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What You Should Know About Aggression in Alzheimer’s Patients

Whether verbal or physical in nature, aggressive behaviors in Alzheimer’s patients are common. These attacks can come on suddenly, with no warning and no apparent trigger. This doesn’t make it any easier for you as the loved one to stand by and watch it happen — or bear the brunt of their hostility. However, it’s important to realize the person before you is not acting this way on purpose. This may bring some small degree of comfort, especially if your loved one is going through end of life care in San Mateo. Here’s what you should know about aggression in Alzheimer’s patients.


Aggression with this disease can be triggered by a variety of factors, from physical discomfort to environmental factors to poor communication, says the Alzheimer’s Association. The main cause behind all the behavioral symptoms that come with dementia is progressive deterioration of brain cells. However, things like pain or inability to communicate their wants and needs can exacerbate symptoms. Let’s go over each one in a bit more detail:

  • Physical discomfort: If your loved one is in pain, this could be due to a urinary tract or other infection, which is common in patients with Alzheimer’s. They may not be able to communicate what’s bothering them because it’s unclear even to them where the pain is originating from, due to loss of cognitive function. Your loved one may also be extremely tired, hungry or thirsty. Perhaps they are on medication that is causing side effects. Speak to their doctor to get them tested or look into possible interactions with their medications.
  • Environmental factors: If the patient has been over-stimulated by loud noises or even clutter in their room, this can also lead to aggressive acts. Perhaps they feel lost or confused due to too much action going on around them. You may notice that they do better during certain times of the day, which is when you should schedule their visits and appointments. Sundowning is very common in elderly and Alzheimer’s patients. You may see big changes in how they act once the late afternoon hits, typically triggered by fading light, according to WebMD. They may yell and pace, become upset and anxious and seem restless, irritable, disoriented and demanding.
  • Poor communication: The inability to properly form the words to tell you what’s wrong can trigger aggression too. Sometimes, your loved one picks up on your stress and irritability and mirrors those emotions. Try limiting your questions and making your instructions easy to understand.

The National Institute on Aging suggests these additional causes of aggression in Alzheimer’s patients:

  • Depression
  • Stress
  • Constipation
  • Lack of sleep
  • Soiled underwear
  • Sudden change
  • Feeling of loss, such as the inability to drive and have freedom
  • Feeling pushed to do a task by another person, such as eat, take a bath, etc.
  • Loneliness

Tips to Respond to Aggression

There are some things you can do to ease the stress on your loved one and help them calm down when agitated. For example, if they are restless, characterized by pacing and drumming fingers, you can try to distract them with a meaningful activity, suggests Dementia Today. Calm your loved one with soothing music or touch. Determine patterns in these behaviors and schedule yourself to be with them at that time. Find a root cause that could be triggering the aggression, such as pain.

The key is to remain calm, don’t get upset, and do what you can to make your loved one safe. For example, rather than restrain them from pacing, clear a path to make sure they are safe. Here are some more helpful tips:

  • Be positive and reassuring, speaking slowly in a soft tone.
  • Limit distractions.
  • Try a relaxing activity, such as music or massage.
  • Shift the focus to another activity if the one they are engaging in suddenly triggers aggression.
  • Take frequent breaks. You need time for yourself too! Just a few minutes to walk away will keep you calm.
  • If you can’t calm down your loved one, ask for help from the hospice team, or, if you are at home, call 911 so they do not hurt themselves.  Always tells first responders your loved has dementia as soon as they arrive. They will know how to react.
  • Join a support group. Eat healthily. Take care of YOU. After all, you can’t expect to give your best to your loved one if you’re not nourishing your body and soul. Seeking caregiver support so you don’t burn out is critical.

Contact Pathways Home Health and Hospice

To learn more about dementia and aggression, and how Pathways Home Health and Hospice can help you and your loved one, call us at 888-755-7855. We offer complete dementia care services as well as resources for dementia patients and grief. Please don’t hesitate to reach out when you need help.