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When people living with Alzheimer’s become angry and combative, their caregivers face new challenges that require new strategies. “I realize I’m the one who needs to change,” shared a myALZteam member who cares for a loved one with Alzheimer’s disease. “Learn not to take it personally — don’t engage and argue.”
Researchers have identified several stages of Alzheimer’s disease. Advanced Alzheimer’s, or severe cognitive decline, may include angry outbursts related to diminished independence and fear. Anger and aggression can also occur with other types of dementia, such as vascular dementia or Lewy body dementia.
Managing emotional outbursts from someone with Alzheimer’s or another type of dementia can be tough for caregivers. Here are some strategies to help deal with dementia-related anger, including tips from members of myALZteam.
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Sometimes, feelings of physical discomfort, anxiety, or overwhelm can manifest as aggression for people with Alzheimer’s.
People with Alzheimer’s can’t always articulate when they’re uncomfortable or in pain. You can first determine if your loved one is hot or cold, hungry or thirsty, constipated, or isn’t getting enough sleep. Resolving these root causes of discomfort may help with the underlying anger.
Feeling anxious or fearful can also be a cause of anger. One caregiver on myALZteam shared, “We see a lot of anxiety in her. We talk quietly and stroke her hands or back and offer reassurance at these times. She often retreats to her bed to relax and process.”
Minimize overstimulation by clearing clutter, reducing loud noises, and narrowing down choices.
One myALZteam member explained her partner’s challenges: “He has difficulty with too many options at restaurants. I often say, ‘You usually like seafood here, like oysters or crab cakes, maybe?’ This typically works fine. Too much choice overwhelms him.”
It can be difficult not to engage with a parent, spouse, or other family member who argues with you or accuses you of something you didn’t do. Although this may be easier said than done, try to step back and avoid taking their unkind words personally.
“I learned that arguing a point, however logical in my mind, is utterly fruitless,” said a myALZteam member. “I have so much more peace now that I have learned to say, ‘That’s a good point. Let me think about it.’”
Journaling can be a good outlet for your emotions and a way to practice self-care as a caregiver. Rather than trying to reason or fight with the other person, you can express your feelings without prolonging an argument.
“I choose not to engage, which sometimes makes you feel weak,” said another member. “I journal about it. I do not reread my pages. I hope one day, I can throw the journal away.”
In a myALZteam conversation about aggression and Alzheimer’s, one member wrote, “I have learned the art of distraction and therapeutic fibs.”
If you can’t walk away or fix the problem, distraction may be the next step. “Listen and see why they’re mad. Try to help. If not, redirect them to a happy place,” said one member.
“Let it go. It is not worth the headache. Just guide the conversation in another direction,” suggested another member. “Life is too short, and memories fade away fast. Enjoy the moments you still can have or make.”
You can also redirect using items, activities, or foods that may interest them, like this member who explained, “Redirect with simple snacks, like grapes, carrot sticks, an apple, or a banana. You can also use a new catalog or piece of mail.”
People with Alzheimer’s can get frustrated and confused when their environment or schedule changes. Familiar routines can add structure to their day.
One member shared, “A daily routine for him is to locate his money. He leaves it in the coat he last wore, so I make a point of putting it nearby to avoid ‘Who’s taken my money?’”
“Having a routine is key and ensuring all her basic needs are met,” said another. “She’s not hungry. She’s not scared or hot or cold. She needs to be reminded often that she is safe and who she lives with and that we love her.”
Reassuring the other person by explaining where they are, the time of day, and what’s happening next can provide comfort and may help prevent angry outbursts.
There are times when people with Alzheimer’s can become a danger to themselves and other people. If this happens, do your best to ensure your and your loved one’s safety.
“He nearly broke my neck because I wouldn’t let him leave the house alone at 11:30 one night,” a myALZteam member shared. “He threatened to beat me to death if I didn’t give him medication I had already given him. I can’t believe this is the same man.”
“There have been two occasions when I have been frightened by his paranoia and anger, and it taught me to be more prepared should I have to exit quickly. The reality is he does not always know what he is doing … so I have to safeguard myself,” explained another.
It’s worth talking to other family caregivers and your loved one’s doctors about how to handle any potentially violent or dangerous outbursts so that you have a plan of action in place. Healthcare providers can help advise you on what to do when situations escalate and offer resources for a care facility, assisted living, or home care if you need more support.
You can also call the Alzheimer’s Association 24/7 helpline at 800-272-3900, chat with a staff member by clicking the Live Chat button, or submit a question through an online form.
Consider calling 911 if you or the other person is in immediate danger. Be sure to explain that your loved one has Alzheimer’s disease, and that’s the reason for their irrational and aggressive behavior.
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He nearly broke my neck because I wouldn't let him leave the house alone at 11:30 PM one night. He threatened to beat me to death if I didn't give him medication that I already had given him. He… read more
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