Imagine this scenario. A senior with dementia needs to get ready for bed. The caregiver has to put on their pajamas and brush their teeth. The person with dementia is thinking…”Who is this person trying to take off my clothes? Why are they saying I need to change? What is that object she’s trying to force me to use on my teeth?” So the senior starts hitting, kicking and throwing their clothes onto the ground.

Not everyone with dementia becomes combative. Some people remain easy going and pleasant their whole lives even with dementia. If this is a problem, there are several things you can do to make your life and their lives easier.

With regards to activities of daily living, such as bathing and dressing, don’t rush. Allow plenty of time when helping your loved one or if the situation is not going well take a break for about 15-20 minutes and try again later. If possible have a different caregiver try to help, they may have a different approach. You can also try playing music as a distraction.

Ask yourself, is what I’m doing necessary? It is okay to have someone with dementia sleep in their clothes from the day before. In other words, don’t argue, remain calm and prioritize what the most important tasks for the day will be.
Oftentimes pain, hunger or fatigue could be contributing to the situation, but the person with dementia is unable to communicate this. There are times when safety is a concern, for the caregiver and the person with dementia. Medications should not be the first choice in responding to combative behaviors, but if personal safety is a concern a doctor should be consulted and they will be able to evaluate if the medication is necessary.

Roslyn Paine, MSW, LSW
DignityFirst Health at Home Care Manager