüscher O.Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder.Front Hum Neurosci. 2014;8. doi:10.3389/fnhum.2014.00698Fostinelli S, De Amicis R, Leone A, Giustizieri V, Binetti G, Bertoli S, Battezzati A, Cappa SF.Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment.Front Nutr. 2020 Dec 16;7:604488. doi:10.3389/fnut.2020.604488Collier S.What’s the best way to manage agitation related to dementia? Harvard Health Publishing.UCSF Weill Institute for Neurosciences. Memory and Aging Center.Behavior & personality changes.
Huang SS.Depression among caregivers of patients with dementia: Associative factors and management approaches.World J Psychiatry. 2022 Jan 19;12(1):59-76. doi:10.5498/wjp.v12.i1.59
Cerejeira J, Lagarto L, Mukaetova-Ladinska EB.Behavioral and psychological symptoms of dementia.Front Neurol. 2012;3:73. doi:10.3389/fneur.2012.00073
Alzheimer’s Association.Hallucinations, delusions and paranoia.
Tzeng RC, Tsai CF, Wang CT, Wang TY, Chiu PY.Delusions in patients with dementia with Lewy bodies and the associated factors.Behav Neurol. 2018;2018:6707291. doi:10.1155/2018/6707291
Liljegren M, Waldö ML, Englund E.Physical aggression among patients with dementia, neuropathologically confirmed post-mortem.Int J Geriatric Psych.2017;33(2):e242-8. doi:10.1002/gps.4777
Johns Hopkins Medicine.Brain anatomy and how the brain works.
Hillis AE.Inability to empathize: brain lesions that disrupt sharing and understanding another’s emotions.Brain. 2014 Apr;137(Pt 4):981-97. doi:10.1093/brain/awt317
Sebastian A, Jung P, Krause-Utz A, Lieb K, Schmahl C, Tüscher O.Frontal dysfunctions of impulse control – a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder.Front Hum Neurosci. 2014;8. doi:10.3389/fnhum.2014.00698
Fostinelli S, De Amicis R, Leone A, Giustizieri V, Binetti G, Bertoli S, Battezzati A, Cappa SF.Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment.Front Nutr. 2020 Dec 16;7:604488. doi:10.3389/fnut.2020.604488
Collier S.What’s the best way to manage agitation related to dementia? Harvard Health Publishing.
UCSF Weill Institute for Neurosciences. Memory and Aging Center.Behavior & personality changes.
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