Solutions for Aggression in Alzheimer’s: How to Safely Respond Using the 6 R’s

Of the many difficult behaviors common in Alzheimer’s, probably the most challenging to manage is aggression. A senior who may have always been mild-mannered can abruptly lash out in outbursts that can be truly alarming: hitting, cursing, kicking, yelling, biting, or throwing objects. How can you, as a family care provider, find solutions for aggression in Alzheimer’s and safely help reestablish a feeling of calm?

First of all, remind yourself that the aggression is a result of the disease. It’s not something the senior can control, and it is not intentional. That said, it needs to be diffused in order to keep both you and the older adult 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 solution for aggression in Alzheimer’s. Read through and refer back to them so you’re prepared for the next burst of aggression.

The 6 R’s

• Restrict. Maintain a calm demeanor and tone of voice while you work to help the individual withdraw from the behavior.
• Reassess. Think through what could have provoked the incident. Causes may include physical pain, too much noise or other distractions in the room, hunger, thirst, fatigue, etc. Keeping a journal of what was occurring before and during each incident can help provide clues.
• Reconsider. Empathize with the older adult by picturing yourself fighting a disease that impedes your ability to clearly communicate your needs and wishes, to accomplish tasks independently which were once so easy, to feel disoriented and confused, etc.
• Rechannel. Redirect the person to a pursuit the individual enjoys, or relocate to an alternative environment, such as moving out onto the front porch or going to the dining area together for a snack.
• Reassure. Let the older adult know that everything is ok and that you are there. In the event that the individual responds favorably to touch, place your hand on their shoulder, offer a pat on the back or hug, or take their hand in yours.
• Review. Note in your journal what went well – or what did not – to help in using the most effective response if the aggression arises again.

Knowing that aggression may develop at any time in a person with Alzheimer’s, it is helpful to evaluate the home environment and take measures to ensure it is as comfortable and calming as possible, for example:

• Playing relaxing music the senior enjoys in the background.
• Placing comforting and familiar objects within quick access.
• Staying clear of television shows that may show violence or other unsettling images.
• Opening the window blinds during the day to allow lots of sunlight to stream in.

Responsive Home Care, the leading provider of home health care in Fort Lauderdale, FL and the surrounding areas, understands the intricacies of Alzheimer’s and how to best manage the related challenges. Reach out to us for more information on our in-home dementia care. See our website for a comprehensive list of the communities we serve.