How to Manage Combativeness in Seniors with Alzheimer’s Disease

When a person develops dementia—such as Alzheimer’s disease—their personality may begin to change as the condition alters their brain. For some seniors, this can mean becoming uncharacteristically combative or aggressive. These shifts can be deeply unsettling for family members who remember Mom or Grandma as kind, patient, and gentle.

Verbal or physical outbursts are often signs your loved one is experiencing confusion, fear, frustration, or an unmet need they can no longer express. What may seem like irrational behavior is frequently a response to feeling threatened—whether the threat is real or perceived.

It’s natural to feel annoyed or overwhelmed by these outbursts, but your loved one is not acting out of malice. Their actions do not reflect who they are but rather symptomatically reflect the challenges they're facing. Compassion, patience, and support can make a world of difference—for both of you.

Tips for Family Caregivers

Visiting Angels professional caregivers are experts in providing families with non-medical support for Alzheimer’s disease and other types of dementia. Here are a few tips to help family caregivers adjust and keep their senior loved ones safe at home.

De-escalate the Situation, Swiftly and Calmly

Seniors who become combative can physically harm others, or they could fall if they become too agitated. Keep a safe distance so you can react and deflect combative behaviors and quickly de-escalate as needed.

First, understand physical and verbal outbursts can be caused by several reasons:

• Feeling restless: The progression of dementia can cause a regression to previous periods in a person’s life. If an 80-year-old reverts back to when he was in his 50s, he may be driven to focus on his past work responsibilities or chores.
  
  
• Unmet needs: For example, they may need to use the restroom, eat a snack, or get a drink. Watch for signs of biological needs such as holding their stomach (may indicate a need to use the bathroom), rubbing their forehead (possible sign of a headache), or furrowed brow (strong indicator of discomfort in a person with dementia).
  
  
• Fear of the unknown: With age often comes reduced peripheral vision, so if a senior is approached from the side, it can startle them and make them really upset. Instead, coach the family to approach them slowly from the front when possible. Fear may also be caused by noises in the home or outside. Shadows or poor lighting can trigger fear, potentially making the senior see something that isn't there.

Reassure your loved one that they are safe and call them by their preferred name. For example, you might say to your mother, “Sally, I’m here to help. You are safe with me. What can I do to help?”

As you approach her, slowly reach out your arm to touch her gently on the arm or shoulder. If she is coming toward you aggressively, back away slowly and say, “Sally, it’s OK. You're safe. No one's going to hurt you.”

Explain Personality Changes to the Kids

It can be scary for kids to see Grandpa getting feisty, yelling, or saying mean things. Depending on the child’s age, be as honest and frank as possible. “Grandpa has a brain illness called Alzheimer’s disease. It might make him do or say things he normally doesn’t when you spend time with him.”

Remind your children, and yourself, that this is no one’s fault. Reaffirm that Grandpa still loves them and his changes are not because he wants to be scary or mean—and that you all need to be extra patient, kind, and helpful when he feels upset. 

Join a Support Group

Twelve million people in the U.S. alone are providing care to loved ones with Alzheimer’s disease, and there are many online and in-person support groups for family caregivers like you.

Meeting face-to-face with people who understand your situation can feel invaluable. But many family Alzheimer’s caregivers feel heavily overscheduled, especially the 25% of them who are in the sandwich generation—caring for aging parents and while their own children are still at home. With online groups, you don’t have to leave home or work, and some offer support 24/7. Check with your local Alzheimer’s Association chapter to get emotional support for your family.

Visiting Angels Is Here to Help

Caring for a loved one with Alzheimer’s Disease is almost always too big of a job for one person. Compassionate professional caregivers from Visiting Angels can provide support you can count on.

Whether your family needs daily or 24/7 home care or just a break through our respite care services, we can customize a care plan that works for your schedule and budget.

Contact your Visiting Angels local home care office today.