Articles

Dealing with Aggressive Elderly Patients

12/08/2015

Unfortunately, there are sometimes elderly patients who are confused who lash out aggressively. This is often due to cognitive impairment, in particular, dementia. Statistics show that over 50% of over 85 year olds have dementia, particularly Alzheimer’s, in the United States, a figure which shows the prevalence of the debilitating disease in the elderly. Another common reason for aggressive behaviour is depression, and the identification of the root cause of the problem is essential in order to deal with it effectively.

It is imperative that the patient is as comfortable as possible and is never given a task that is beyond what they are capable of. Feelings of worthlessness and a declining ability to do things that were once easy can build frustration and lead to aggression and panic. Never force bathing on a resistant client as the intrusiveness of such an action could be extremely distressing. Try again at a later date, or simply give a wash with a flannel until a bath or shower can become possible.

The most important thing is that the elderly person feels valued and listened to. Sometimes, they will make unreasonable or impossible requests (particularly in the case of those patients with dementia). Do not tell the patient ‘no’ under any circumstances, but instead tell the patient that you will happily do what they ask, but why not have a cup of tea first. The chances are that the patient will forget about their request and you can avoid conflict.

If at all possible, exercise is an excellent way to remove stress and to keep the patient mentally astute. This could be achieved indoors in the form or aerobic activity or outdoors via a stroll in the park. In the event that aggression has already been demonstrated by the patient, safety measures need to be employed. Ensure that sharp objects and objects which could be thrown or used offensively are kept out of reach.

Do not take the elderly patient’s aggression personally. It is perhaps more common than you think. As well as the previously mentioned resistance to showering or bathing, there are several other ways that aggression surfaces or is expressed. Elderly people can feel disempowered and refuse help. They might complain about things. Social withdrawal can be quite common and sometimes the patient will refuse to eat. Wait a while for the client to calm down and try again at a later time.

Be aware that as well as dementia and depression, these behaviours can be caused by urinary tract infections or a thyroid condition. These ailments are very common in the elderly, and can cause extreme irritability, so if a patient suddenly changes from a compliant to difficult then these common problems could be the cause. In the case of prolonged aggression, it is advisable to get a medical assessment carried out in order to treat the underlying cause. 

 

Written by Daniel James