Managing Aggression/Combativeness

<TITLE>Managing Aggression/Combativeness</title>
 

<H1>Managing Aggression/Combativeness</H1>

 



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When a person with Alzheimer’s disease is frustrated, scared, or unable to communicate, he or she may become aggressive and even combative.

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<H2>Possible causes</H2>

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Combativeness can be caused by many factors, including physical discomfort, environmental factors, and poor communication. If the person you are caring for is exhibiting combativeness, consider the following:

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<strong>Physical discomfort</strong>

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<LI>Is the person tired because of inadequate rest or sleep?

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<LI>Are medications causing side effects?

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<LI>Is the person unable to let you know he or she is experiencing pain?
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<strong>Environmental factors</strong>

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<LI>Is the person overstimulated by loud noises, an overactive environment, or physical clutter?

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<LI>Does the person feel lost or abandoned?
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<strong>Poor communication</strong>

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<LI>Are you asking too may questions or making too many statements at once?

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<LI>Are your instructions simple and easy to understand?

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<LI>Is the person picking up on your own stress and irritability?

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<LI>Are you being negative or critical?
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<H2>Caregiving Strategies</H2>

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Understanding why aggression occurs is usually not enough to prevent it.  The following ideas may prove helpful as you interact with cognitively impaired individuals.

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<LI>Try to avoid direct confrontation.  Many times, waiting a few minutes before pressing on for some aspect of personal care such as bathing or dressing will allow a cooling-off period and aggression will be prevented.

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<LI>Keep explanations as simple as possible.  Cognitively impaired individuals may have problems with lengthy, complex conversations.  This can increase the potential for aggression.

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<LI>Try to recognize when behavior is escalating to aggression.  Many times, aggressive incidents are preceded by agitated behavior.  Be alert to these signs so that you can alter your approach.

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<LI>The better you know the individual likes and dislikes of the person, the less likely aggressive behavior will develop.

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<LI>Anger or fear may be at the root of aggressive behavior.  When possible, allow the individual to verbally express anger and use calming techniques when the person is fearful.  Sometimes touch can be a useful calming technique, but be watchful that the individual is able to recognize you before you touch.
 
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<LI>When an individual is being physically aggressive protect yourself by staying out of harms' way.  When it is safe to leave he person alone, do so.

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<LI>If the individual becomes aggressive while you are giving personal care, it can be useful to give them something to hold while you assist them.
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Perhaps what is most important is realizing that not all aggressive behavior can be prevented.  Caregivers can easily consider themselves failures when it does occur.  It is much easier to write about possible preventive measures than to always use them in the day-to-day care of a cognitively impaired person!  Aggression may happen and you have to be ready to move on.  It may be especially helpful to talk about it with someone who has also had the experience of caring for an impaired person.  Sometimes, talking about it can help in identifying alternative approaches and simply sharing your feelings with another can be very helpful.

  Managing Aggression/Combativeness