The Angry Dementia Patient
The Angry Dementia Patient
Seniors With Dementia are Easily Frustrated and Stressed
Sometimes it seems like seniors with Alzheimer’s or dementia get angry at the drop of a hat. What’s most likely happening is that they suddenly reach a breaking point because of frustrations that build up. Here are some ways to make everyday life easier and less stressful for seniors with dementia.
Why Dementia Patients Get Angry
When someone has dementia, their ability to function well in the world declines.
Tasks that we consider simple, like brushing teeth, are actually quite complex. To a person with dementia, it can be difficult to remember all the steps and sequence them properly.
For example, these are the major steps they need to take to brush their teeth:
- Enter the correct bathroom (the one with their toothbrush)
- Find switch and turn on light
- Locate correct toothbrush (theirs)
- Locate toothpaste
- Take cap off toothpaste
- Put an appropriate amount of toothpaste on toothbrush
- Put toothbrush (with toothpaste still on) in mouth and gently brush every tooth surface
- Spit out toothpaste
- Rinse mouth thoroughly with water – spit, don’t swallow
Once we break it down, brushing our teeth is far less simple than we might think. And, someone with dementia may also have trouble with the smaller steps that make up many of these major steps.
When even the most basic parts of the day are so difficult and overwhelming, it’s easy for the frustration to build up. When they’re expected to do yet another “simple” thing, they may erupt in anger.
For example, when you’ve had an extremely stressful day, someone coming to you with even a simple request can cause you to lose your temper – it’s the last straw, right?
That’s often what’s happening to seniors with dementia. Because their world is becoming more confusing and difficult to navigate, it doesn’t take much for them to reach that “last straw” feeling and react with anger.
Taking Steps to Reduce Anger in Dementia Patients
Accept Their Limitations
Avoid pushing seniors with dementia beyond their limits by expecting them to do things they’ve been struggling with. They aren’t refusing to do things because they’re lazy or refuse to remember.
Their brains are failing and they’re losing the knowledge and abilities they need to accomplish those once-easy tasks. Accept where they are now and work with the skills they have today.
Reduce Complex Decisions
Making choices about every part of their day isn’t necessary, but there are some decisions your older adult may still want to make.
The goal isn’t to take away their right to choose, but to simplify so making choices is easier – too many options are confusing and overwhelming.
For example, when changing, lay out all the clothes they need, but offer a choice between two shirts – the red shirt or the blue shirt? That way, they are still participating in the process. But they won’t have to find and select all the other clothing items they need.
Similarly, for lunch you could offer a choice between two entrees you know they enjoy – a ham sandwich or split pea soup? That decision is much easier to deal with than a broad question like “What do you want for lunch?”
We’re used to moving at a “normal” pace, but that’s because our brains are fully functional and can quickly process information and thoughts.
When someone has dementia, those cognitive processes slow down significantly. That’s why your older adult needs more time when thinking, speaking, or taking action.
To reduce stress and allow them to feel successful, don’t rush them through daily life. Take the pressure off and let them move at their own pace – even if it seems really slow.
Keep the Environment Calm and Quiet
Being in a noisy, bustling environment can overwhelm the senses and make it hard to think, especially when someone has dementia.
Have you noticed that we all need calm and quiet when we’re trying to think? For example, if you’re driving to an unfamiliar location, you automatically turn down the radio so you can concentrate. And, most students seek out quiet places like libraries when they need to learn complex new concepts.
For someone with Alzheimer’s or dementia, everyday tasks have become difficult and require extra thought and concentration. When you add loud noise or lots of people, it’s natural for them to feel frustrated and stressed.
Treat Them With Respect
Everyone, no matter their age or abilities, wants to be treated with respect. Seniors with dementia are no different. Even if they struggle with decisions or everyday tasks, there are many ways to make things easier while still showing respect.
A good way to do this is to offer simplified choices, like with the red or blue shirt mentioned above. That way, you’re not giving orders and expecting them to follow. You’re helping your older adult make decisions in a way that suits their current abilities.
Rely on Routine
Routines reduce the amount of thinking and number of decisions that need to be made on a daily basis. We don’t have to remember what time to eat breakfast because we always eat around 9am, after getting up and brushing our teeth.
Routines are especially helpful for seniors with dementia because they reduce the number of things they need to remember or think about.
Having a steady, constant routine is comforting and far less stressful than if each day was unpredictable and they had to go hunting for their toothbrush every time they needed it. Putting objects in the same places and doing the same activities at the same time of day means they know where things are and what will be happening.
Alzheimer’s and dementia affect the brain’s ability to process and retrieve information. Short, direct sentences with only one thought per sentence are easier for your senior to understand.
The goal is to give your older adult less to think about and less to remember. If you’re giving instructions, make it one step. If you’re sharing information, keep it to one thought.
Using fewer words and a warm and positive tone will be far less frustrating for your senior.
Getting overtired isn’t good for anyone’s mood, but it can put even more pressure on an already frazzled senior with dementia.
Just like you’re more likely to snap when you’re exhausted, someone with dementia is more likely to have an angry outburst when they’re fatigued.
Modify Tasks to Help Them be Successful
When a task is too difficult, it’s frustrating and stressful. The answer isn’t to have your older adult stop doing things for themselves. That will only make them feel worse. Instead, find ways to modify activities so they will be successful.
For example, if they’re having trouble cutting meat at dinner, consider serving more foods where the meat is already in smaller pieces or getting a specialized knife that’s easier to use (like this one).
Or, if your older adult struggles to zip their pants, consider switching to elastic waist athletic-style pants or specialized pants with velcro fastening in place of a zipper (like these). Another idea is to switch to easy, slip-on shoes if they have trouble tying their shoes.
For further information, see
- Hands Free Shoes That Make Dressing Easier
- Practical Shoes for the Elderly
- Shoes and Slippers for Swollen Feet
Bathing is another good example. Similar to brushing teeth, there are many steps involved in taking a bath or shower. It’s much easier to be successful if you help by laying out a towel, comb, and fresh clothes. Then, turn on a heater in the bathroom and start the water running at a comfortable temperature. Now there are less steps for your older adult to manage and bathing will be easier.
Recommended: The 36-Hour Day, 5th Edition
by Nancy L. Mace, M.A. and Peter V. Rabins, M.D., M.P.H.
Thoughts, questions, tips? Feel free to comment below.
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