Oliver: Caregivers may see ‘mean’ behavior but it often signals something else is going on

Aggression in those with dementia happens; here’s what caregivers need to look for

A few years back, when Tony’s Alzheimer’s disease diagnosis still was relatively new, we were taking part in the annual garden walk.

We had just gotten to one of the stops, and Tony realized that he had forgotten his ticket in the car. So off I went to retrieve it.

When I got back, I explained to the ticket taker what had happened. Another woman must have overheard me because she sidled up to me and conspiratorially whispered in my ear something that I have never forgotten: “Wait until he gets mean.”

“He,” of course, was Tony. What she was referring to is the tendency of some Alzheimer’s patients to become aggressive and belligerent.

Although I’m not quite sure what this woman meant by the remark, other than perhaps to scare me, I have thought about it a lot.

I also asked Tony’s neurologist about it. He tried to reassure me by saying that in his experience, the ones who are “mean” usually had those tendencies when they were healthy. Those who weren’t inclined to aggression often stay “mellow.”

The experiences I had with my mother, who had vascular dementia, seem to bear this out.

My mother had had a very difficult childhood, and the succeeding years hadn’t exactly been without their challenges. She worked hard to fight against her negative tendencies, but I remember many times during my own childhood when she would lose her temper, say things she didn’t mean and lash out.

When she came to live with me in her last few years, it wasn’t much different. Although she tried to be pleasant and oftentimes succeeded, she had times when she was downright mean.

One night she had gotten up in the middle of the night and was walking in the hallway. I got up to make sure she was OK and to guide her back to bed.

When she looked at me, her usually blue eyes appeared to be little black dots of hate. She clenched the handles of her walker and lunged at me while saying, “I want to burn your face off.”

There were other incidents, but that one stands out.

Usually these incidents came when she didn’t get her way or when she was overly tired or when she wasn’t feeling well. I did my best not to take them personally, but it was really hard.

The Alzheimer’s Association points out that aggression in those with dementia can have a lot of causes, including physical discomfort, frustration over poor communication or some other environmental factor. When those with dementia are overstimulated by noise or when they are lost can be times when frustration leads them to lash out.

Still, as caregivers, we need to be on the lookout for aggressive behavior because it often means that something else is going on. And remembering that goes a long way to not taking it personally. No matter how hurtful the behavior is.

Of course, I outweighed my mother by about 30 pounds. And her lack of mobility meant she very rarely landed any of her punches.

Things could be vastly different if my dear Tony, who has about 40 pounds on me, ever tried that. If he did, I’d definitely need some help.

That’s why I’m glad that my mild-mannered, sweet and wonderful husband so far has exhibited none of the “mean” I was warned about. And I’m hopeful it will stay that way.

Dealing with a “mellow” fellow is a lot easier than the alternative. I’ve already been there and done that.

Joan Oliver

Joan Oliver

A 30-year newspaper veteran who has been a copy editor, front-page editor, presentation editor, assistant news editor and publication editor, as well as a columnist and host of an online newspaper newscast.