When Someone with Dementia Becomes Angry or Aggressive

Anger can turn into shouting, pushing or hitting, and that can be frightening for everyone nearby. The behavior may not be deliberate. It does not prove that the person intends to hurt someone. Start by making the situation safer, then look for what the person may need.

What should I do when anger becomes aggression?

Pause the task, step back and use a calm, short sentence. The Alzheimer’s Association advises caregivers to focus on feelings, speak slowly and reduce distractions. If you are in immediate danger or someone is injured, move to safety and contact local emergency services.

• Stop what is happening if you can. If bathing, dressing, a visit or another task seems to be upsetting the person, pause. It can wait unless there is an immediate safety or health need.
• Give space. Step back and keep a clear way for each of you to leave. Do not corner, block, crowd or touch the person unexpectedly.
• Keep your voice low and your words brief. You might say, “I can see you’re upset. I’ll give you some room.” Do not argue, threaten or demand an explanation.
• Move other people away. A child, visitor or helper can go to another room while the person settles. One calm person speaking may be easier than several people trying to help.
• Leave if physical violence occurs. Get to a safer place and ask someone else for help. Do not try to restrain the person.

The Alzheimer’s Society recommends stepping back, avoiding restraint or sudden touch, and leaving to seek help if physical violence occurs. The Alzheimer’s Association also advises asking permission, reducing stimulation and not cornering or restraining the person. Use the emergency number for your location when there is immediate danger; do not wait for an episode to pass if someone may be hurt.

What might be contributing to the behavior?

There may be more than one factor, and a family member cannot diagnose the cause. The Alzheimer’s Association lists physical discomfort, environmental stress and communication problems among possible contributors.

Think about what happened shortly before the change:

• Was the person tired, hungry, thirsty, too hot or cold, or uncomfortable?
• Was a task difficult, rushed or unfamiliar? Did someone keep going after the person showed distress?
• Were there loud sounds, several people talking, clutter or an unfamiliar place?
• Was the person having trouble seeing or hearing what was happening?
• Did a medicine, routine, caregiver or health condition change recently?

The Alzheimer’s Society suggests looking for patterns and considering what the situation felt like from the person’s point of view. These questions are prompts for observation, not proof that any one factor caused the behavior. Do not try to examine, restrain or medicate the person yourself.

How can I lower the chance of another episode?

Use what you observed to adjust the next interaction. This may help, but it cannot guarantee that the behavior will not happen again. Try one change at a time so it is easier to notice whether the person seems more comfortable.

• Choose a calmer time. If a task often goes badly when the person is tired, ask whether a different time works better.
• Make the setting easier. Turn off background noise, reduce the number of people in the room and gather what you need before starting.
• Explain one step and wait. Approach from the front, say what you are doing, ask before helping and allow time for the person to answer.
• Stop at signs of distress. A refusal, pulling away, a tense face or a louder voice can be a cue to pause. Do not treat finishing the task as more important than comfort.
• Share a simple plan. If several people provide care, agree on the signs that mean “pause,” a calm phrase to use and who to contact if the pattern changes.

For task-specific ideas, see our guides to bathing and getting dressed. The guide to communication tips covers ways to speak and listen without adding pressure.

What can I do after the situation settles?

Offer reassurance and return to a familiar, low-demand activity if the person wants that. Do not scold, blame or punish. The Alzheimer’s Society notes that the person may still feel upset after the behavior has passed, even if they do not remember what happened.

If you want to understand a pattern, make a brief private note of what happened just before, what you observed, how long it lasted and what seemed to help. Keep the note factual and share it with the person’s care team when appropriate. Avoid recording the person or sharing private details without permission.

If a task often leads to distress, change the timing or approach, or ask another trusted person to help. You can accept a refusal and try later. Our guide on what to do when someone says no offers more ways to pause without pressure.

When should I seek medical advice?

Contact the person’s doctor about new, sudden, repeated or worsening aggression. The Alzheimer’s Association advises a medical checkup for behavior changes, especially when they appear suddenly. Pain, illness, sleep, the surroundings and medicines may all need review. A clinician can assess the person’s situation.

Seek local urgent medical help if the person suddenly becomes confused, is injured or seems acutely unwell. If you or someone else is in immediate danger, contact local emergency services. Do not wait to collect notes or try to work out the cause first.

Your safety matters too. Tell a trusted family member, clinician or local dementia support service if episodes keep happening or you feel afraid. Ask for a plan that protects both the person and the people around them. You deserve help; managing this alone is not a requirement.