Guidelight Dementia Care
A Six-Step Plan for Caregivers Managing Aggression/Agitation
Caring for someone with dementia who exhibits aggression or agitation can be intimidating and having a plan to manage it is essential. If nothing else, have a safety plan and prioritize de-escalation techniques.
One important aspect of providing care is mindset. We encourage all caregivers to believe that their LO is trying to tell them something but unable to find the right words and thus, they resort to unrestrained outbursts. Though this is the most generous interpretation of their actions, it can help move this issue from feeling insurmountable to feeling like it's a problem that can be solved. Read on for more info!
Step 1: Make a Safety Plan
Prioritize safety by assessing your environment for potential risks, such as sharp objects, unsecured doors, or tripping hazards. Remove those items or secure them. Establish an emergency protocol including a list of contacts (i.e., family, neighbors, or crisis hotlines) and identify a safe space to retreat if needed. Consider installing monitoring devices, like cameras, which can be monitored by the emergency contacts if appropriate.
Step 2: Identify Triggers
Observe and document patterns in your LO's behavior to pinpoint what provokes agitation. Consider things like hunger, fatigue, pain, overstimulation, unfamiliar surroundings, or other unmet needs like toileting.
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Keep a record noting the time, setting, and preceding events to recognize common triggers or identify trends. This will allow you to anticipate episodes and intervene before the situation escalates.
Step 3: Modify the Environment
Create a calming space by reducing noise, clutter and bright lights. High energy spaces can exacerbate agitation. Introduce soothing elements life soft music, familiar objects, or aromatherapy. Establish consistent routines for meals, sleep and activities to provide structure and reduce overwhelm that might lead to aggressive outbursts.
Step 4: Employ Communication and De-Escalation Techniques
Approach your LO calmly with a gentle tone, maintain eye contact at their level without invading their personal space. Validate their feelings (i.e., "I can see you're upset. That's okay") rather than arguing or correcting any confusion. Use distraction methods, such as redirecting attention to a favorite object or activity, and avoid confrontation during heated moments.
Step 5: Address Underlying Causes and Seek Medical Input
Always try to assume that your LO is trying to communicate but doesn't have the words. It's the most generous interpretation of their actions and really reframes your thinking.
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Consider that physical issues, like infection, medication side effects, pain or discomfort, may fuel episodes of agitation or aggression. Consult their doctor or a dementia specialist for evaluations, which might include adjusting medications or recommending non-pharmaceutical therapies like Cognitive Behavioral Therapy (CBT).
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Of course, sometimes the underlying cause isn't apparent or easily identified. In those cases, the next step becomes even more important.
Step 6: Prioritize Caregiver Self-Care and Support
The role of caregiver is really exhausting and unrelenting. Prevent burnout by scheduling regular breaks, enlisting help from families or services, and joining support groups.
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Maintain your own health through exercise, proper nutrition, prayer/meditation, and stress management. Be mindful that you can't pour from an empty cup.