How do you handle them getting aggressive with you and not losing your temper?

Does anyone have specific Teepa Snow video links that pertain to this topic? I know her videos are mentioned a lot , but there are so many of them on youtube etc.

I'm dealing with this now. I'm trying telling him "I didn't come to argue, if you continue arguing, I will leave." We'll see if this works. This is a new pattern for him, he's always been manipulative and controlling but I would ignore it or talk him out of it. Of course you can't argue with someone with dementia (he has lewy body) but it's hard not to try to get your point across. I am realizing that I live in reality and he lives in his reality complete with people he talks to, works with and generally engages with just as he used to do in my reality. I'm not sure if this is common but he has elaborate scenarios that involve him & them, I'm just on the sideline. I try to agree or respond in some way that indicates I'm going along with him. Sometimes it works, usually it doesn't. I'm no expert but I'm trying not to engage with his argument and just leave. Time will tell if it works. I'm not optomistic but I'm trying to hopeful. I've read the answers here and I know that everyone reacts differently. I'm trying to get them to figure out some type of medicine that might give him some relief but the neurology doctors he goes to can't seem to get hooked up with the NH, we are stuck in the middle. I know he is extremely stressed, it just seems to be vicious circle. Good luck and wish me luck too.

UTI's can be a huge factor when there is a change or increase in behavior change incidents (aggression included). This is true for my mom. In her case, I have had to advocate for her many times when she was in memory care. I would ask the nursing staff, "Did you check for a UTI?" They would say, "She just had one" or "It came back negative" (only to be told days later that a culture test was positive). Look for patterns in behaviors - keep a behavior log. When she was in memory care, I was told many times that they wanted to add to her med plan specifically for aggressive - I advocated to not have this happen. I started to keep a log as to when I was getting the calls about the aggression - I noticed a pattern. The behaviors increased when demands were made on my mother, or she was asked to do something quickly like get out of bed to get dressed. Given, they were on a schedule, but my mom was not on that schedule. For example, they wanted her up at a certain time, take her meds quickly, go to bed at a certain time, shower at a certain time, etc. With my log, I observed that the aggression was more frequent when these "schedule" demands were directed at my mom. I asked staff to give her opportunity to say "No" or "Later" and added that they should allow ample time for here to process what was excepted using a visual schedule.
Hope this helps.

Agree MTraver regarding 911…

except not all police are untrained in mental health,

the thing is…

if the police do arrive and not the EMT (you need both)… if you do call 911 explain that dementia, mental episode you need EMERGENCY EMT …) bc if the police take your loved one to lock up or a hospital, even if they believe you, you open a WHOLE set of incarceration situations with a 302 if the police decide your loved one is unsafe. Better to make it a 201 where you have choices.

this winding journey…

For anyone you care about old, young or in between - I never call 911 unless someone is not breathing or they are bleeding out. Someone may end up in handcuffs and taken away not in the ambulance but in the back of a police car, or end up dead. Unfortunately who ever shows up may be the police and not the paramedics. The police are not to be trusted with someone who is in mental distress.

I have not gone through all 27 answers but if no one has mentioned this..or if it has been mentioned it needs repeating....
If at any time she gets aggressive to the point that YOU or she will or may be harmed you HAVE to call 911 and ask for a transport to the hospital.
There are medications that can help with aggression, agitation and anxiety.

Now if it a mild aggression do any or all of these
Leave the room if it safe to do so.
If it is verbal, wear headphones or earplugs.
Ignore it.
If it is physical aggression leave the room. For physical aggression that is the only act you can do that will take you out of the way.

Consider getting caregivers. That will remove you as the target and may people are a bit less aggressive with a "professional"
If that does not work then considering placing mom in Memory Care where there is trained staff 24/7 and more than 1 staff person can be assigned if there is cause.

