What to Do With a Violent Dementia Patient?

Written by Nguyenjessica

Published on April 24 2025

When a loved one with dementia becomes aggressive, it’s heartbreaking and overwhelming. You might feel scared and unsure how to handle the situation. But with the right strategies, you can ensure safety and reduce aggression. By understanding triggers, staying calm, and creating a soothing environment, you can make a big difference. This guide will show you how to manage violent episodes, prevent future outbursts, and know when to seek help. Keep reading to learn practical steps to protect yourself and your loved one.

Key Points

Understand Triggers
Aggression in dementia is often caused by confusion, pain, or sensory overload. Identifying and addressing these triggers can help prevent outbursts.

Stay Calm and Ensure Safety
Use a soft tone, remove dangerous objects, and give them space. Avoid physical restraint unless absolutely necessary to prevent harm.

Create a Safe Environment
Reduce noise, improve lighting, and remove hazards like sharp tools or clutter. Plan for emergencies and seek professional help if aggression escalates.

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Table of content

Why is my loved one suddenly becoming violent?

How do I know when family's about to get aggressive?

What should I do when family gets violent?

I'm scared - when should I call for help?

How do I keep myself and my family safe?

Why is my loved one suddenly becoming violent?

When a loved one with dementia suddenly becomes violent, it’s usually not intentional. It’s often their way of reacting to something they can’t fully process or communicate. There are a few common reasons behind this behavior.

One big cause is cognitive decline and confusion. As dementia progresses, they might not recognize familiar faces or places. This can leave them feeling scared and frustrated, which sometimes turns into aggression.

Communication difficulties are another factor. If they can’t explain what they need or how they feel, they might lash out as a way to show their discomfort.

Physical discomfort or pain is also a common trigger. A person with dementia might not be able to tell you they’re in pain, so they express it through aggressive behavior.

changes in routine or environment—like meeting a new caregiver or being in an unfamiliar setting—can cause stress and agitation, leading to sudden outbursts.

It’s about sensory overload. Bright lights, loud noises, or crowded spaces can overwhelm them, provoking fear or aggression. Emotional factors like fear, anxiety, or loneliness can also make them less patient and more prone to outbursts.

hallucinations or delusions caused by dementia can make them feel threatened, prompting defensive aggression.

Understanding these triggers can help you better respond to their needs and reduce the chances of such episodes happening again.

How do I know when family's about to get aggressive?

If you’re caring for someone with dementia, you’ve probably noticed that aggression doesn’t just happen out of the blue. There are usually signs leading up to it, and if you know what to watch for, you can often step in and calm things down before it gets worse.

One of the first things to check is their body language and facial expressions. For example, if they’re frowning, clenching their fists, pacing back and forth, or looking tense, it might mean they’re starting to get upset.

Their tone of voice is another giveaway—they might suddenly start talking louder, sharper, or faster than usual. Sometimes they’ll yell or say something like, “Why is everyone bothering me?” or even start swearing. These are all signs they might be feeling overwhelmed or frustrated.

Behavior changes are another big clue. Let’s say you’re trying to help them get dressed, and they push your hands away or refuse to cooperate. Or maybe they’re pacing around the room and won’t sit still. This kind of agitation can be a warning sign, especially if they also seem confused or scared.

For instance, if they say something like, “Who are all these people in my house?” when there’s no one there, it could mean they’re feeling paranoid or threatened.

There are also common triggers that can set off aggression. Physical discomfort is a big one. Imagine sitting in the same chair for hours—you’d get cranky too! If they’re hungry, thirsty, or in pain (like from arthritis or a headache), they might not be able to tell you, so it comes out as frustration.

Environmental stuff matters, too. For example, if there’s a loud TV on, kids running around, or too much going on in the room, it might overwhelm them. like eating dinner an hour later than usual—can throw them off.

Communication struggles are another trigger. Think about how frustrating it is when you can’t find the words to explain something important. Now imagine that every single day. If they’re trying to tell you they’re cold or need the bathroom and you don’t understand, it’s no surprise they might get upset. Emotional factors like feeling lonely, scared, or misunderstood can also add fuel to the fire.

