ASOCIACION DE ALZHEIMER DE PUERTO RICO

AGGRESSION

When an Alzheimer patient becomes aggressive, angry or exasperated, this could be caused by frustration. The individual may feel like he is being pressured into doing something he simply cannot do.

Consider the following factors as possible sources of frustration:

Getting Dressed:

Once the patient has difficulty dressing, he could start to feel disgusted and/or exasperated.

Bathing:

When the patient becomes afraid when he hears the water run from the bathtub, he may push the caregiver who is trying to help him bathe.

Eating.

If he doesn't like certain types of food, he could refuse to eat.

Aggressiveness takes on many forms. Sometimes the person can simply try to pull away his hand, while in others, they can try to resist or try to hit the caregiver.

Try to evaluate and identify the motives for which cause the aggression and consider the following points:

Physical Causes:

The person may be tired because of lack of rest or sleep.

It is possible that medications, such as sedatives and tranquilizers are creating an adverse reaction.

Probably, the Alzheimer patient is not capable of expressing that something is hurting him.

Environmental Causes:

The patient could be bothered and tired of noises, people or physical disorder.

The environment could be unknown to the patient.

The patient feels lost and abandoned by the caregiver.

Lack of Communication:

The patient cannot understand if you are asking a lot of questions at the same time.

Instructions must be simple and easy to understand. The patient can observe your tension and irritability.

You may frustrate the patient by being too negative or critical.

STEPS TO FOLLOW

Try to Understand the Origin of his Frustration.

Observe the first signs of frustration in activities such as bathing, dressing or eating. Respond in a calm tone and offer assurance.

Don't take aggressiveness personally.

Remember that the patient is not necessarily mad at you. Instead, he/she could be misinterpreting the situation or be frustrated by his/her own inabilities.

Teaching and Motivation.

Offer motivation, but remember the capacity of the person and don't expect more than he can do. Avoid big explanations or arguments.

Use Distraction.

Don't persist in making the person finish a particular task, especially if he hasn't had success earlier. If you see that the patient gets frustrated when trying to button his shirt for example, try to distract him with another activity, such as putting on a pair of pants or shorts. After a while, you can have him try again.

Communicate Directly with the Person.

Avoid expressing anger or impatience with physical actions or with your voice. Use positive expressions of acceptance, such as; "Please", "Thank You", and "Don't worry, every thing will be alright". In addition, use tact to give confidence and comfort to the person with Alzheimer's disease. For example, you could want to put your arms around the person, or give them a kiss. Also, we suggest the following steps:

• Speak slowly and clearly.

• Use short simple sentences.

• Approach the patient face to face and slowly.

• Use repetition in frequent reminders.

Reduce the Level of Danger.

Evaluate the level of danger for both yourself and the patient. In other words, if the person becomes aggressive, ask yourself this question; What kind of problem am I in and what can I really do to approach this? Frequently you can prevent harm, simply by being five steps away from the patient and staying away for a short period of time.

On the other hand, if the person goes out of the house and goes toward a street full of traffic, you must do something immediately.

Be Prudent with Restrictions and Force.

Unless the situation is serious, try to avoid grabbing or restricting the person. Fighting with the individual probably will frustrate him and make him more anxious.

Experiment with Other Objects.

Some caregivers believe that stuffed animals, have a soothing affect for the person, while other find that domestic animals - dogs, cats, birds and fish - have a peaceful affect.

Learn from Past Experiences.

Try to avoid situations or experiences that make the person aggressive. For example, if the patient tires easily when there is a family visitor, you could limit the duration of these visits.

Try to identify the first symptoms of agitation. For example, the moments of anger sometimes precede the lack of rest, frustration or anxiousness.

Change the Environment and the Patient's Activity.

When the patient finds himself in the best condition during the day, simplify or plan more difficult tasks.

Give him sufficient time to respond to your indications or questions.

Permit the patient to make certain choices. Having too many decisions to make about how to eat or dress, can confuse and overwhelm the patient.

Divide each of the tasks in small parts and allow the person to do them step by step.

Maintain the environment tranquil, comfortable and free of disorder.

 



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