Caregiver Resthelp and hope for the one doing the caring
DementiaOther conditions
Display

When they hit, grab or threaten you

The short answer
  • Step back, out of arm's reach, with the door on your side. (Distance keeps you safe and looks less threatening to them.)
  • Never grab, hold or block them. (Someone can get hurt in a struggle.)
  • If they keep coming, leave. Take your phone to a room that locks.
  • Hurt, a weapon, or no way out? Call 911 and say “dementia” first.
  • New or worse? Call their doctor today. (Pain, infection and new medicines can all set it off.)
  • This week, get any guns out of the house. (Locking them up may not be enough.)
Anyone hurt or in danger? Step out of reach and call 911. Call from a room away from them, and speak slowly. (A frantic call can bring a more forceful police response.) Say: My husband has dementia, and the dementia is making him aggressive. He hit me. He has no weapon. I am at [address]. Please send a crisis-trained officer, a CIT officer, if you have one. Guns in the house? Tell them.
Then stay on the line, and answer every question.

Being hit by someone you love is a shock. Guilt and anger afterward are normal too, and the behavior comes from the dementia.

In the moment

At a glance

  1. Step back, out of arm's reach. (Turn a little sideways. It looks less threatening and keeps your face out of reach.)
  2. Keep a clear path to the door. (A table or chair between you helps, if it does not block your way out.)
  3. Stop the task. Say less, low and slow. (Do not argue, correct or explain, even if they shout.)
  4. Never grab, hold or block them.
  5. If they keep coming, leave. Take your phone to a room that locks. (A bathroom works. Call a friend or 911 from there. If it is safe, give them 10 to 15 minutes.)
  6. Hurt, a weapon, or no way out? Call 911. (The words to say are at the top of this page.)

Words that help

If someone else sets it off

If they want to leave

The prudent see danger and take cover, but the simple keep going and suffer the consequences.

Proverbs 22:3

Calling 911

Say the words at the top of this page, then:

Arrest, the ER, holds and APS: what can happen next.

Watch Teepa Snow's 10 Steps to De-Escalating a Dementia Care Crisis, Teepa Snow's Positive Approach to Care, 4:55.
Aggressive language and behavior, UCLA Health caregiver training, 4:44.
What families report

From caregiver forums and news stories: what can happen, not how often.

Wives and daughters describe locking themselves in a bathroom, or sleeping in a closet, on the worst nights. Their advice to each other: a charged phone on you, keys under your pillow, a way out. In one 2026 news story, a calm 911 dispatcher talked a man with dementia who held a handgun into coming out with his hands up. No one was hurt. One UK carer wrote that being told to stay calm during an attack felt unrealistic.

Right after

At a glance

  1. Anyone hurt, including you? Get medical care.
  2. Bitten, and the skin is broken? Wash it and get seen today. (The NHS says any bite from a person needs urgent advice.)
  3. Give them quiet, and keep your distance. (Settling can take more than 20 to 30 minutes. Small things can set it off again for a few hours.)
  4. Reassure them. Do not scold or bring it up. (They may not remember. Reminding them upsets them again.)
  5. New or worse? Call their doctor today.
  6. Tell one person what happened, today. (Dementia UK says this is hard to talk about, and getting help is essential.)

Injuries

Worried a clinic will call the police? See your injury.

Settling them

Calling the doctor

The VA advises a medical check for any sudden or escalating behavior. Say:

This is a sudden change. He hit me today, and that is new. I need him seen today or tomorrow. Can you check for pain, infection, constipation and his medicines?

Ask them to rule out:

Urine test positive, but no fever or burning? Ask what else they checked. (A 2019 guideline tells doctors to look for other causes first in an older adult with no urinary symptoms.)

You

One review estimates that more than 1 in 5 family caregivers face severe aggression, though it calls the research thin. In a UK study of 12 carers, many kept quiet about it for fear of being judged.

Watch What causes aggression in dementia? 5 reasons, Dementia Careblazers, Dr. Natali Edmonds, 7:59.
Recognizing and managing pain in people with dementia, U.S. Department of Veterans Affairs, 4:49.
What families report

In several accounts the turning point was medical: a urine infection found and treated, or a medicine changed. Some families recorded episodes on a phone. They said it helped with doctors, and with their own guilt afterward.

Stopping the next one

At a glance

  1. Write down what happened just before. (Three lines each time: the time, what came before, what helped.)
  2. Ask the doctor about pain relief first. (Ask about acetaminophen, also sold as Tylenol, on a schedule.)
  3. Slow down personal care. (Come from the front and say your name. One question at a time. If they say no, stop and try later.)
  4. Make bathing gentler. (A warm room, a towel bath in bed, or a different time of day.)
  5. Ask hard questions about any calming medicine. (What is it for? What are the risks? When do we check if it works?)
  6. Get guns out of the house. Lock up knives and car keys.

Common triggers

Aggression usually has a reason, the National Institute on Aging says. The common ones:

Keep your three lines in the behavior log, then look for the pattern.

Bathing and dressing

Personal care is a frequent flashpoint. In a trial in 15 nursing homes, a gentler, person-centered shower cut aggressive incidents by 53%. A towel bath in bed cut them by 60%. That study used paid aides in 2004, not families at home.

For the moment itself: the bathing card.

Pain

The VA calls pain an often-overlooked cause of irritability and aggression. A trial in Norway followed 352 nursing home residents with moderate to severe dementia. A step-by-step pain plan, starting with acetaminophen, cut agitation scores by 17% over 8 weeks. It measured agitation, not hitting.

Ask whether scheduled acetaminophen is right for them.

Medicine, plainly

Guidelines say to look for causes and try care without drugs first, except in an emergency. They allow calming drugs when someone is at risk of harm or in severe distress.

Antipsychotics carry a boxed warning. They include risperidone, quetiapine, olanzapine, aripiprazole, haloperidol and brexpiprazole. In trials in older people with dementia and psychosis, about 4.5% on these drugs died over about 10 weeks, against about 2.6% on a dummy pill. Most deaths were from heart problems or infections like pneumonia. Labels also warn of strokes and falls.

The American Psychiatric Association says to use them only when symptoms are severe, dangerous or very distressing. The average benefit is small. No change after 4 weeks at a proper dose? Taper and stop. Even if it works, try to stop within 4 months. The Alzheimer's Association says these drugs should never be used to sedate or restrain.

Brexpiprazole (Rexulti) was approved in 2023 for agitation in Alzheimer's dementia. It is an antipsychotic, with the same warning. Dextromethorphan-bupropion (Auvelity) was approved on April 30, 2026. It is the first approved treatment for Alzheimer's agitation that is not an antipsychotic. It is taken daily, not as needed. Dizziness was 9% against 3% on a dummy pill, so watch for falls. Ask before combining it with an antidepressant. It is new, so experience in frail older people is short.

More questions for the visit: the doctor page.

Guns, knives and car keys

Some states have Extreme Risk Protection Orders, a court route to remove guns. Transfer laws vary by state.

When home is no longer safe

One review found severe aggression may be the strongest sign that a person will move to a nursing home. It calls the evidence thin. Faithful, loving families land on both sides of this choice.

Start with the free help. The 24/7 helpline will plan with you. The Eldercare Locator, 1-800-677-1116, finds local respite and adult day. Asking a church plainly: building your circle of help. Making the move: when home isn't enough.

If it's just you

Watch Addressing major safety risks in dementia, U.S. Department of Veterans Affairs, 7:46.
Refusal to bathe, UCLA Health caregiver training, 4:29.
What families report

Knives were the weapon in four of the news stories. In one research interview, a man surrounded himself with guns, and police and a SWAT team came. His wife had already hidden the ammunition. Families who came through it advise finding a geriatric psychiatrist before a crisis.

Hurt, or police involved? What happens next: arrest, the ER, APS and care homes.

Sources for this page, with the dates we read them: the sources page.

Is it urgent?← Is this an emergency? Pairs withChallenging Moments →