MiaMoor, 

Thank you, yes. Mary Poppins… up wrinkles… whistle while you work…

Once I decided that my husband actually WAS like a toddler in so many ways, it completely changed my perspective. (Before the toddle aspect, I “might have” had a negative thought or two) Now… who could ever be negative with a toddler who needs encouragement and kindness and a strong, positive mentor.

i started the Power Naps as if he were a Two year old…. “I’m tired. Will you lay down with me?” So it was HIS idea to HELP me (very manly). And I will not kid you, I do believe that once or twice I actually fell asleep… 

And then the pattern starts… Let’s take a break, You’ve helped so much today, why don’t you put your feet up? Lead him into the bedroom… We have so much to do later, I’m going to need all my energy… then I have him sit on the bed. Next thing you know, he decides to put his feet up, hands clasped behind his head; I wait until his eyes are closed and he is asleep and partially close the door and then have the next 30-45 minutes to myself. When I wake him, he is great and bc he sees me right there, has no idea that I wasn’t there the whole time.

Every dementia person is different. Every relationship is different. Find what works. With my husband, he is a protector and manly helper. So I appeal to his core.

NUTRITION is key. There is a fantastic book: The End of Alzheimer’s Program by Dale Bresden MD. There’s a lot of science and chemistry in the book. Read that part for backgrounder or don’t. DO READ and follow the action plan menus and how to make it happen. Then Giada has her Eat better feel Better cookbook with very easy recipes (and great photos!!)

Also someone mentioned 36-Hour Day. Yes!! Please get the 7th Edition… it has updated information. My friend was a nurse at Johns Hopkins and has very high regard for the authors.

this winding journey…

Kimmiemoon66: Perhaps you can garner knowledge on the disease of dementia by reading the book, 'The 36 Hour Day.'

This is what I do: I've learned that people with dementia "die as they lived" (Hospice Nurse Julie). So, my dad has always been a narcissist to all of us. I was raised to never talk back, or raise my voice, and do as you're told, etc. you know the drill. But now I'm 68yrs old and here 24/7 - just Dad and me! And that crap doesn't work for me any longer. So, I get the brunt of his moods every day. My Dad has moderate/severe lewy body dementia - he is 96yrs old. Hallucinates a lot - accuses me of losing his stuff (glasses are on your head Dad - sort of thing) Still wants to be active but that is mostly too difficult so he can be very rude (to say the least) Lately I've taken to the highest road I possibly can muster and that is when he blasts me over something, anything - I in turn answer him in the happiest voice I can manage, I'll say "well okeeeedokee dad" He'll fire back "What'd you say?!!!", and I'll say it again with a smile and a pat on his shoulder. Works every time for some reason. I have no idea why - but it's working for me. Sort of kill-em-with-kindness concept Hahahaha. I just find being overly nice to him all the time has made a vast improvement in his moods! Not sure why. But it has. Wishing you the best of luck with this!. Deep breath. Oh and I also, do "Release Your Fks meditations" with Yogi Bryan he's on Youtube for free (strong language used - I use his sleep meditation as well the non-strong language version - I feel better and can handle the stress more when I sleep well and release Fks!! That has helped immensely. lolol - Take care.

This is how you do it ... (Of course, you do what works ... this has worked 'best' for me over the years).

Ask yourself: Do I want to respond by losing my temper when xxx gets aggressive? If you answer NO, consider:

(1)

Understand what dementia is and realize that the person cannot express or communicate differently. They do not have the brain cells, some cells have died, others are dying - the person doesn't have have the cognitive functioning to communicate differently.

(2)

Realize the person is FRIGHTENED, SCARED, CONFUSED, FRUSTRATED - and more.
They take it out on the person closest to them.
Then can't do anything else.

(3) "Do not take it personally".

What does this do? It shifts 'your' knee jerk reaction / automatic response to one of COMPASSION vs having other expectations.

Is this easy: No. It is quite challenging. It is an ongoing practice. However, practicing will support you to feel better about yourself and how you emote.
You won't be sucked in ... as often.

(3) Practice ahead of time 'this is the way it is ... " be prepared so you aren't surprised: xxx will react xxx. This is how I am going to handle it 'next time.'

FIRST: If you tend to immediately lose your temper - LEAVE.
For a few minutes to a few hours to a couple of days - take respites as you need.

SECOND: It actually helped me to tell my client "This is not acceptable."

If the person has 'enough' cognitive functioning to realize that you are helping / wanting to help, they won't want you to leave or stop being there helping. So, setting boundaries will / could help. Say:

"If you do not stop xxx, I am going to leave." And then leave. Then may or may not understand. It depends on the degree of dementia.

