Anger in dementia patients

Everyone gets angry from time to time, but for people who are living with dementia this can be labelled as challenging, without the people around them understanding why they’re acting in that way. This can occur for various reasons, including a phenomenon known as ‘sun downing’, where people’s behavior will become more difficult to manage later in the day, which can be very distressing for both the person and the people around them. According to the Alzheimer’s Society, “As a person’s dementia progresses, they may sometimes behave in ways that are physically or verbally aggressive. Looking at what causes this behavior and being aware of the person’s needs can help to reduce this behavior or make it easier to manage.”
If caring dementia professionals can make a difference to yours or a loved one’s life then Skillsro is the company to consider for live-in care or visiting care. We’re fully regulated by the Trade Register which operates under the jurisdiction of the Ministry of Justice, meaning we will always deliver exceptional standards of dementia care across Romania.

Common causes of anger

There are many reasons why a person with dementia may exhibit angry behavior, but the most important thing to remember is that they are behaving that way for a reason, they are not just being ‘difficult’ (as it’s sometimes labelled.) It can need an element of detective work to discover the reason for their behavior, but it’s important to do everything to discover why they’re doing it and not just dismiss it as a ‘symptom of their dementia’.

‘Sundowning’ is described by Dementia UK as “changes in behaviour that occur in the evening, around dusk. Some people who have dementia experience a growing sense of agitation or anxiety at this time.” This can be because the person has regressed to a time when they were much younger and the common time for sundowning, late afternoon to evening, represents a time when they would’ve been busy and dealing with responsibilities. Often this would’ve revolved around childcare – for instance collecting their children from school, preparing an evening meal, then putting children to bed – so the person is convinced they should be doing something important. If they are unable to verbalise their anxiety or frustration then they may make use of whatever method is available to them to gain the attention of someone nearby, such as grabbing, pinching, or hitting. They may also argue or shout if they’re able to, pace about, or become more confused than usual. This would all be labelled as ‘challenging’ or ‘disruptive’ behaviour in some cases, however it’s just the person trying to get help with what they perceive they need to be doing at that time. Dementia UK elaborates by describing sundowning as often making the person with dementia “feel very strongly that they are in the wrong place. They might say they need to go home, even if they are at home, or that they need to pick the children up from school, even if they’re now adults.”

How to manage and react to the situation

The most important thing to remember is that the person is displaying anger for a reason. It may be closely tied to frustration at their inability to voice their concerns, pain, or to follow a conversation that people are having around them. It could also be because their basic comfort rights need to be attended to, or perhaps because of pain. It’s essential that, once everything else such as hunger, thirst, being too hot or cold, tiredness or the need to go to the toilet have been ruled out, a medical professional is consulted. This is because the situation may be being caused by the side effects of a medication, or an underlying infection could be present that is causing pain and discomfort. Therefore, for someone looking after a person with dementia, even though it can be distressing to witness their behavior, checking what the underlying cause may be is crucial.

Even if no apparent cause has been identified it’s vital to always remain calm and to not mirror the person’s aggression. The person may be shouting but never raise your voice to match their, instead explain calmly that you are going to help them with whatever it is they need to do and listen patiently if they are able to explain their feelings to you. It’s important to take their concerns seriously and not dismiss them out of hand. For instance, if a 90-year-old woman tells you she needs to collect her children from school never say something like “don’t be silly Gwen your children are all grown up” as this will just cause them further distress and confusion. Instead, distract their attention away, if possible, perhaps with the promise of a cup of tea, a gentle hand on theirs, or their favorite activity. If the person feels their anxieties aren’t being listened to it will just make them more anxious and concerned.

How Skillsro can help with dementia care

We are a specialist company, priding ourselves on our quality of dementia care and the training that our carers receive around the topic. We consider one of our primary goals to be helping people living with dementia to live well, and we are integral to many organizations in Malta  to ensure that happens.

We offer exceptional visiting and live-in care on an individualized or couples basis, and because we only deliver person-centered support all of our customers remain at the centre of their care journey for as long as they need us.

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