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Understanding Angry Outbursts in Elderly Parents with Dementia

11 minute readLast updated December 1, 2023
fact checked
Written by Anna Nichols

Caring for a senior with dementia who has verbal or physical outbursts on a regular basis can be extremely stressful. Such outbursts are referred to as responsive behavior, indicating that there is a reason behind the behavior – it is the person with dementia’s way of communicating. More than one-third of people with dementia have exhibited aggressive behavior, especially those whose condition is in the moderate to severe stages. There are three main causes of aggression in elderly dementia patients. Understanding these causes can help you cope. If you’re caring for a senior who has verbal or physical outbursts, know you are not alone.

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What causes angry outbursts in elderly dementia patients? Common triggers of responsible behavior

Responsive behaviors in seniors with dementia are common and finding the trigger is not always easy. Keep in mind that someone with moderate to severe stages of dementia may be unable to recognize, meet, or communicate their needs to their caregivers. Also, someone with dementia may have difficulty understanding what behavior is socially acceptable. Often the trigger of the responsive behavior falls into one of three categories: Biological, social, and psychological.

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Biological triggers

Seniors with dementia are often in chronic pain, but may not be able to communicate their specific symptoms to you or their physician. Aggressive outbursts may be the only way the senior can express their physical discomfort. Talk to your senior’s physician about your loved one’s responsive behavior. Your doctor will help rule out some of these biological triggers. If the senior is on medication, perhaps it needs to be adjusted or changed. Some of the most common biological triggers of angry outbursts in the elderly are the following:

  • Pain or Illness. Your loved one may have general pain or may be suffering from an undiagnosed or untreated condition.
  • Difficulty Hearing or Seeing. Seniors who have difficulty hearing or seeing may express their frustration with aggressive behaviors.
  • Hallucinations or Delusions. Some dementia patients experience hallucinations or delusions, which can cause them to respond in a way that may not make sense to their caregivers.
  • Physical Discomfort. The only way your loved one may be able to express basic discomforts, such as heat, cold, hunger, or thirst, is through outbursts.
  • Medication. Inappropriate behavior like aggression could be a side effect of medication. Talk with your loved one’s physician before stopping any medication.

Social triggers

A senior may react aggressively to a number of social triggers, because social situations can be especially disorienting to seniors with dementia. While not all of these scenarios can be controlled or reduced, knowing the trigger may help you to avoid or at least diffuse the situation more effectively.

  • Unfamiliar settings. Seniors with dementia may feel confused and uncomfortable in unfamiliar settings, and may express their feelings through anger or aggression.
  • People who remind the senior of someone from their past. Your loved one may be unnerved by relatives who they haven’t seen in a while or by someone who looks like a friend from their past.
  • Someone or something that causes fear. Even though you may not understand why your loved one is fearful, don’t dismiss their reaction. Instead, try to separate your loved one from the trigger.
  • Large, unfamiliar crowds. Crowds can be disorienting for anyone, but especially for a senior with dementia.
  • Boredom. Seniors with dementia need mental stimulation, just like you do. Sometimes, an angry outburst can be your loved one’s way of creating mental activity.
  • Feelings of loneliness, mistrust, anxiety and paranoia. Generalized anxiety or paranoia in seniors with dementia doesn’t have to be based on any external triggers. Even if you don’t understand why your loved one is acting this way, you can still respond with compassion.

Psychological triggers

Psychological problems resulting from dementia can lead to misunderstandings, misperceptions, and difficulty communicating. These psychological symptoms often cause frustration and physical or emotional outbursts. Again, you may not be able to avoid or reduce these triggers, but knowing the cause may help you take command of the situation before it escalates into a serious outburst.

  • Memory loss. Often, seniors with early-stage dementia are aware that they’re losing their memory. This self-awareness can cause serious frustration with both themselves and others. This frustration may look like aggression or angry outbursts.
  • Difficulty processing information. An inability to understand a situation or a conversation can cause serious anger or frustration.
  • Loss of touch with reality. At times, your loved one with dementia may misunderstand a situation, and react to their understanding of the situation instead of what actually happened.
  • Paranoia, fear, and anxiety. Feelings of paranoia, fear, and anxiety are common in dementia patients. These emotions cause the senior to be in a state of fight or flight, which may translate into angry outbursts.

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How to Handle an Angry Outburst from an Elderly Parent

There are two steps to handling an angry outburst in a senior with dementia: Acting strategically in the moment and finding compassion after the outburst.

In the midst of an angry outburst, do this:

  1. Take a deep breath. Try to remember that this is not abuse or aggression toward you.
  2. Adapt. Try to understand the perspective and needs of your loved one.
  3. Remain calm. If you need to remove yourself from the situation for a few minutes, you can do so.
  4. Don’t show anger, fear, alarm or anxiety. Showing these emotions could increase the senior’s agitation and escalate the situation.
  5. Speak using a calm, reassuring voice. Even if your loved one doesn’t understand what’s going on, they can be calmed by your attitude.
  6. Acknowledge the senior’s feelings. Listen to what your loved one is saying. This will help you determine the trigger while also showing that you want to help.
  7. Maintain eye contact. Do this throughout your communication with your loved one.
  8. Distract. If you can’t resolve or eliminate the trigger, try to distract the senior from the problem.

After an angry outburst, do this:

7 Ways to Reduce Aggression in Elderly Patients with Dementia

If your loved one has frequent angry outbursts or hostility and you can’t identify the trigger, try these therapeutic approaches for dementia patients. You should first rule out any biological causes of the behavior with your loved one’s doctor.

  • Regular physical activities. Exercise is a great option for you and your loved one because it can help you both relieve stress, combat boredom, and encourage good health. Even a short daily walk can make a huge difference in the emotional state of someone with dementia. Make sure you get your doctor’s approval before trying a new exercise regime.
  • Social interaction. Spending time one-on-one with individuals can help combat loneliness. If you don’t have family or friends to help, there are many local programs that can connect with volunteers who can give you a break while spending quality time with your loved one.
  • Stay busy. Watering plants, folding laundry or even just reorganizing an area of the home are good ways to keep your loved one occupied and feeling useful.
  • Music therapy. Calming music is a great way to get someone to relax, and many music therapy programs have proven to help combat the effects of dementia. Try adding music to your daily routine, especially at times where you are faced with unavoidable triggers (like bath time).
  • Art therapy.Art therapy is calming and may help your loved one find new ways to communicate or express their emotions, thoughts and feelings.
  • Pet therapy. Many cats and dogs are trained to be companions to seniors with dementia. Studies show that the simple touch and love of these animals can help decrease responsive behavior in seniors with dementia.
  • Doll therapy. Doll therapy is a new form of therapy in which a patient with dementia cares for a doll as if it were their child. A study found that doll therapy is an effective approach when trying to increase positive behaviors and decrease negative behaviors in Alzheimer’s patients.

Consider Memory Care Options

Consider reaching out to one of A Place for Mom’s Senior Living Advisors if you are interested in finding a memory care facility for your loved one. Senior Living Advisors can help you find the right memory care facility at the right price for your family. This service comes at no cost to you or your loved one. Or, search for memory care facilities near you and compare services, cost, and more with A Place for Mom’s Compare Communities tool.

If you are caring for a senior with dementia who has angry outbursts and aggressive behavior,  the most important thing is to seek help. You don’t have to deal with this extremely stressful and distressing situation on your own. Trying to handle it on your own can cause more stress for you and your loved one.


Meet the Author
Anna Nichols

Annaleta Nichols is a copywriter at A Place for Mom, where she covers a wide range of senior living topics, including home care, dementia care, and choosing the right environment. Before joining A Place for Mom, she taught secondary English and journalism in Kansas. Annaleta holds a master's degree in theology from the University of Notre Dame and a bachelor's degree in English Education from John Brown University. She grew up in South Korea, Wyoming, and Colorado and now lives in the Midwest.

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