Is this easy: No. None of this is easy. However, leaving will help you shift out of the automatic response / losing your temper.

4) SELF COMPASSION - be your own cheerleader. You need to be your own self-advocate. Create a list(s) ahead of time so these words come out when you need them.

Consider phases such as

"I am doing the best I can and so is xxx."
"I will not allow myself to be verbally (or otherwise) abused."
"This feels like s--- t and isn't personal to me ... it just feels that way."
"I need a self hug" ... Go inside and visualize giving yourself a hug or do it.
* Create any self-talk / affirmations that might work.

5) SELF CARE
You absolutely have to do the basics of self care ... even when you feel like drinking your dinner (?) or overeating or over-anything as a way to release the stress (negative numbing out which is the easy self-destructive behavior--that you don't want to do.

You want to:

* Eat healthy
* Exercise (move somehow) daily --- you MUST get the stress out in positive ways.
* Meditate or do something spiritual to support you.
* Journal writing
* Have a 'day with the gals or guys' - take yourself to a movie, garden, museum, whatever you can do.
* Give yourself breaks with caregiver fill-ins. Even if just one day a week or a few hours a week - do what you can (financially). You cannot run on empty.

6) LASTLY (for now) - put yourself in THEIR place. How would you want someone else to respond to your aggressiveness?
- Would you want them to understand that you can't help it?
- Would you want them to take care of themselves so they will be there for you 'tomorrow' - (or later today)

I hope this helps. It is the million dollar question. I personally believe losing a temper is a reaction of being over-stressed out and needing to deal with the stress (self-care) / it will help if you realize you can LEAVE the immediate environment vs staying there 'taking' it in.

If a parent, old patterns of behavior from likely childhood likely are 'running you' - you are triggered not only from the current immense responsibilities, but from decades of conditioning. Try seeing a therapist to help you cope during this time.

Gena / Touch Matters

I'm a caregiver for my sister, whom I noticed would become irrational, unreasonable, argumentative, and start shrieking and slapping whenever she ate too much gluten or sweets. It takes a lot of vitamin B to process carbs, and taking that B away for use on processing carbs means there's less B (B6 in particular) in the corpus striatum to make dopamine. I've altered her diet and give her B supplements, and now she rarely acts out. There isn't only one cause, so you may have to try each of the recommendations in these answers to find the one, or combination, that works for your family. I hope you're able to find the best answer for your situation, and may God bless and keep you!

I too would like to know the answer. My 83 yo mom has mild dementia that has increased since hospitalized b/c of sepsis. It has changed of lot of her old normal issues. But to put some icing on the cake, she is has passive aggressive narcissistic tendencies. She will be fine with me doing something for her, then I'm Satan for trying to help her.
ANY thoughts???

There is a wonderful book that I have found helpful – at least some of the time! It’s Kisses for Elizabeth, written by Stephanie Zeman, a memory care nursing supervisor. She emphasizes that we are dealing with a brain with damaged cells, often compounded by hearing and vision loss. Misunderstanding or misinterpreting events and situations – and the inability to process and/or regulate own feelings – is a challenge. She emphasizes not to argue but to listen, divert attention, redirect, reminisce, etc.  She also suggests working on our own body language while we do so as this is a major cue that either calms or escalates a situation. My biggest “take away” was to try to figure out and address what my spouse believed, what ever was the triggering issue.  She gives some wonderful examples of the visual and emotional changes that lead to fear and/or other negative reactions.

The reactivity and agression is really hard – stressful, wearing, and sometimes hurtful - so I also found it helpful to put up lots of pictures of positive moments with my spouse to help me maintain perspective and also to look for ways to care for myself. Taking a break helped!

Kimmiemoon66,

Oddest thing ever and yet, makes perfect sense…

My husband is in later stages (10 years in w 4 years of MCI prior) dementia. Recently, I noticed a paradoxical aggressive- anxious behavior very soon (20 minutes or so) after taking a controlled medication that he successfully was on for a year and half.

