Dealing With Aggressive Dementia Patients
One of the most difficult situations care professionals and families ask about is how to handle a combative dementia patient. It is crucial to recognize that labeling a person living with dementia as combative is not helpful. Behavior is communication, and people living with dementia may strike out, yell, kick, or engage in other physically aggressive behavior as a means of communicating what they are perceiving. Angry outbursts may be a sign that the person is in pain, is thirsty, hungry, tired, frightened, or frustrated.
A commonly overlooked trigger related to dementia and anger outbursts has to do with the ways visual processing often deteriorates for people living with Alzheimer’s disease and other types of dementia. As the occipital lobe at the back of the brain deteriorates, the brain’s ability to make sense of visual inputs coming through the eyes is compromised. What gets labeled as dementia aggression and paranoia may be a simple result of the fact that some people with dementia lose peripheral vision, depth perception, do not always differentiate between things that are similar in color when they are right next to each other, and may not process movement fluidly.
Consider what the world might look like if you had no peripheral vision, for example. You can simulate this by looking through a couple of cardboard tubes or by holding your hands up to your eyes as if you were mimicking looking through binoculars. This would cut your visual field down to about ten percent. Try it and you will soon notice that people approaching from the side startle you because you do not see them coming. Without peripheral vision, your depth perception is a bit compromised, so you may become tentative at transitions in flooring or using stairs. Try blinking fast while simulating the loss of peripheral vision, then have someone reach up as if to wipe your face or hand you something. Without the ability to perceive fluid movement, you might think the person is going to hit you. If you think you are about to be hit, you are likely to either dodge or try to hit the other person first.
So before you find yourself thinking that your loved one or someone you are caring for professionally needs more help and you start searching for care homes for aggressive dementia patients do some detective work to determine if visual processing challenges or other mis-perceptions might be at the root of what gets labeled as dementia aggression and paranoia.