Caregiver safety in face of anger and aggression

This post may be of interest to caregivers dealing with loved ones who are angry and aggressive.

Many people in the local Lewy Body Dementia support group will remember long-time Brain Support Network volunteer Denise Dagan. In the past, she has shared helpful resources she’s found.  She’s doing that again today….

Here’s something she shared on the topic of caregiver safety.  This is Denise’s description of a 30-minute podcast about anger and aggression aimed at the caregiver.



Notes from Denise Dagan, BSN volunteer

Talking FTD with Geri: Caregiver Safety
Guest – Geri R. Hall, PhD
Podcast – August 25, 2016

On August 25, 2016, presented “Talking FTD with Geri: Caregiver Safety,” as part of their weekly “Your Caregiving Journey” podcast series.  Geri R. Hall, PhD, ARNP, GCNS-BC, FAAN, addressed the topic of anger, aggression and caregiver safety in a 30 minute Q&A format.  You can listen to the podcast here:

Although the discussion is entirely in the context of caring for someone with frontotemporal dementia, some points are worth remembering for anyone potentially dealing with aggression as a symptom of cognitive impairment or dementia.

There are medications that can help control aggression, and should be sought from your neurologist at the first sign of regularly occurring verbal aggression (3 times weekly).  These medications should be adjusted or increased at the first sign of physical aggression.

People with cognitive impairment or dementia will often indicate when they are becoming overwhelmed by their current activity by asking to leave or commenting on noise, etc. before they become agitated or aggressive.  Try to tune into those comments to avoid getting to the point of agitation or aggression.  If they do get to that point, help them leave immediately.

If a person does become agitated or aggressive, best practice is to apologize for whatever they are upset about, agree with their point of view and promise to resolve things to their liking as soon as possible so they don’t see you as opposition, but as being on their side, so aggression is not directed at you.

If aggression does not subside, or escalates, put a barrier between you and them, and call 911 for assistance.   Dr. Hall says arriving uniforms are usually comforting.  EMTs will take the person to the ER where urinary tract infection, etc. will be ruled out before admitting for medication adjustment to control aggressive outbursts.

Agitation or aggression can occur without current stimulation.  Dr. Hall recommends looking at changes in the usual routine over the past 24 hours, including visitors, a noisy or chaotic environment, even TV shows like news broadcasts, aggressive talk shows, and CSI or Law & Order genre programming.  Essentially overstimulation leading to fatigue can cause behavior changes.

If you are living with someone who is physically aggressive, you should sleep apart from them in a room with a locked door and alternate egress (e.g. a window).

Don’t blame yourself if a loved one with dementia becomes verbally abusive or physically aggressive.  It is a symptom of their disease process.  Often the behavior change is the result of a delusion, which is a fixed, false belief about which they cannot be dissuaded.