Anger and Aggression in Alzheimer’s Dementia (A.D)

Here is a copy of a handout i will be giving to Alzheimer’s support groups. Please feel free to comment and discuss.

Describing Anger and Aggression

  • The American Psychiatric Association suggests that anger is an emotion which can be positive or negative depending on how it is controlled. It can be positive giving you a way to express negative feelings or motivate you to find solutions to problems. It can be negative when it causes problems at home and at work.
  • According to the McGraw-Hill Concise Dictionary of Modern Medicine Dictionary (2002), Aggression is a forceful physical, verbal or symbolic action which may be appropriate and self-protective. For example, there can be healthy self-assertiveness or inappropriate aggression that is hostile or destructive which may be directed to the environment, another person/personality or toward the self
  • Anger and Aggression usually occurs during the middle to last stage of Alzheimer’s Dementia (A.D)
  • Usually when the sufferer is still physically strong but judgement has fallen
  • Always remember that the violent behaviour is a part of the reactions that occur like sleep disturbances that can be controlled
  • Note that your loved one is not acting out on purpose
  • There may be more verbal attacks such as cursing or insults
  • Physical attacks such as throwing objects or resisting care by pushing or hitting may occur

Causes of Anger and Aggression in A.D

  • Frustration
  • Delusions, hallucinations (imagined threats)
  • Reactions to drugs
  • Pain/physical discomfort
  • Inadequate sleep
  • Environment (loud noises, feeling lost)
  • Poor communication (too many questions or statements)
  • Constipation, soiled underwear or diaper
  • Sudden change in place, routine or person
  • A feeling of loss e.g. missing the freedom to drive
  • Being pushed around by others to do something
  • Feeling lonely and not having enough contact with people

Coping with anger and aggression in A.D

  • Observation and diagnosis from a doctor-observe drug reactions, any pattern in behaviour, any recent injuries, history of the anger outbursts, any recent moves or big changes
  • Treatment and management-depending on the cause the doctor may not be able to treat the problem but it can be managed at home
  • Reassure the person and be positive using a calm voice
  • Let the person feel like they have as much control of their life as possible
  • Keep a routine for bathing, dressing, eating the same time everyday
  • Keep well-loved objects such as photographs around the house to make your loved one feel more secure
  • Reduce noise, clutter or a lot of people in the room
  • Try to distract your loved one with a favourite snack, activity or object
  • Anticipate a situation where your loved one may feel uncomfortable, overstimulated or confused
  • Better communication, avoid asking too many questions at once
  • Do not contradict the reality they are in, ask questions about how your loved one may perceive a thing
  • Talk about memories your loved one remembers as they will lose short term memory and it will be easier for him/her to recall events from the past
  • Use reminder cues to lessen frustration over failed tasks e.g. reminder notes on how to brush your teeth/change clothing
  • Think about what happened right before the reaction that may have triggered the behavior.
  • Rather than focusing on specific details, consider the person’s emotions. Look for the feelings behind the words or actions
  • Use music, massage or exercise to help soothe the person
  • Decrease the level of danger by avoiding harm and stepping away from the person
  • Avoid using restraint or force which can cause more frustration and anger
  • Share your experience with others through support groups online, in communities, speak to friends, neighbours or families
  • Remove any object that may cause harm from around the house to ensure safety
  • Seek help if you see these behaviours occur daily, get others to help you with routine tasks
  • Make a list of phone numbers, emergency numbers of people to call
  • If the behaviour becomes too difficult to handle you may want to seek professional help. For example, moving into a long term facility and communicating with a healthcare team

Taking care of yourself as a caregiver

  • Learn and use stress-reduction techniques, e.g. meditation, prayer, yoga, Tai Chi.
  • Attend to your own healthcare needs.
  • Get proper rest and nutrition.
  • Exercise regularly, if only for 10 minutes at a time.
  • Take time off without feeling guilty.
  • Participate in pleasant, nurturing activities, such as reading a good book, taking a warm bath.
  • Seek and accept the support of others.
  • Seek supportive counseling when you need it, or talk to a trusted counselor, friend, or pastor.
  • Identify and acknowledge your feelings, you have a right to ALL of them.
  • Change the negative ways you view situations.
  • Set goals.

 

Recommendations 

  • Watch the movie entitled Shirley Adams (the movie is about a mother that raises a paraplegic son after being shot, Shirley Adams (the mother) deals with anger and resentment from the son, does not accept help from others, does not take time off, does not work and has financial concerns, smokes and steals to provide for her son )
  • As a caregiver you may be able to identify with this movie, you may want to take notes while watching this movie to examine some of the behaviors’ you need to avoid as a caregiver which will to help you take better care of your loved one and yourself
  • Reference Link to find out more information about this movie (http://www.imdb.com/title/tt1483507/ )

References

http://apa.org/search.aspx?query=aggression

http://www.caregiverslibrary.org/caregivers-resources/grp-diseases/hsgrp-alzheimers-disease/dealing-with-aggressive-behavior-article.aspx

http://www.alz.org/care/alzheimers-dementia-aggression-anger.asp

http://www.webmd.com/alzheimers/alzheimers-aggression

http://www.helpingyoucare.com/25323/alzheimers-caregiving-tips-for-dealing-with-aggressive-behavior-issued-by-national-institute-on-aging

https://caregiver.org/taking-care-you-self-care-family-caregivers

 

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