Agitation and aggression

Dementia changes people’s behaviour and emotions. Sometimes, people living with dementia can become agitated or aggressive.

They might:

• get upset or cry
• pace or fiddle
• repeat themselves and talk constantly
• swear, scream, shout or make threats
• be physically violent or damage things.

Agitated or aggressive behaviour is stressful for everyone. Certain situations or feelings can cause it. But there are also things you can do to reduce these behaviours.

Causes of agitation and aggression

There are many things that can trigger agitated or aggressive behaviour in people living with dementia. They might become overwhelmed in crowded or noisy places. Or they might get frustrated when they’re doing a complex task. They could also be feeling unwell or in pain.

Dementia can make it harder for the person to tell you how they feel, which may cause them to get upset or lash out.

These are some common things to look out for:

Health issues

Are they tired or having problems with their sleep? Are they in pain or ill? Is their medication causing side effects? Do they have poor vision or hearing? They could be experiencing hallucinations. A urinary tract infection might also cause agitation.

Humiliation

They might feel defensive or embarrassed about needing help for tasks like showering. They may feel like they are losing their independence.

Confusion

They might not understand what’s happening around them. This can lead to them being distressed.

Fear

They may feel frightened because they don’t recognise people or places. Or they might remember something scary or uncomfortable from the past.

Finding out what’s causing the agitation or aggression can help you respond to the behaviour.

What you can do

If your friend or family member is agitated or aggressive, there are a few things you can do to support them.

Supporting someone who is agitated or aggressive

If the person is experiencing agitated or aggressive behaviour, you can try:

• staying calm and reassuring them
• gently responding to the underlying feeling that’s caused the behaviour
• distracting them with an activity they find calming
• using the strategies that make sense for you and the person. For example, if the person is repeating a question, it may work to answer the question. But for other people, it may be better to ignore the question.
• if necessary, moving yourself out of reach or to a safe place. Avoid crowding or restraining the person unless you have to.

Talking to the person’s other care-givers can help to create a consistent approach to dealing with aggression or agitation.

Reducing agitation or aggression

You can also make changes that might reduce agitated or aggressive behaviours in the future. These include:

• visiting their doctor to rule out any underlying physical causes or mental health issues, such as depression
• identifying and removing triggers from their environment
• maintaining a consistent daily routine and avoiding rushing them
• minimising changes around their home
• breaking down big tasks into smaller tasks, and explaining them step by step
• avoiding crowded or noisy places that might overstimulate them
• communicating with simple sentences and a calm tone
• encouraging regular exercise and activities that they enjoy
• creating a safe and comfortable environment.

Protecting your safety

It's normal for you to feel unsafe, anxious or frustrated when your friend or family member is agitated or aggressive. And despite your best efforts, the behaviour may still happen. Be gentle with yourself, stay calm and take regular breaks away from the person if you can. Prepare a safe place for yourself, like a lockable room, and keep your phone handy.

If you're regularly feeling frustrated or angry, talk to a doctor, friend or counsellor.

If you or anyone else is in immediate danger, call 000.

It’s okay to take care of your own health and happiness. If you're struggling as someone who cares for a person with dementia, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night, for information, advice and support.