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If you see these behaviors during sundowning then you need to make an effort for that time of day for everything to be very low key. Unfortunately that means it is the end to dinners out for the two of you, or with other family or friends. This does not mean it has to be an end to evening activities for you, sound like you have a live-in caregiver that would handle an occasional night so you can get out.
My Dad [94] would be assigned a male caregiver every now and then, and it depended on the age of the caregiver. One young fellow in his 20's, huge personality, Dad had no problem with him cooking and cleaning up.... but Dad said it felt strange having when a male caregiver in his 50's was doing the cooking and cleaning.
It sounds like your husband needs medication to control his behavior and I wouldn't leave any caregiver alone with him until you can find a medication that's effective in treating this aggression.
Also, if there are any weapons in the house, remove or secure them where your husband can't access them.
The first caregiver the agency sent was an older woman of color. The first time went ok, not great by any means, but nothing bad happened. The second time all h@!! broke lose. Mom thought the woman was there to steal from her, and wanted her to leave immediately. This soon escalated to where my mom tried to physically throw this woman out of the house with the phone in her hand threatening to call 911. Many with Alzheimer's have problems if a caregiver's appearance is not acceptable to them for a variety of reasons. It is embarassing for us, but it is just the world of Alzheimer's. Agencies understand this and hear it often, very unfortunate, but it is a fact in their business that they will adjust to. If there is something you can identify in this caregiver that may be causing the aggression tell the agency so they can find another caregiver.
This brings up another important thing for you to do. The day that this incident happened with my mother I called the police department to notify them that there was a person with Alzheimer's living there that is not in touch with reality. I sure wouldn't want emergency personnel responding without this information. It could be dangerous for anybody there. So notify your police department.
Also, GA makes an excellent, strong recommendation for you to contact his doctor to see what med may be right to try. And that could be trial and error to find the right one as meds work differently in those with dementia, sometimes the completely opposite effect as was intended. Seroquel was a miracle drug for my mom, ativan was a nightmare for her as it had the completely opposite effect.
And it does not sound like a good idea to leave your husband with a caregiver at least until you get the meds figured out. And GA had another excellent recommendation that since your husband becomes extremely agitated a facility with sufficient staff/resident ratio might be the best solution. Was he ever abusive to others in his younger days? Old, bad behaviors return in dementia and most often intensified as the social filters disintegrate within the brain.
But I wouldn't leave her alone again with him. It's too dangerous. Did she suffer any other physical injuries? He could easily have broken some bones in her face.
Is this the first time this has happened? If not, I think I'd be considering a placement where there are more people who can control and restrain him if necessary. Even if you really wanted to keep him at home, if he's in the violent and aggressive stage of Alzheimer's, his dementia and lack of control might be more than you can handle.
I'm so sorry for you - this must be so upsetting and traumatic for you and the aide.