All behaviors have meaning and ‘aggressive’ behaviors have been called responsive behaviors because they are not unpredictable or meaningless, but rather a response to an unmet need.1 Even though it may not be apparent to us, those in distress always have a reason that makes sense and is very real to them. Every situation is unique but according Wehry (2015), here are approaches that may be effective.
Agitation versus ‘Aggression’3
Agitation says “help me”
Approach with kindness and a genuine smile on your face, using a calm soft voice. Investigate what might be causing the problem (internal or external—ask what the need is: e.g. pain, hunger, a hug, boredom, quiet, bathroom).3
‘Aggression’ says “leave me alone” (I’m not safe)
Fear-based: be careful about their personal space—getting too close can cause someone to feel threatened and then lash out physically.
First provide safety for all and give them time and space. Don’t leave them alone, but unless safety is a concern, only one person is best.
Don’t stand over them, use a calm level voice, don’t smile (can be misperceived) or argue, reassure them that they are safe. Look for unmet needs, e.g. tired, overstimulated, etc.
These are a few simple approaches to consider when helping those in distress, but there are a growing number of comprehensive trainings available in this capacity. Below are two excellent books that offer more detailed approaches:
Power, G. A. (2010). Dementia Beyond Drugs: Changing the Culture of Care. Baltimore: Health Professions Press, Inc.
Feil, N. (2012). The Validation breakthrough. Baltimore, Maryland: Health Professions Press.
1Ontario Behavioural Support System Project Team. (2010). Behaviours have meaning. Toronto, ON: Alzheimer Society of Ontario.
2Power, G. A. (2010). Dementia Beyond Drugs: Changing the Culture of Care. Baltimore: Health Professions Press, Inc.
3Wehry, S. (2015). Differentiating between agitation and aggression. Paper presented at the LEADER: Louisiana enhancing aging with dignity through empowerment and respect, New Orleans, LA. http://www.susanwehrymd.com