It seemed as though your dad was really sailing through his old age. Still relatively healthy and sharp, your normally sweet tempered dad is suddenly prone to angry outbursts and cursing. What's going on?
A trip to your parents' physician is definitely in order, especially, if violent or physically aggressive behavior has emerged. The physician will want to determine whether the behavior problem stems from an emotional vs. physical/disease related issue. Leading causes of verbal and physical aggression include:
An underlying health problem like urinary tract infection, pneumonia, and endocrine problems associated with the thyroid or adrenal glands can cause aggressive behavior. Medication reactions and interactions as well as drug or alcohol abuse can also create this type of behavior.
Unrecognized or verbalized physical pain can lead to sudden displays of anger and aggressive action.
Depression and mental diseases can manifest as aggressive behavior. A depressed senior may feel sad, hopeless or guilty which can evolve into anger and frustration. Any small incident can ignite an "over the top" reaction.
One of the leading causes for aggressive behavior among seniors is dementia including Alzheimer's Disease. "Sun-downing" describes the agitated behavior a dementia patient may exhibit in the early evening hours.
Aggressive behavior related to a diagnosis of Alzheimer's disease is not curable so effective management tools are essential. As a family member, how will you best respond during one of these episodes?
Suggestions for diffusing agitated/aggressive behavior:
Do NOT argue or correct your loved one when he/she is agitated. Arguing only serves to increase the likelihood of escalation. Use a calm, confident voice to communicate and avoid making sudden or large movements.
Do NOT minimize or dismiss their anxiety and concerns. The anxiety or delusions they may be experiencing can be extremely realistic and alarming. Telling them that "it doesn't exist or not to worry" will not bring comfort. Instead, acknowledge just how frightening or upsetting the experience must be.
To the extent possible, reduce environmental stressors. An individual suffering with dementia may reach a point of "sensory overload" which triggers the aggressive behavior. Excessive noise, temperature extremes, new people or environments, hunger, need to empty bladder or bowels, multiple activities...all can lead to a "melt down." Take the time to observe unique triggers for your loved one.
Do NOT insist on completing an activity that is agitating your loved one at the moment. For example, if getting him into the shower is a struggle; reschedule for a later time. Remain flexible as much as possible on non-essential activities. Consider enlisting the support of another trusted person to assist. Perhaps, a new face will elicit cooperation.
When your parent is upset but NOT displaying physical aggression, try communicating at or below eye level to appear non-threatening. If physical aggression is threatened, use a calm, firm voice and remain at or slightly above eye level.
Always try and redirect your loved one away from the activity or situation that is triggering the anxiety. Suggesting that you take a walk together can be a great way to redirect and diffuse the situation. Allow your parent to express their feelings openly while you just listen. Changing the topic to something pleasant or reminiscing about happy times can be a successful tactic. Get your parent started on an activity that affirms their usefulness like sorting laundry, clipping coupons, folding clothes, making the bed, setting the table, etc.
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