Navigating dementia & anger outbursts calmly

Sudden behaviour changes in people living with dementia can be common. As a person’s dementia progresses, angry outbursts can be one of the signs of people living with dementia. It can be challenging for caregivers, family and people around them to know how to respond appropriately.  Being aware of what causes these behaviours, the triggers and how you can manage dementia and anger outbursts calmly, can help make their behaviour easier to manage.

At what stage is aggression in dementia commonly seen?

Typically, anger outbursts are seen in the later stages of dementia, and they tend to become more severe, the more dementia develops. They may become more noticeable as a person needs more help with daily tasks such as dressing or bathing. It’s important that we consider why a person with dementia might become angry. Most of the time, it's not the person who is angry; it’s the dementia that fuels anger outbursts, so even though it may be hard, try not to take it personally. For example, a symptom of dementia is memory loss – dementia and being mean to family members can occur if they are helped to dress by someone whom they don’t recognise, even if it's by a family member who they once remembered. In moments of distress, it's crucial that we remain calm and compassionate to help people with dementia as not doing so may make the situation worse.

Why may people with dementia get angry?

According to the NHS, Behavioural and Psychological Symptoms of Dementia (BPSD) are symptoms of disturbed perception, thought content, mood, or behaviour, that frequently occur in patients with dementia. More than 90% of people with dementia will experience BPSD as part of their illness, and nearly two-thirds of those living with dementia in care homes will have BPSD at any one time. It can be psychological factors such as experiencing pain, mobility problems or dehydration or dementia factors such as memory loss, confusion or disinhibition that cause people with dementia to get angry. Emotional factors can also play a part. Someone prone to anger before developing dementia is more likely to present aggressive behaviours. We should all get clued-up on how to deal with aggressive dementia patients so we can help manage their wellbeing better.

Increased agitation

People with dementia are highly likely to experience communication difficulties. They may be unable to find the right words to express their thoughts and needs, making it challenging for caregivers to meet their needs effectively. For example, a person with dementia may be hungry and not be able to express it in a way that a caregiver can understand. It can also be the case that because a caregiver may not respond to their needs effectively, a person living with dementia may feel they are not being valued, which can lead to angry outbursts.

Confusion

It becomes more difficult for people with dementia to process information, causing them to become confused with themselves, which can disrupt their day-to-day routine. Because of their confusion, they can be wary of others or not feel like their needs are being met, which can result in a range of emotions, including anger and frustration.

Paranoia

A common symptom for people with dementia. People may feel threatened, even if there is no actual reason why they should feel this way. People experiencing this may feel they are being watched or someone is against them. This can cause distress as they feel like their privacy is being invaded, or they are being negatively perceived.

Hallucinations

Hallucinations happen from chemical reactions or changes in your body. In the case of people with dementia, their brain misinterprets information from their senses, which means they will typically perceive things differently, for example, seeing things in their vision that are not there in reality. It's impossible for people around them to know what hallucinations people are experiencing—some can be comforting, and some can be distressing. In many cases, if someone is expressing a distressing hallucination, they may become frightened or respond with anger, particularly if the hallucinations cause them to become suspicious of others around them.

Factors in their environment

The environment can be a trigger for people with dementia. For example, they could be in a loud environment, making it difficult to have a conversation or have trouble interpreting sounds, which can cause them to be overwhelmed. They could also be in an environment they might find too hot, which can cause them to respond aggressively.

How to deal with people with dementia who become aggressive

Sometimes, there are warning signs of dementia anger outbursts, such as scowling or swinging their arms. However, sometimes, it's hard to predict upcoming anger outbursts as there may be no warning signs.  Here are the ways to deal with aggression in people living with dementia:

Distract them

Try to distract the person’s attention. Music tends to be a great distraction and, as a bonus, can positively affect a person’s well-being. You could put on their favourite type of music, or songs you know they love, which can help quickly calm them down. If there is a certain time of the day when the person usually gets distressed, scheduling a music session for around that time can greatly help. You can also combine music with other tasks. For example, playing their favourite music can result in a more positive bathing experience if they get distressed during bath time.

Respond politely

You want to ensure you respond positively to the person. Communication is hugely important in managing angry outbursts. After all, people are responding to your behaviour. Expressing or responding negatively can make the situation worse, so make sure you’re responding politely and kindly at all times to make the person feel calmer.

Show positive body language

Try to keep your body language positive, for example, making eye contact, smiling, and not crossing your arms. This helps to convey feelings of comfort and openness, helping people relax more in your presence. Mirroring their body language can also help. It shows your desire to connect and can be a powerful rapport-building tool.

Give them time and space

Give the person space. People living with dementia may become aggressive if they feel someone is invading their space. It may be a good idea to leave the space and let them calm down. Check that it's safe enough to leave the space before you do, and make sure they're not likely to harm themselves.

Do not take it personally

When people express anger towards us, it's natural to take it personally. However, it's important to remind yourself that it's not the person expressing anger towards us who is causing them to behave in that way, but the dementia. Thinking about it from this perspective helps us respond more calmly. You want to show that you are not against them and that you want to help.

Resources and support for navigating dementia care

There is a lot of information available to caregivers of people with dementia. We’ve put together a helpful list of support groups, resources and respite care options: 

• Getting help and support as a carer
• Dementia carers support guide
• Dementia support groups

Barchester care homes: Specialised dementia care services

For more than 30 years, we’ve welcomed families into our Care Home. We provide specialised dementia care services delivered by expert teams, with everything we do centred around your every care need. Regularly working alongside your family to enhance your day-to-day life and ensure you retain your independence, joy, and life skills.

Our dementia care:

• Barchester dementia care

Our respite care:

• Barchester respite care

Find a Barchester dementia care home near you

We have over 260 homes across the UK. Find your nearest one.