Dementia Behaviors: How to Respond Safely to Aggression Using the 6 R’s

Of the many difficult dementia behaviors, possibly the most challenging to manage is aggression. A senior who has always been mild-mannered can suddenly lash out in outbursts which are truly intimidating: hitting, yelling, cursing, kicking, biting, or throwing things. How can you, as a family care provider, safely help restore a feeling of calm?

To begin with, remind yourself that the aggression is a consequence of the disease. It is not something the older adult can control, and it is not intentional. That being said, it must be diffused in order to keep both you and the senior protected from harm. 

The 6 R’s of Managing Difficult Behavior,” developed by Dr. Peter Rabins and Nancy Mace in their book “The 36-Hour Day,” can be an ideal way to help. Read through and refer back to them so you are prepared for the next burst of aggression.

The 6 R’s:

  • Restrict. Maintain a calm tone of voice and demeanor as you strive to help the senior withdraw from the behavior. 
  • Reassess. Consider what may have provoked the incident. Triggers might include physical pain, too many distractions, noise in the room, hunger, thirst, fatigue, etc. Keeping a journal of what was occurring before and during each occurrence might help provide clues.
  • Reconsider. Empathize with the senior loved one by picturing yourself dealing with a disease that suppresses your ability to clearly convey your needs and wishes, to accomplish tasks independently which were once really easy, to feel disoriented and confused, etc.
  • Rechannel. Redirect the person to a hobby the individual takes pleasure in, or relocate to another type of environment, for example, stepping out onto the front porch or going into the dining room together for a snack.
  • Reassure. Let the senior know that everything is all right and that you are there. In the event that the person responds favorably to touch, place your hand on their shoulder, offer a hug or pat on the back, or take their hand in yours.
  • Review. Make note in your journal what went well – or what didn’t – to aid in using the most effective response when the aggression arises again.

Knowing that aggression may happen at any time in a senior with Alzheimer’s, it is beneficial to evaluate the home environment and take measures to make certain it is as calming and comfortable as possible, for example:

  • Playing quiet music the older adult enjoys in the background. 
  • Placing comforting and familiar objects within easy access. 
  • Avoiding TV shows that may show violence or any other troubling images. 
  • Opening the shades in the day to allow plenty of natural light to stream in.

Seniorcorp is here for you as well with highly trained dementia professional caregivers who understand the nuances of the disease and how to most effectively manage the corresponding challenges. Contact us online or call us at 757-640-0557 for more information on our dementia care and home care in Chesapeake and nearby communities.