It started when our elder needed to go for a test. We were driving her to the facility when she got so enraged it took strong effort of will not to react to it. It was “only” verbal, but it was extremely aggressive verbal abuse.
What to look for: It may seem obvious, but there were a few warning signs that we missed. Whether or not others will follow this pattern I don’t know. However, inappropriate comments that were out of character and very hurtful were made. Her reaction to others in a crowded restaurant became more vocal and loud. They weren’t frequent, but they were a sign that this was coming.
How to handle it: Even if you recognize the warnings, it’s doubtful that anything will be done unless it gets to a certain level. What the warnings can do is help you know what to expect and what to do. In this instance, we had the option of walking away for a few moments to calm ourselves down. Once that was done, we were able to get her to some semblance of calm. It is very important that no one act in kind; it won’t help and it could cause harm.
Who to call: I put in an emergency message to our elder’s doctor as soon as we were back from the test. A medication was ordered that stopped most of the verbal abuse. A second medication had to be added due to the agitation that can lead up to the abuse. This is the front line in preventing aggressive behavior.
There are also means of helping our elder move her thoughts from her anger to a happier mood. It’s called redirecting. This may be all that’s needed for some patients. In our case, it takes a combination of the medication and the redirection to bring some peace back.
Why should I medicate; it’s only words: There are two reasons. The first is the myth that “words can’t hurt.” Yes, they can and the words being used have caused permanent pain for a family member. Being constantly harassed and screamed at is not conducive to good health for any of us.
The second is the probability that untreated verbal aggression will lead to physical aggression. There are sites that say “it doesn’t happen that often.” That is not what the people who actually work in eldercare and specifically with dementia patients say. I was told “it happens more often than you think.”
What happens if physical aggression starts? This is where the patient can no longer be at home or in assisted living. This takes a skilled care facility and people that can prevent the physical aggression from repeating.
It may seem silly to take verbal aggression in a dementia patient seriously, but it’s not. This is a sign that the patient has moved into a more severe category of dementia and it has to be treated. It’s both in your best interests and that of the patient.