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Identifying reasons for aggression

You will only really be able to identify the possible causes for the outburst when the incident is over, but trying to find out the cause (called the trigger) may help you understand the problem and prevent further outbursts.

The areas that we look at for the possible causes are physical, emotional and environmental:

Physical factors:

  • It may be a side effect of the medication
  • May be sick or be in pain
  • Possibly cannot hear or see as well as she or he used to
  • The disease itself has caused the aggression
  • May be hungry or thirsty
  • May need to go to the toilet
  • May be having hallucinations (seeing or hearing things that are not there)
  • May feel tired
  • May have had enough of what is happening

Emotional factors:

  • May feel embarrassed about needing help with personal functions and at the same time angry about the loss of independence
  • Fear is often a cause of anxiety and anger for the person with dementia. These fears may seem unnecessary to us but are very real to that person
  • Too many demands are being placed on the person to perform tasks or to answer questions that he or she cannot cope with
  • Perhaps the person is responding to your mood
  • Could be being asked too many questions
  • Upset from change in routine
  • Frustrated as cannot communicate his or her needs
  • Loss of understanding
  • Cannot control her or his own behaviour
  • At times the person may realise that things he or she used to do are now not possible, and get angry about what is happening
  • Might have just misunderstood what was said or done
  • Feels he or she is being treated like a child
  • May be bored or lonely and looking for attention
  • The person may become aggressive because you are trying to stop her or him from doing something. This often happens when people with dementia wander and attempts are made to bring them back
  • Then again, the person might become aggressive when you want her or him to do something and that person doesn't want to do it, like bathing
  • Does not recognise the environment or the people and may even think the people are strangers who have broken into his or her home

Environmental factors:

  • Too much happening at the same time
  • Upsetting or unfamiliar environment
  • Sudden noises or movement
  • Too many people around
  • Temperature is too hot
  • Not enough stimulation
  • Something specific happened that set the person off