WHEN THE PERSON WITH DEMENTIA HITS, PUSHES, OR GRABS

When a person with dementia strikes out, it is upsetting for all involved. Whether it is hitting, shoving, grabbing or whatever physically aggressive episode, finding out the cause is most important.

Start keeping a journal of these outbursts. Include the time the incident happened, the date and most important what was happening right before the outburst. Who was with the elder during the outburst, and what worked to change the situation.

Every caregiver needs to know the elder’s routine and realize how important it is to stay with the routine. Approach is all important. Always approach a person with dementia from the front, in a calm and caring manner. Quick movements or coming from behind the person can be perceived as a threat to the person due to his dementia.

Make direct eye contact with the elder, use his chosen name, and explain what you will be doing step by step. Do not overwhelm the elder with too much information too fast. When giving directions, make them easy to understand, one step at a time and wait at least 10 seconds for a response. Persons with dementia have slower reaction time and need more time to process directions.

When the elder attempts to hit, or act aggressively, step back, making direct eye contact assure him of his safety. Using his name, state his inappropriateness, and tell him that you are leaving the room. Return in 5-10 minutes acting as if nothing has happened and start fresh.  Do not turn your back on an angry confused person, and stay at least 2-3 feet away, out of arms reach.

If the elder is doing something dangerous to himself of others, in a very firm voice say “”No” or “Stop.” Once the outburst is over assure the elder that he is safe, this incident upset him as much as everyone else involved.

Keeping track of outbursts by writing them down will help in identifying triggers. Is the elder over stimulated, tired, hungry, thirsty, are there too many people and the environment too stimulating? Is the task you are doing with the elder too difficult?

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing