How to react when someone with dementia becomes aggressive?
My dad, who has always been a calm person, sometimes shouts at me and once even pushed me when I was trying to help him get dressed. I feel lost — I don't know if I did something wrong.
Verbal or physical aggression is one of the most difficult behaviours to experience, but it is rarely directed at you personally. It is almost always the way the person expresses fear, pain, frustration, or confusion that they can no longer put into words. You haven't done anything wrong, and you're not alone — it's a common symptom in various stages of dementia.
Why it happens
When the person can no longer explain what they feel, their body "speaks" for them. They might be in pain, hungry, have a full bladder, be anxious because they don't recognise where they are, or simply feel invaded — for example, during bathing or dressing, situations where someone touches their body without warning. Aggression is almost always a reaction to an unmet need or a feeling of threat.
During agitation
- First ensure your safety and that of the person — physically move away if necessary, without abruptly turning your back.
- Don't argue or raise your voice. Speak softly and slowly, using short sentences.
- Always approach from the front, never from behind, and enter the person's field of vision before touching or speaking.
- Give space. Step back a little and lower your tone — often the reaction diminishes just by feeling less pressure.
- Identify the trigger. Ask yourself: are they in pain? Are they tired? Was it a specific task (bathing, dressing) that triggered this?
"I realised my dad only became aggressive during bathing. I started explaining each step before doing it — 'now I'm going to wash your arm' — and the aggression almost disappeared."
What NOT to do
- Don't confront or try to "demand respect" — this usually escalates the situation.
- Don't hold the person down forcefully, unless strictly necessary to prevent immediate injury.
- Don't take it personally or hold a grudge — the person is not acting with conscious intent to hurt.
When to seek professional help
If episodes are frequent, intense, or put your safety or the safety of the person you care for at risk, speak to the GP. It's important to rule out medical causes (unidentified pain, infections, medication side effects) before considering any pharmacological adjustment, which should always be prescribed and monitored by a healthcare professional. If at any point you feel in physical danger, do not hesitate to seek immediate help — your safety is as important as that of the person you care for.