Proven Strategies: How Do You Calm an Angry Person with Alzheimer's?

Nearly 90% of individuals with dementia experience behavioral and psychological symptoms like agitation. When wondering how do you calm an angry person with Alzheimer's, the key is not to confront, but to connect with compassion and proven strategies.

Quick Summary

Calming an angry person with Alzheimer's involves staying calm yourself, validating their feelings, gently redirecting their attention, and creating a soothing environment. Avoid arguing or reasoning with them.

Key Points

• Stay Calm: Your calm demeanor is essential. The person with Alzheimer's will mirror your emotions, so take a deep breath before you respond.

• Don't Argue: Avoid correcting them or trying to use logic. Their reality is shaped by the disease, and arguing will only increase agitation.

• Validate and Reassure: Acknowledge their feelings, even if they seem irrational. Use comforting words like, "I see you're upset. I'm here for you."

• Identify Triggers: Look for underlying causes like pain, hunger, a noisy environment, or frustration. Solving the root problem can prevent future outbursts.

• Redirect Attention: Gently shift their focus to a pleasant and familiar activity, like listening to music, looking at photos, or taking a walk.

• Simplify the Environment: A calm, quiet, and uncluttered space can significantly reduce stress and confusion for someone with dementia.

Understanding Anger and Agitation in Alzheimer's

Anger, aggression, and agitation are common behavioral symptoms of Alzheimer's disease, often grouped under the term Behavioral and Psychological Symptoms of Dementia (BPSD). These reactions are not intentional acts of malice; they are typically expressions of unmet needs, fear, confusion, or physical discomfort. The person's brain is changing, affecting their ability to process information, communicate needs, and control impulses. Understanding the root cause is the first step in managing these challenging behaviors.

Common triggers for anger can include:

• Physical Discomfort: Pain, hunger, thirst, constipation, fatigue, or needing to use the restroom.
• Environmental Factors: Loud noises, clutter, excessive activity, or being in an unfamiliar place can be overstimulating and frightening.
• Communication Breakdown: Inability to express needs or understand what is being said can lead to immense frustration.
• Task-Related Frustration: Feeling overwhelmed by a task that was once simple, like getting dressed or eating.
• Psychological Distress: Feelings of loss, loneliness, confusion, or paranoia.

By acting as a detective to identify these triggers, caregivers can often prevent outbursts before they begin.

The Core Principles of De-escalation

The foundation for calming an agitated person with Alzheimer's rests on a core principle: their reality is different from yours. Logic and reason are often ineffective. Instead, an approach grounded in empathy, patience, and redirection is paramount.

The Three R's Method

A widely accepted approach is the "Three R's":

1. Reassure: Your first job is to make the person feel safe. Use a calm, gentle tone of voice. Say things like, "You are safe here," "I'm here to help you," or "Everything is okay." Use comforting touch, like holding a hand or a gentle pat on the arm, but only if it's welcomed.
2. Reconsider: Step back and analyze the situation from their perspective. What might be causing the distress? Is it a noisy TV? Are they in pain? Did something you said or did trigger the reaction? This is where your detective work comes in.
3. Redirect: Once you've offered reassurance, try to shift their focus to a different activity or topic. Suggest a simple, enjoyable task like listening to their favorite music, looking at a photo album, or going for a short walk. The goal is to move their mind away from the source of agitation.

Step-by-Step Communication Strategies

Effective communication is crucial. The words you choose and the way you deliver them can either escalate or de-escalate a situation.

Do's and Don'ts of Communication

Action	Recommended Approach (Do)	Approach to Avoid (Don't)
Tone of Voice	Use a low, calm, and gentle tone.	Don't raise your voice or sound angry/frustrated.
Body Language	Maintain eye contact (if comfortable for them), keep a relaxed posture, and give them space.	Don't stand over them, cross your arms, or make sudden movements.
Responding to Accusations	Validate their feelings: "It sounds like you're very upset about that."	Don't argue, correct, or try to reason: "That didn't happen."
Giving Instructions	Break down tasks into simple, single steps. Use visual cues.	Don't give complex, multi-step commands.
Asking Questions	Ask simple yes-or-no questions.	Don't ask open-ended questions that require memory recall, like "What did you do today?"

