Memory Care for Aggressive Dementia: Benefits and Management

Staff who work in memory care communities or care homes are often trained in dementia care techniques for managing aggression and calming residents. They use a person-centered approach to care and communication that helps center and soothe the individual. David Troxel, former president and CEO of the California Coast Alzheimer’s Association, explains:

“The best facilities and programs develop an individualized care plan that focuses on remaining abilities and strengths. I believe 90% of the time, you can make things better.”

To help staff manage aggressive behavior, memory care training and ongoing dementia care education are typically required. This extensive training teaches caregivers how to respond to aggressive behaviors and how to prevent future altercations.

Within A Place for Mom’s nationwide memory care network, more than 83% of communities require specialized memory care training for staff. About 94% of these communities specifically train staff to handle restlessness, manage anxiety, aggression, and agitation, and use redirection to relieve disorientation in residents.

Here are some common ways memory care communities manage aggressive behavior in people who have dementia.

Personalized care plans

Memory care staff create individualized care plans by understanding each resident’s background, personality, likes, dislikes, and health history. This tailored approach helps to prevent aggressive behavior. Memory care facilities may hold regular staff meetings to help all parties remain aware of the person’s particular triggers and specific strategies to address them. They also communicate directly with the resident’s family to further personalize their care plan.

Identifying root causes and triggers

Analyzing individualized needs helps caregivers to effectively communicate with and assist the person who has dementia. By recognizing triggers in the moment and detecting patterns, caregivers can intervene effectively and work toward prevention.^[02]

Using specialized communication techniques

Appropriately communicating with people who have dementia is an important component of training for staff who work in memory care communities. One of the first things anyone should learn to do with a potentially violent person who is living with dementia is to speak with them calmly and in a controlled, patient, and non-threatening manner.

“Any of us would get aggressive if we were frightened, in pain, or frustrated,” said Troxel. “Sometimes, these behaviors are not all that mysterious. Being reflective can help you understand if the behavior was something inadvertently caused.”

Staff in memory care communities and care homes use research-driven strategies to manage aggression in residents.^[03]

• Redirecting attention by suggesting an activity, asking questions, or changing the environment.
• Validating feelings by listening empathetically and speaking with, and not at, the resident.
• Adjusting tone and body language by using a supportive tone of voice and language, sitting or standing next to the resident, and maintaining eye contact.

If you ever find yourself wondering about what to do with a violent person who has dementia, you might find success by applying these techniques with your loved one.

Maintaining a calm environment

Memory care facilities promote a soothing environment with research-backed, dementia-conscious community design features.^[04] Helpful elements such as comfortable temperatures, activity-specific lighting, and quiet spaces can ease aggression in people who have dementia and create a more peaceful environment.

Providing activities and therapies

Another way memory care communities and care homes combat aggression is by incorporating memory care activities and calming therapies into everyday routines, such as:

• Engaging activities. Memory care programs include tailored social events, brain-stimulating games, crafts, and holiday celebrations. These fun events can redirect attention, soothe aggression, and spark memories.
• Music therapy. Memory care staff members have long relied on the effects of music therapy for dementia. Studies show that music can lower stress levels and evoke positive memories. In particular, memory care staff often select classical music, church hymns, or cheerful sing-alongs to provide a sense of comfort.
• Aromatherapy. Diffusing lavender essential oil twice a day can significantly reduce aggression among people who have dementia.^[05] Aromatherapy can also be used to remind residents of cherished memories or daily events, such as mealtimes.

Is memory care the right fit?

Medication to treat aggression caused by dementia is typically a last resort. Although some caregivers may turn to medication to manage aggression, most dementia care experts caution against them.^[05]

“The problem with using medication for dementia is that you often trade one problem for another,” said Troxel. “It could knock down a patient’s aggression, but side effects could cause them to fall and break their hip a week later. With good care planning and productive activities, about nine out of 10 times dementia patients don’t need to be medicated.”

Family caregivers and memory care staff members should consult a resident’s doctor about adding any medication to a care plan.

Yes, but evicting an aggressive resident from a memory care community or care home is both rare and a last resort. Before taking this action, an individual’s care team will often work with them and their family to explore other options.

While causes for eviction vary depending on the community, most facilities will only evict a resident who is a persistent danger to other residents, to staff members, or to themselves. Memory care communities will typically highlight eviction guidelines and standards in resident contracts.

Troxel noted that residents who are “spontaneously aggressive” — versus those with consistent, predictable triggers — are more likely to be evicted.

When you begin your search for a memory care community or care home, be sure to share information about your loved one’s behavior openly with community care and admissions staff. They understand the behaviors caused by dementia and will plan accordingly rather than judge your loved one. The better staff understand your relative’s care needs, the more they’ll be able to help. If staff can’t understand and minimize triggers for unpredictable and aggressive behavior, then they may feel they can’t help your loved one.

Transferring residents to a better unit as an alternative to eviction

Many senior living communities offer both assisted living and memory care in different areas of the same building or complex. This allows them to meet changing care needs without requiring a resident to leave the community entirely.

Mark Young, who worked with A Place for Mom to find care for his mom, said that her community worked with them to offer a solution to her changing behavior. His mom was living in the assisted living unit when she was diagnosed with sudden onset dementia, and her symptoms, including verbal aggression, began to progress quickly.

“She was really disturbing the other residents in assisted living with her swearing and loud outbursts,” Young said. “And when someone would come in to change her or give her a shower, it became a dramatic event for the facility and [the caregivers].”

Rather than evict his mother, the staff kept everyone’s best interests in mind and helped place her in the proper setting to meet her new care needs.

“[The community] recommended we move her [from the assisted living unit] into memory care because of her states of agitation.”

Read more:When to Move From Assisted Living to Memory Care: Signs, Steps, and Finding a Community

Memory care questions? Get expert help

If your relative is exhibiting aggressive behaviors, using some of the above techniques at home may help. But if caregiving has become overwhelming, or you feel like your loved one’s behaviors are unsafe for you or your family, it may be time to find a memory care facility.

Olivia, 57, whose mother resides in one of A Place for Mom’s partner memory care communities in Pensacola, Florida, said, “Early on in her dementia, I really thought I could care for mom at home throughout. But her doctor helped talk me through the symptoms and let me know that they weren’t going to get better if we did this on our own.”

Discuss your loved one’s behaviors with their doctor to determine whether memory care may be the next step. If your loved one has dementia along with other serious medical conditions, doctors may recommend a nursing home with a memory care unit that’s equipped to handle people who have become aggressive.

A Place for Mom’s Senior Living Advisors can help your family find memory care that fits your loved one’s specific needs. Our advisors will consider your loved one’s unique situation, care needs, and budget to help you find the best fit — all at no cost to your family.