How To Deal With A Dementia Patient Who Is Aggressive

Caring for a person with dementia can be challenging and complex. This is especially true when faced with challenging behavior like aggression, physical violence, agitation, and distress. While understanding that aggressive behavior is not intentional, it can still be difficult to determine: “What can I really do when a dementia patient starts getting aggressive?”

This article will describe 5 strategies for dealing with an aggressive dementia patient. 

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5 Ways To Deal With An Aggressive Dementia Patient

1. Assess Safety 

When a dementia patient is exhibiting aggressive behavior, it’s important to immediately determine whether the situation is a threat to your safety or the safety of the patient. 

Some signs that the situation is unsafe, or could get unsafe quickly, include if the person with dementia is:

• Continuing to approach your personal space after multiple attempts to back away.
• Displaying physical aggression like grabbing, hitting, or scratching you.
• Throwing or destroying items in the room. 
• Threatening your physical safety.
• Running away from the home or building unattended (if previously deemed unsafe for them to do so alone).

If you identify any of these signs, prioritize safety by:

• Leaving the room 
• Calling out for help
• Calling 911 if either of you is at immediate risk of being injured 
  

2. Remain Calm & Validate Emotions

As a caregiver, it can be difficult to remain calm when faced with dementia aggression; however, you can significantly impact the situation with:

• Your composure
• Calm body language
• Tone 

Becoming agitated or showing your own anger and frustration can easily escalate their distress. Instead:

• Pause
• Take a deep breath
• Remind yourself that their behavior isn’t directed at you

With time and the correct steps, their body will mirror your calm.

If you’re in the middle of a care task when this happens, consider taking a break and returning later when the patient is feeling better. Remember to:

• Listen and validate emotions: Calmly acknowledge their feelings without arguing or dismissing their concerns. Phrases like “I can see why that would be upsetting” can help them feel heard and trusted.
• Avoid escalation: Don’t try to convince them that their upset isn’t a “big deal,” as this can lead to more frustration and aggression if they feel misunderstood.

By validating their distress simply and clearly, you can help reduce their desire to communicate aggressively in the future.

3. Identify & Address Triggers 

Aggression, agitation, or violent behavior is a dementia symptom that is a form of communication, telling you something is not quite right. 

As a caregiver, you can go through this checklist to investigate what may be distressing the person with dementia. Consider how you can address it immediately, or in the future:

• Pain or discomfort
• Overstimulation, like bright lights, loud or repetitive noises, or many people in a room
• Understimulation, like a lack of engaging, purposeful activities
• Unmet needs like hunger, needing to use the bathroom, or feeling too tired
• Medication side effects
• Changes in routine
• Confusion or fear
  

4. Distract & Redirect 

Distracting a dementia patient who is aggressive with an object or activity they would find interesting can redirect their attention and reduce their agitation. 

After validating their emotions, guide them to an activity like:

• Helping you with a task. For example, folding towels or watering plants.
• Preparing for an event they are looking forward to. For example, picking out an outfit. 
• Engaging them in a calming sensory activity. For example, picking an essential oil to diffuse or playing music.

5. Ask For Help 

You’re not alone. If a dementia patient has become aggressive, it’s important to seek help. This is especially true if behavioral symptoms and distress are becoming more common. Their healthcare team, family members, and other caregivers can help determine what may be contributing to behaviors and what can be done to help. 

Expert Tip: The Alzheimer’s Society explains the importance of not punishing or blaming the person for what happened after the aggression or challenging behavior has passed. Their behavior was likely due to something distressing or confusion due to their condition.  Take care of your mental health by talking to someone about what has happened, like your healthcare team, the agency you may be working for, friends, family, or other peer caregivers in a support group.

Dealing with an aggressive dementia patient can be challenging. Still, with help and the right strategies, you can navigate these tough moments with greater confidence to provide your care recipient with the best care possible. 

Don’t forget to check if you have free access to Trualta’s resources, support groups, forums, and more.

References

1. Alzheimer’s Society. (2021a). Aggressive behaviour and dementia.
2. Alzheimer’s Society. (2021b). Preventing and managing aggressive behaviour in people with Dementia. 
3. National Institute On Aging. (2024). Coping with agitation, aggression, and sundowning in alzheimer’s disease.