Why Are Some Dementia Patients Combative?

I am so encouraged as to the wording of this question. Yes, some dementia patients can be combative.

First, dementia does not make people mean. It does not change their core values. It doesn’t take a really passive, timid, quiet type and turn them into a rendition of Linda Blair in “The Exorcist” as a general rule.

Certain forms of dementia affect different parts of the brain. Different parts of the brain control different aspects of what makes our personality. What if, like an oil filter is to a car, we removed the “filter” off of the part of the brain that controls judgment, emotions, and reactions?

Our brain has a filter. It’s our moderator. It’s to keep us from overreacting or underreacting to our first broken heart, our failed exams, loss of someone special, and life-changing experiences. It keeps us from getting out of a car and beating a person up for cutting us off in traffic. It helps to regulate our moods and the way we react to stimuli, other people, and situations.

Alzheimer’s and dementia affect that filter. Corroding it and shrinking it. I liken this resulting in the old saying of, “wearing your heart on your sleeve”. That filter is diminished and its purpose is compromised. Imagine what it would be like if one were to say anything that came to mind no matter who it hurt or offended?

I also believe that too much of a person’s actions, reactions and personality are blamed on Alzheimer’s or dementia after a diagnosis. Everything becomes defined by dementia. “It’s his/her dementia that did that.”

How well do you know this person? What was their personality like before they had a diagnosis of dementia? Often I see every (perceived) negative behavior, confusion, anxiety, aggressiveness, passiveness, indecision, depression, mania, chalked up to a client’s dementia if those in the support circle know there’s dementia involved.

A caregiver had a recent situation that seemed to contain all of the negative aspects of dementia that a person could possess. Some days the client’s indecisiveness lead to hours of coaxing and pleading to accomplish daily needs. Other days, the caregiver was lucky to get inside the house. Some days were fraught with verbal abuse of cursing, yelling, berating and name calling. I watched this family and their dynamics for several weeks. It occurred to me that this client’s behavior seemed way too familiar to her family and way too practiced. These weren’t outbursts. This was a way of life for her as a person. This client was of this aggressive, domineering, autocratic, overbearing person, normally. This was not a symptom of her dementia.

The key to the combative or belligerent behavior is to know the person with dementia well enough to decide if it’s a normal reaction for them as a pre-dementia person or not. You, as the caregiver, may not approach decisions with the same intensity or emotions. You may not see a request as a reason to be antagonistic. You are a different person in your way of handling situations just as the person with dementia is different in their way of handling situations. A person with dementia is still an individual that just happens to have dementia.



About the Author: Michelle L. Belton is the owner of Companion Home Care Inc, providing non-medical senior home care in Roanoke, VA since 2004. She is a Certified Dementia Practitioner (CDP) and has been caring for seniors with Alzheimer's disease and dementia for over 15 years.



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Companion Home Care Inc

424 Campbell Ave SW

Roanoke, VA 24016

(540) 981-2255