Took him to the psychiatrist, who specializes in dementia who then took him off of almost everything and prescribed mandatory power naps of not more than half hour. Definitely one in the afternoon at near 2 pm and possibly one before lunch. Just like a toddler who needs naps and gets cranky and miserable and then too tired/awake to sleep.

I said, “Yes!!!! That’s it. Nothing is right. Everything is wrong and then he lashes out!!! And because he is six foot two and I cannot put him in a play yard or crib…”.

Seems that as we age and especially with dementia, we do not easily make dopamine. Power naps help restore. The psychiatrist promised that my husband would wake up cheerful and be happier for the next few hours refreshed and no pharmaceutical side effects.

Two weeks into this new program and I have a happier husband, and for me… I’ve gained an hour of self time every day!!!

I hope that my experience helps.

PS agree that when we smile, be kind, walk away, inverse mirror, refuse to engage… we diffuse or de-escalate adverse and dangerous consequences. It’s difficult sometimes bc we are so exhausted and worn thin.

A loved one care giver I met once asked me why I smile all of the time and smile bigger when I’m upset. I told her that I believe that smiling in the face of adversity gives “up” wrinkles. And up wrinkles are far more flattering on my face than permanent “down” wrinkles. It’s all about me.

Laughter and smiles. I saw Janice a few weeks ago and she was smiling. “Janice, look at you with that big smile!! Oh, yes. “It’s all about ME!!! I now am able to complain and smile at the same time. He’s not giving ME bad wrinkles!”

It depends on the severity and what you are experiencing. I see a lot of different perspectives on here.
making jokes, validating and redirecting only work on minor situations and for a caregiver who is not looking for advice on how to cope with it.
From my personal bank of experiences with my father, I had to laugh at the thought of validating and redirecting when he had me by a handful of hair calling me stupid b*tch for trying to stop him pouring his milkshake on the carpet.
If the aggression is mild physically or verbally then laughing it off, redirecting may work but try to steel yourself into expecting things just to be this way. Take moments away, walk around the block if you can etc. If the aggression, is hitting ,punching, hair pulling, demeaning language etc then you are being abused.. it doesn't matter who it comes from. you matter. I was constantly told it wasn't him, he couldn't help it etc, ..but that does not make the abuse any less.
Then it is time for Medication, outside help so you can at least get a break, a facility etc but do not suffer at the hands of someone else if there can be an alternative found.

As many have pointed out, aggression is a common issue for individuals with cognitive challenges. For my father, his aggressive behavior started with me and eventually affected the staff at his assisted living facility. I worked closely with his neurologist, who adjusted his medication to address the aggression as the cognition declined. Although the aggression never completely vanished, these adjustments were successful in significantly reducing its severity.

My solution was to never engage, just say good bye and walk away. Your LO might not remember the incident tomorrow but you will and it will only create ressentiment.

Best wishes

Medication. It’s the only way to keep them calm and not get to the point of being aggressive to their caregivers.

No one has to live with abuse. If it's verbal abuse only, walk away. Completely ignore them. No attention whatsoever and step away until you're cooled down. Then talk to the doctor about medication. Anti-anxiety and depression meds can wor wonders.

If the lashing out and verbal abuse gets threatening or physical that is when the person should be placed in residential care.

You know what, sometimes you have to be a little intimidating too. Especially if you have to get things like hygiene care done or mediations taken. If you lose your temper and yell from time to time, so what? Really, so what if the demented person gets scared for a few minutes? It's certainly better than holding it all in and having it turn to you getting physical with her.

Are you alone with no outside help, Kimmie? I hope for your sake as well as your mother's that you are not. If you're the only caregiver and doing it with no help, this creates the perfect conditions for elder abuse. Don't let that happen. Put her in a home if you have to.

DISENGAGE !! Put out of YOUR mind and maybe get out of the house for a ride or something. Let them settle down and if they DON'T then call 911 and let the authorities take it from there.
You should also have a resource you can call and vent to or solicit advice for some distraction.
This can either escalate to untenable or....spontaneously just settle down.

Its a mental issue. Once you come to realize nothing your loved one does is intentional there is nothing to get mad at. Just remember the good times. I would often go to a different room to collect my thoughts. You will never know what frustrations they are dealing with until it is your time.

