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

aggression in dementia
Implement these tips to diffuse aggression in dementia.

Aggression in dementia is one of the most challenging behaviors to manage. A senior who may have always been mild-mannered can abruptly lash out in outbursts that are truly alarming: hitting, cursing, kicking, yelling, biting, or throwing things. How can you, as a family care provider, safely help reestablish a feeling of calm?
First of all, remind yourself that the aggression is a result of the disease. It is not something the senior can control, and it is not deliberate. That being said, it needs to be diffused 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,” could be an effective way to help. Go through and refer back to it so you’re equipped for the next burst of aggression.

The 6 R’s:

  • Restrict. Maintain a calm demeanor and tone of voice while you strive to help the senior disengage from the behavior.
  • Reassess. Consider what may have provoked the incident. Causes could include physical pain, too many distractions or noise in the room, fatigue, hunger, thirst, etc. Maintaining a journal of what was occurring before and during each incident might help provide clues.
  • Reconsider. Empathize with the senior by imagining yourself struggling with a disease that suppresses your ability to clearly convey your wishes and needs, to complete tasks independently that were once so easy, to feel disoriented and confused, etc.
  • Rechannel. Redirect the person to an activity the individual takes pleasure in, or relocate to another type of environment, such as stepping out onto the front porch or going into the living room together for a snack.
  • Reassure. Let the older adult know that everything is okay and that you are there. If the individual 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. Take note in your journal what went well – or what didn’t – to aid in using the most reliable response as soon as the aggression arises again.

Understanding that aggression may happen at any time in someone with Alzheimer’s, it’s beneficial to gauge the home environment and take measures to make sure it really is as comfortable and calming as possible, for instance:

  • Playing quiet music the senior enjoys in the background.
  • Placing comforting and familiar objects within easy access.
  • Staying clear of movies that may display violence or other distressing images.
  • Opening the window shades in the day to allow a lot of sun light to stream in.

Serenity Home Care is here for you as well with specially trained dementia care providers who understand the nuances associated with the disease and how to best manage the related challenges. Email or call us at 250-590-8098 for more information on our dementia care in Victoria, BC and surrounding areas.