Sometimes the going gets rough and caregivers may have to be ready to handle any type of situation, including physical altercations. For some, age and illness can bring out or intensify unpleasant personality traits and behaviors. Over time you may notice the person you’re caring for becomes more irritable, impatient, impulsive, demanding, or even physically aggressive.
Although some outbursts may happen without warning and for no apparent reason, in most cases, these difficult and aggressive behaviors are a sign of stress and frustration. Knowing the proper de-escalation tactics and working with the client and the client’s family to understand triggers is integral to creating a care plan that mitigates discomfort and aggression. Here are the best tips on how to manage physically violent behavior from seniors.
Identify The Triggers and Warning Signs
The first step in managing aggressive behavior is to try and understand what the client is feeling and what they were triggered by. Sometimes seniors turn on their home caregivers because they are frustrated, whether it's about chronic pain, getting old, having memory issues, losing loved ones, or being unable to take care of their own needs. They may be acting combative as a reaction to something threatening or uncomfortable in their environment, or perhaps they are just feeling hungry or thirsty and don’t know how to properly express themselves in the moment.
Watch out for warning signs and learn their common triggers. A senior’s agitation can also come from discomfort from lack of sleep, side effects of medication, indescribable pain, loud noises, too much clutter, or busy environments. It’s important to remember that sometimes clients are just getting frustrated with themselves. They can feel confused if they are asked too many questions at once or get frustrated when trying to understand complex instructions. That’s why it is important to listen and pay attention to what the client is frustrated about.
Everyone reacts to frustration differently, but there are some warning signs to watch out for. Usually there are verbal and nonverbal cues, such as pacing, restlessness, clenched fists, louder speech, profanity, abusive remarks, and threats of violence. As a home caregiver, you need to learn how to react and behave in challenging situations. Once you can identify common triggers that cause aggression from the client, you can work out a care plan that best addresses their unique needs.
Dealing with Alzheimer’s and Dementia
When someone is normally gentle and loving but then suddenly starts swearing or saying inappropriate things, it can be confusing how to handle these behaviors. If this behavior is out of character, it may be a symptom of dementia setting in. You may think Alzheimer's is a disease that only affects the memory, but there are a lot of complex neurological and psychological symptoms.
People with dementia or Alzheimer’s disease experience a different reality and have trouble controlling some of their feelings, reactions, or behaviors. They may feel confused, frustrated, or scared, and unable to properly identify their own emotions or communicate what they may be feeling. When someone reaches the combative stage of dementia, they may start showing more signs of anger and aggression because of their inability to properly communicate. These situations can arise out of nowhere or be triggered by physical discomfort or environmental factors. If the client has dementia, it's important to first rule out pain as the cause of the aggressive behavior.
To help avoid confusion and frustration in clients with Alzheimer’s or dementia, try using labels and signs at home as memory cues. Put labels on common items that they use, signs on different rooms that say what they’re for, and signs that explain what’s inside different doors, cupboards, and drawers. This will make daily tasks like brushing teeth, getting dressed, or grabbing snacks easier and encourages independence.
Tips to Prevent and Manage Aggressive Behavior in Seniors
There is no ‘one size fits all’ solution for aggressive physical behavior from seniors. As a home caregiver, you must be attuned to all their behaviors and reactions and learn as you go. It requires that you act with extreme patience, love, care, and compassion. You need to educate yourself on how to properly react to difficult behavior so that you are not aggravating the situation and making things worse. There are many things you can do to defuse violent situations and manage physically difficult seniors. Here are the best tips and strategies we recommend:
Don’t argue. Ask questions, listen, and focus on what they are feeling instead. Validate their feelings and let them know that it’s okay to be frustrated. There is no use in trying to convince them that they’re wrong. Avoid criticism completely.
Be kind, gentle, and reassuring. When a difficult situation arises, it’s important to remain calm, patient, and kind. Try to smile as much as possible to reassure them that you have good intentions. Use gentle touches to show natural affection and soothe the client.
Speak calmly, use simple sentences, and do not try to shout over the client if they are getting loud.
Do not ask too many questions at once, as it may be overstimulating or confusing.
Pay attention to the environments that your client responds negatively to. Avoid loud noises and clutter.
Don’t be accusatory when they are being difficult. Instead, try to ask questions and use logic to remind them and walk them through why they should or shouldn’t do something.
Use distraction during verbal or physical altercations. When the client is acting hostile or experiencing delusions, try to re-direct their attention to focus on something new. Pick something positive that they can immediately click with, like an old joke or memory that brings them joy.
Do not take their irritable or aggressive behavior personally. Avoid becoming defensive and reacting to abusive statements. Try to stay calm and focus on distraction tactics, but if all else fails: set some firm limits on what behavior is acceptable.
Take things step by step. Do not overwhelm the person under your care with too many instructions, activities, or expectations.
Think ahead and stick to a regular routine. Recognizing warning signs and triggers will help steer your client away from feeling uncomfortable and confused.
Try music! Research has shown that music can be used to calm down and reduce difficult behaviors in seniors. Singing one of their favorite songs or playing an old album from their collection can do wonders if you try.
Don’t Forget To Take Care Of Yourself Too
Dealing with aggression or violence can be exhausting and can affect you emotionally. It’s important to remember that you are doing your best to care for your clients. Don’t ignore your own feelings or needs. If you take good care of yourself, you can take better care of your clients.
If you are taking care of a loved one and they become more violent, you may want to consider hiring a home caregiver. People often leave their worst behavior for their loved ones because they feel comfortable doing so. A professional home caregiver from Alegre Home Care has the skills and experience to help seniors with difficult behavior. A home caregiver will also be able to devote more time and give their full attention to trying to prevent and defuse aggressive situations. They are experienced at tracking behavior, figuring out common triggers, and working on strategies to prevent hostile situations and ensure the comfort and wellness of the client.
If you have questions, please get in touch with us at one of our locations.