Practical Phrases to Use:

• "I can see this is frustrating for you."
• "Let's try this together."
• "How about we take a break and have a snack?"
• "Tell me more about what's bothering you."
• "I'm sorry you're feeling so upset."

Creating a Soothing and Safe Environment

A person's surroundings have a profound impact on their mood and behavior. Proactively managing the environment can prevent many instances of agitation.

Key Environmental Adjustments:

• Reduce Clutter: A tidy, organized space is less confusing and overwhelming.
• Control Noise Levels: Minimize loud or sudden noises from the TV, radio, or household appliances. White noise machines or calming nature sounds can be beneficial.
• Ensure Adequate Lighting: Good lighting can reduce shadows and prevent disorientation, which can cause fear.
• Establish a Routine: A predictable daily schedule for waking, meals, activities, and bedtime provides a sense of security and reduces anxiety.
• Incorporate Calming Activities: Integrate activities that the person enjoys and finds relaxing. This could be anything from listening to music, folding laundry, gardening, or looking at art.

What to Do When Nothing Seems to Work

There will be times when, despite your best efforts, the agitation persists. In these moments, prioritizing safety is the number one goal.

1. Ensure Safety: Gently remove any objects that could be used to cause harm to themselves or others. Give them space if they are physically aggressive, but do not leave them alone unless you are in danger.
2. Take a Step Back: If you feel your own frustration rising, it's okay to step away for a moment. Ensure the person is in a safe location, and take a few deep breaths to calm yourself before re-engaging.
3. Seek Professional Help: Persistent or severe aggression and anger may be a sign of an underlying medical issue, such as a urinary tract infection (UTI), or may require a medication review. Do not hesitate to contact their doctor. The doctor can rule out other causes and discuss potential treatments.

For more in-depth resources and support, the Alzheimer's Association offers extensive guides and local support chapters.

Conclusion: The Power of Compassionate Caregiving

Learning how to calm an angry person with Alzheimer's is a journey of patience, empathy, and continuous learning. It requires shifting your perspective from correcting their reality to joining it. By focusing on the person behind the disease, identifying the triggers for their distress, and responding with calm, reassuring techniques, you can navigate these challenging moments more effectively. Remember that you are not alone; support is available, and every small success in bringing a moment of peace is a significant victory for both you and your loved one.

Frequently Asked Questions

Why do people with Alzheimer's get angry so suddenly?

Sudden anger in Alzheimer's patients is often a reaction to confusion, fear, physical pain, or an inability to communicate their needs. It's not a choice but a symptom of the brain changes caused by the disease.

What should you NOT say to someone with Alzheimer's?

Avoid saying things like "Don't you remember?", "I just told you that," or correcting their memories. This can cause frustration and embarrassment. Also, avoid complex questions and instructions.

Is it okay to use touch to calm someone with Alzheimer's?

A gentle, reassuring touch can be very calming for some, but it can be startling for others. Always approach from the front, announce your intention, and be sensitive to their reaction. If they pull away, respect their space.

Can certain foods or drinks make agitation worse?

Yes, stimulants like caffeine and sugar can sometimes increase agitation and restlessness. It's often helpful to limit these, especially later in the day, and focus on a balanced diet and proper hydration.

What is 'sundowning' and how does it relate to anger?

Sundowning is an increase in confusion, anxiety, and agitation that often begins in the late afternoon and extends into the evening. This can lead to angry outbursts as the person becomes more tired and disoriented.

When should I call a doctor about my loved one's anger?

You should contact a doctor if the anger is a new behavior, if it's becoming more frequent or severe, if you suspect an underlying illness (like a UTI), or if the behavior poses a danger to the person or others.

What is the best way to respond if they make false accusations?

Do not argue or deny the accusation directly. Instead, respond to the emotion behind it. You can say, "It sounds like that was a scary experience for you," and then gently redirect the conversation to another topic.