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Dealing with difficult situations with clients with dementia

Perhaps the most stressful part of being a caregiver is when your clients with dementia cause troublesome situations by behavior that we call  aggressive. To get through the moment check these five tips on what to do in such difficult situations.

People with dementia often find it hard to understand their environment and to communicate their needs and emotions with words. Like anybody else, they may sometimes feel insecure, agitated or unhappy, which may result behavior caregivers describe as aggressive or anxious.

Although each person may react differently in different situations, there are a couple of tips caregivers should have in mind when a difficult situation arises and the caretaker with dementia behaves in an aggressive or agitated way:

1. Remain calm in any situation

Remember that your feelings are contagious – the more calm and composed you are, the easier it will be for the person you care for to calm down. Try to speak calmly and thoughtfully while paying attention to those words which actually have a calming effect. Not only words have impact. Eye contact and reassuring touch can help to convey your message.

2. Consider others’ feelings

Respect the private space of the person. If they become aggressive, do not come too close as this may intensify the negative reaction. Avoid correcting the person’s behavior or intervening abruptly in difficult situations to prevent the emotions from escalating and to show your positive attitude.

3. Create a positive atmosphere

Divert the person’s attention to something else, so they can focus on another, more pleasurable activity. Try to have a “pleasant stimulators” in your mind to easily evoke positive feelings in a person. It can be a favorite song, photo, text or food – anything that you know they enjoy.

4. Be patient in any situation

If the aggression has reached its peak or is already ending, wait it out. Our feelings tend to fade away after some time. Try to give this person some space or breathing room if you are sure it is safe to do so. Follow their body language to be aware of how they feel.

5. Analyze and prepare

Assess the causes and triggers of the difficult situation to prevent it from occurring in the future. Try to monitor what the client is doing day by day to understand the behavior patterns which can help to predict their further actions.

To handle difficult situations with persons with dementia calmly and patiently can be extremely hard. Ask your colleagues for help when you feel that you are experiencing difficulties and emotional strain. You can find more practical tips about how to deal with caregiving stress in our blog post “Coping with caregiving stress“.

Read more about difficult situations in dementia in: McDonnel, A. (2010) Managing Aggressive Behaviour in Care Settings: Understanding and Applying Low Arousal Approaches, Wiley-Blackwell.