If you are talking about physical aggression, then you need to discuss this with mom's doctor.

If you mean verbal aggression, I have to overrule what has been my normal response of interaction and reaction (which only escalates things), and I've learned to just walk away. Not a word, I just turn around and walk away. I don't engage.

Example: Yesterday dh was having trouble with his belt, so he was frustrated. He is very picky about matching his clothes so I offhandedly mentioned that his shirt did not work his shorts as I was fixing his belt. He blew up -- and I turned around and walked out of the room. A few minutes later, I found him crying in the living room and he said he is so afraid of becoming an invalid and not even being able to dress himself any more and that's why he tries so hard to get dressed by himself every day. Needing my help was hard enough to ask for, and then I added what he perceived as correction regarding his clothing choices, and it put him over the edge. Walking away gave both of us a chance to get our minds in a better place.

You are only human. Don’t feel bad for times you’ve lost your temper. It can’t always be avoided.

Best thing is, if at all possible, walk away for a few minutes. Easier said than done. Step away from the patient and go scream into a pillow, scream in the car or a closet, splash water in your face, kick a couch cushion. One thing about dementia is, thoughts and feelings are usually short-lived.

When you come back, lower your voice, speak calmly, try to smile and think kind thoughts. Maybe put in some calm music at a low volume. Be prepared to keep stepping away. Hopefully the thing you are trying to do can be done in “increments”…getting dressed, taking meds, eating.

Getting stuff done will take 2-3 times longer than working normally, but it will get done. Not perfectly, but best you can do. That’s all you can do.

We went through this with dad. Not sleeping at night and aggressive during the day. Finding the right medication combo helped. We raised his Divalproex and added some trazadone to sleep better at night (half dose). This helped a lot. After 6 months or so he started getting really sleepy during the day. We reduced the divalproex in steps and reduced the trazadone in half again. He is sleeping great at night and no aggression.

Aggressive behavior has to be medicated, or a facility won't accept the elder either! No Memory Care is going to accept a resident with aggression problems because the safety and peace of ALL residents is the main goal. Call "their" doctor and discuss the situation to see what medication is recommended, or if a geriatric psychiatrist consultation is advised.

Best of luck.

One day I went in to say good morning to DH aunt who didn’t want to get up from bed. I said something, don’t remember what now, but aunt sat straight up in bed in anger (we didn’t know she could even do that any longer) she pushed her face right up to mine and said something defiant. Her aide was looking on unsure what was about to happen. Spontaneously, I quickly leaned in and kissed aunt on the lips. She howled with laughter. She was no longer angry and got right up. I could easily have lost my temper when she wanted to have an argument but thankfully I didn't. To me, I have lost if I allow myself to get angry.

There is a fine line between anger and abuse. Verbal abuse can lead to physical abuse.

The care topic “violet behavior” beneath your question has great advice. Click on it and it will take you to an article and comments from others.

I think the one key for me for being more patient with any annoying dementia habits.

Was learning more about dementia. I saw a news piece once where, they simulated dementia and just body decline and it really helped me. It was such a an eye opener. If I find it I'll let you know.

Learning as much as you can really helps, you have more compassion and understanding of what they are going through.

36 hour day , is a great book
Teepa Snow on YouTube, also great
And just go on Google find everything you can.

If I've tried the redirecting or offering a drink or snack and nothing works, I will leave them alone especially if they are stuck in a loop. I will sit nearby until they've calmed down. To keep my feelings under control, i remind myself that the brain is broken. One thing I've noticed with dementia is that once they become fixed on an idea, or a feeling no matter how false, this is when validation comes into play. You have to come down to their level and go along with their topic even if you have to let the imaginary cat out in the yard to play.

Every person is different. It was rare my father would get upset enough to start yelling but when he did he would remind me he was my father as if that somehow meant he outranked me. If I was 17 I could see his point but I was in my late 40s so...NO. I found yelling back just as loud stopped him in his tracks. His mother was not a nice women and I think he was afraid of domineering women so for a brief moment I would become one.

Aggressive in what way? If the person is hitting you, time to place them.

I think that this would be very difficult to do with someone you are related to. If they are getting aggressive, I would say its time to get outside help