When caring for someone who has Alzheimer's disease or any other kind of dementia, it is likely that you will have confrontations with them. Some may even lead into dangerous, combative behavior.
The progression of the disease will reach a point where loved ones will begin to lose their communication skills. This will increase their level of frustration, which often leads to problems with conduct.
I do have some good news, however: This seems only to be a phase; unfortunately, it could last a couple of years.
In my case, my father wasn't very combative, but he was extremely verbally abusive. Regardless, difficult as it is, we can't take it personally. Instead, we must investigate what caused the person to become upset in the first place.
Often, our patient's behavior is due to an uncomfortable or stressful environment. It's wise to investigate the "Five Ws": when, where, who, what and why the incident occurred.
Be sure to pay attention to body language and envision how the person might be feeling. Imagine what he might be trying to express. Then, ask yourself what happened just before the behavior problem started.
The next thing you want to ask yourself is: How did you react to the situation? Did your response help things or make them worse?
As a caregiver, you may or may not be able to control the patient's mood swings, but you do have a chance to calm his or her environment. Look for potential stressors: loud or unidentifiable noises, dim or shadowy lighting, or reflecting surfaces. Mirrors have been known to cause severe problems with dementia patients.
Don't confront the person or attempt to discuss the angry behavior. Whatever you do, do not initiate physical contact. This will often backfire on you and make matters worse. A timeout may be the best solution for both of you.
Redirection would be my first tool of choice. Pet therapy is another good call. Just make sure that both of you are safe and don't back yourself into a corner.
Most of the time when the patient strikes out, he doesn't realize who you are. He may be thinking you're a complete stranger. If things turn nasty, leave the room and let him play out the aggression, as long as he is safe.
Again, don't take this outrage personally. It is part of the disease and, truthfully, it's not the patient's fault or yours. It's a hard concept to understand, but in most cases it's true.