Posted on June 29, 2010 - by Nurse Virginia

AGITATION AND AGGRESSION IN THE CONFUSED ELDERLY WITH ALZHEIMER’S DISEASE

Aggression on the part of an elderly person with Alzheimer’s disease is usually a reaction, and triggered by a small unimportant incident.

Aggression on the part of a confused elder is typically:
Not planned
Not premeditated
Doesn’t have a long-term goal
Can be explosive with no obvious buildup
Unusually is periodic
Is part of brief outbursts between long periods of calm behavior
More likely to be a burst of aggression and quickly forgotten by the elder
Seen in a married man who is taken care of by his spouse
A confused elder with few social contacts
Is likely to occur during times of direct hands-on care; bathing, toileting, dressing, shaving, eating

We are told that 70-90% of the elderly with Alzheimer’s disease have some behavioral problem. Who wouldn’t? If you don’t understand what is going on around you, what people are saying to you, what’s happening to you, why wouldn’t you become agitated or aggressive.

Leading cause of agitation and aggression -is loss of physical function
When the confused elderly person, wants is to take care of themselves, put their shirt on by themselves and they can’t seem to remember how.  And then someone tries to help them, when they struggle with that shirt. The elder can become agitated. A decline in physical function will lead to aggressive behavior faster, than a decline in cognitive function.. The caregiver many times doesn’t even know what the elder wants or what they are trying to do for themselves.

Aggressive and agitated behavior is one of the leading reasons a confused elderly is admitted to a Nursing Home. The family is able to handle the forgetfulness and confusion in the elder. But the aggression, especially on the part of an elderly man who is still very strong, becomes just too much for the family.

Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance