One of the most useful things I’ve learned on this dementia journey is that when people who live with dementia exhibit responsive behaviours which appear angry and/or aggressive there’s usually a perfectly reasonable and rational explanation for it – from their point of view.
Such behaviour is not random (although it may appear to be), it’s not willful (although it may appear to be), and it’s not their fault (although it may appear to be).
“Problematic” responsive behaviour is most often the result of:
- A physical issue they are unable to pinpoint and/or articulate (e.g. pain, incontinence issue)
- A “trigger” or triggers in the environment (e.g. noise, temperature, activity)
- How I or someone else has interacted with them
The obvious way to stop anger and aggression is to address the root cause:
- Find and address the physical issue
- Identify and remove the environmental trigger(s)
- Stop blaming them and start taking responsibility for causing responsive behaviours
In the third instance, dementia care expert Teepa Snow suggests learning, practicing and using these six simple phrases to acknowledge the person, accept responsibility, diffuse the situation, restore positive energy and create the opportunity for healing.
- “I’m sorry I was trying to help.”
- “I’m sorry I made you angry.”
- “I’m sorry I embarrassed you.”
- “I’m sorry I made you feel stupid.”
- “I’m sorry I didn’t mean to, but I treated you like a child.”
- “I’m sorry, this is really hard.”
Meaning what you say when you say these phrases is important. Putting yourself in their shoes is helpful. Ask yourself these 20 questions to imagine what they might be feeling.
You can experience the power of the statements in the video below in which Teepa plays the part of a care partner, and the woman in the light blue top plays the part of a person living with dementia.
I know these words work because I have said them many times myself.
I would add one more phrase: “You’re right. I’m sorry, I was wrong.”
Telling the other person they are right is extraordinarily powerful. It’s like throwing a big wet blanket on a small campfire – it smothers the flames immediately. Clearly the wet blanket will be less effective on a towering inferno; you must stop the fire before it gets out of control.
An even more effective strategy is to not do things that are helpful in intent but not helpful in reality, and to not do or say things that embarrass, demean, patronize or anger the person to start with! Then there’s no need to apologize 🙂
“I’m sorry” isn’t easy for most people to say. It’s even more difficult for family care partners with all kinds of goop in the relationship soup. But they work. They really do. Why? Because “suddenly you’re in a different place than you were. And that’s because you were willing to do something different.” If you want to change the dance, you’ve got to change the steps.
See also:
https://myalzheimersstory.com/2015/06/09/10-teepa-snow-videos-on-dementia-basics/
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My Alzheimer's Story 
Thanks Susan for these tips from you and the video from Teepa Snow. Very meaningful.
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Thanks Michael ❤
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I see this issue with anger and aggressiveness talked about so much in Facebook groups. Family members are really at a loss for how to cope with the situation, and invariably there is someone who is going to recommend medication. But really, really, really, they should try to identify the cause and change it, as you say. Hopefully, more and more families will find these invaluable resources to help them.
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Yep, and Mike, I think we should shift the focus of the upcoming workshop to this (i.e. 5 proven ways to kill that damn dementia devil!) Will be in touch soon… 🙂
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Not with every one i can tell it all with my dad yea boy oh boy it was not easy he set in his way and noting could not change him no matter what hope u understand like to hear from soon thanks have bless day
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Yes, sometimes it is very difficult and the solutions are elusive…
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Very helpful thank you
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You’re most welcome 🙂
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My husband was just dxed with FTD, Semantic Variant. He will misplace something, then yell at ME for losing track of it and being so forgetful. While I don’t respond with anger, it can be frustrating, because I wasn’t watching him when he put (whatever) away and I have no idea what he did with it. How can I calm him down when he’s like this? If I say I didn’t do it, he accuses me of lying.
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yes. There is no end to the frustration 🙂
I think sometimes the anger comes from a deeper issue than the issue at hand. So, for example, something has been misplaced, but that’s incidental. Behind it lies the feeling of incompetence, of being out of control, of being ill, having forgotten, etc. etc. and so the person accuses/ projects his or hear fears onto someone else – and guess what? You are the closest someone else 🙂
I don’t know if this will work for you, but this is what sometimes works for me: accept responsibility and say you’re sorry. So for example, the wording would look something like this:
“I know I’m so forgetful. I must’ve put it somewhere, and now I can’t remember where. I know it’s frustrating for you, and it’s frustrating for me too. I just can’t think of where I’ve put it. Do you have any ideas? I’m so sorry. I should try harder to remember. But sometimes I just can’t.”
Sometimes, when I use this kind of wording, I will get an even angrier response; thus:
“How could you be so stupid? Why don’t you remember where you put things? You should be keeping track!”
To which the response should be along the same lines as above:
“I know. I can’t believe I’ve done this again. I’m so sorry. Maybe if we put our heads together we can find it…”
One apology may not work. It may take six or seven or 10 apologies before the person begins to calm down.
Also, one thing to focus on is the person you have control over, which is you – you are the one you want to calm down. If you calm down, and stay calmed down, there’s a greater chance you’ll be able to achieve your objective of calming him down.
All of that said, nothing might work – that’s dementia for you.
Give these things a try, and let me know how they work. One thing for sure, none of this is easy. I also share some of my experiences and a bunch of tips in the series of posts that start at this link: BANGS
Hope that helps!
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To add to my previous answer, here’s a blog post that might be helpful: https://lifelongmetamorphoses.wordpress.com/2016/04/14/crime-scene/
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My husband was diagnosed with early stage Alzheimer’s and early stage Huntington’s disease. He is aware of what is going on some of the time but he refuses to bathe or do any of the things the doctors tell him. He could hardly get around because all he does is sit in front of the TV all day. He refuses to go for a walk or to a senior center and he refuses to bathe. I was beside myself as we cannot go anywhere when he is dirty and stinks. I didn’t know what to do, I could not physically overpower him and make him do things and when I ask him he tells me I am not his boss. There has been little if any progress in finding a reliable treatment. His Primary care provider introduced me to Kycuyu Health Clinic and their amazing Herbal treatments. The treatment is a miracle. the disease is totally under control. No case of delusion, disorientation, forgetfulness, making things up, hallucination, Muscle weakness, jumbled speech, loss of appetite or confusion in the evening hours
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