How To Handle Verbal Abuse By A Dementia Patient

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Verbal Abuse

Ninety percent of people with dementia are likely to exhibit verbal outburst in the later stages of the disease.

They may throw a fit due to a frustrating situation or for no apparent reason at all. They curse, argue, and threaten anyone when angry or stressed out. This behavioral psychiatric symptom is found to be the most challenging and distressing effect of dementia. Because of this worsening condition, families of the dementia patient may now entertain the idea of moving him to a residential care.

The most common intervention to ease the verbal outburst is to administer medication. Pharmaceutical treatments can significantly reduce or stabilize the symptoms. But sometimes, medications can rather cause an increase in the symptom being treated. Thus, putting the patient at greater risk.

Fortunately, there are non-pharmaceutical options that work much better. These types of interventions have been proven to have fewer side effects.

Physical evaluation. Conduct a physical evaluation on the person. If he has just been given a new medication or taken off one that he has taken for a while, there will certainly be some reaction on his part. Constipation, infection, injury, pain related to arthritis, or other medical problems may also cause his agitation.

Identify the trigger. Most often, a person with dementia reacts to certain environmental alterations, such as:

  • The presence of house guests
  • Change in his living arrangements
  • Alterations in his routine
  • Hospitalization
  • Travel
  • A new caregiver

Bathing and being asked to change clothing can also trigger agitation and anger. Likewise, under-stimulation can be a problem for the person.

Redirect the person’s attention. Do not disagree, argue, or be confrontational with your loved one. Instead, look for ways to divert his attention from his disruptive behavior. You may apply any of these strategies:

Play a soft and relaxing music, especially during meals or bathing. Employ pet therapy. Give him a massage.

Allow the person to look through photographs of family, or familiar people and places

Allow enough rest in between stimulating activities.

Provide adequate lighting to lessen confusion and restless nights

Assess the caregiver. Whether he is in a long-term care facility or in a home environment, the dementia patient can be affected by the disposition of his care provider. If the caregiver is feeling stressed or not in a good mood, he will surely pick up on this as well.

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About the author 

Dr Michael Chua PT, DPT

Dr Michael Chua is a physical therapist practising in Home Health, Skilled Nursing Facilities and Acute Care Hospital. His clinical interest involves pain management, geriatrics and dementia management. He enjoys treating patients and bringing out the best in them using positive treatment approaches, his dynamic work setting in a rural area provides an opportunity to treat a wide range from geriatrics to orthopaedics.

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