And of course, medical issues like infections or medication side effects can make everything worse.

What should I do when family gets violent?

When a family member with dementia becomes violent, it can be really stressful, but staying calm and knowing what to do can help keep everyone safe. Here’s how to handle it in the moment and plan for the future.

First, stay calm and speak softly. Even if they’re yelling, don’t raise your voice or argue—it’ll just make things worse. Use a gentle tone, like you’re trying to reassure a scared child.

Next, focus on safety. Move any dangerous objects out of reach, like glassware or sharp items, and make sure you and others are at a safe distance. Just don’t corner them, as that could make them feel trapped.

Avoid physically restraining them unless it’s absolutely necessary to prevent harm. Restraint can make them more agitated, so it’s usually a last resort. Instead, try to redirect their attention.

For example, if they’re upset about something, you can say, “Let’s go sit over here and have some tea,” or hand them a familiar item they like to hold, like a soft blanket or a photo album. Meanwhile, try to reduce distractions around them—turn off loud TVs, dim bright lights, or move them to a quieter, calmer space.

Take a moment to figure out what might be triggering their behavior. Are they in pain? Hungry? Tired? For example, if it’s close to lunchtime and they’re getting aggressive, they might just be hungry and unable to express it. Meeting those basic needs can often ease the situation.

For the long term, there are strategies to reduce the chances of aggression happening again. Physical activity can be a great outlet for their energy. A short walk or even light stretching can make a big difference.

Social interaction also helps—engaging them in meaningful activities, like chatting about old memories or doing a simple puzzle together, can reduce feelings of loneliness or frustration.

Remember, when dealing with aggression, it’s not about “fixing” the person—it’s about understanding their needs, creating a calm environment, and keeping everyone safe. You’re doing your best, and that’s what matters most.

I'm scared - when should I call for help?

If a loved one with dementia becomes violent or uncontrollable, calling for emergency help (like 911) may be necessary to keep everyone safe. Here’s when to act:

Call for help right away if they’re physically violent and a danger to themselves, you, or others. If you feel unsafe or unable to calm the situation, or if there’s a medical emergency like unconsciousness, severe injury, chest pain, trouble breathing, or a seizure, don’t hesitate to call. Also, if their aggression escalates despite your efforts to de-escalate, and you can’t ensure safety, it’s time to seek professional help.

When you call, let responders know they have dementia. This helps them approach the situation appropriately.

While waiting for help, stay calm and use a soft voice. Keep a safe distance, remove anything dangerous, and, if possible, try redirecting their attention to something calming. If it’s safe, have another person assist you. Most importantly, prioritize your safety.

Remember, calling for help isn’t a failure—it’s about protecting everyone involved and ensuring your loved one gets the care they need. Early intervention can make a big difference.

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How do I keep myself and my family safe?

Keeping a loved one with dementia safe at home doesn’t have to be overwhelming, but it does take some thoughtful changes and planning. Here are some simple ways to make their environment safer and reduce risks.

Start by removing hazards. Lock up anything dangerous like cleaning supplies, medications, or sharp tools. Use covers on stove knobs and unplug anything that could be unsafe, like the garbage disposal. Clear out tripping hazards like rugs, cords, or clutter, and make sure the house has good lighting—especially in hallways and bathrooms.

Adding grab bars in the bathroom and securing carpets can help prevent falls. If you’re worried about burns, keep the water temperature low or use automatic controls. And if there are weapons in the house, it’s best to lock them up or get rid of them entirely.

Doors and windows can be tricky if wandering is an issue. Install locks or alarms to alert you if they try to leave. It’s also a good idea to get them an ID bracelet or keep emergency contact info in their wallet, just in case they wander off.

For medications, keep them in a locked cabinet or use a pill organizer to avoid mix-ups. Writing down doses and checking them off can help you keep track.

When it comes to safety during emergencies, make sure smoke detectors and carbon monoxide alarms are working, and keep a list of emergency numbers handy.