Anger, agitation and even hitting can be part of dementia, and the National Institute on Aging (NIA) says most of the time they happen for a reason. The reason is often something the person cannot put into words: pain, illness, tiredness, fear, noise or a task that has become too hard. Check for those first, respond calmly rather than arguing, keep everyone safe, and tell the doctor about any new or worsening behavior.
Why does a person with dementia become angry or aggressive?
The NIA explains that Alzheimer’s changes the brain in ways that affect behavior, and that it is the disease, not the person, causing these changes. Getting upset or angry more easily, hitting and pacing are on its list of common changes. People may seem like themselves one day and act very differently the next.
The Alzheimer’s Association says aggression can be verbal or physical and can come on suddenly or after a frustrating moment. It adds that the person is not acting this way on purpose, and that people who cannot say what hurts may show it through aggression.
Our guides to the stages of dementia and dementia care at home put these behaviors in context.
What should I check first when the behavior suddenly changes?
Start with the body and the room. The NIA and the Alzheimer’s Association list the same kinds of causes, and many can be fixed once someone notices them.
| Check first | What to look for |
|---|---|
| Pain or illness | Grimacing, guarding a body part, restlessness. The Alzheimer’s Association says pain from infections, for example of the urinary tract, ear or sinuses, can show up as restlessness or agitation. |
| Hunger and thirst | When did the person last eat and drink? |
| Toilet needs | A full bladder or constipation. The NIA lists constipation as a cause of agitation. |
| Tiredness | Too little sleep or too little rest between busy events. |
| Noise, crowding, clutter | Loud TV, many people talking at once, glare, a busy room. |
| Temperature | Too hot or too cold, which people may express through behavior. |
| Medicines | The NIA lists certain medications, or interactions between two medications, as possible causes. Tell the prescriber about any new behavior. Do not change anything yourself. |
| Being pushed | Being hurried through bathing or asked to remember something that has become too hard. |
| Change | A new place, a new routine, a new caregiver or a hospital stay. |
The NIA says sudden or rapidly changing behavior, especially after an infection or a recent medication change, should be brought to a doctor’s attention immediately. Sudden confusion can also be delirium, a medical problem that needs prompt attention. Our page on delirium versus dementia explains the difference.
The NIA says keeping track of behavior changes can help caregivers and clinicians see a pattern and find the cause.
What should I say and do in the moment?
These steps come from the NIA’s agitation guidance and the Alzheimer’s Association’s page on aggression.
- Stay calm and slow down. Speak softly and slowly. If you feel yourself getting upset, breathe and count to 10.
- Do not argue or correct. Listen to the person’s concerns and reassure them that they are safe and you are there to help.
- Respond to the feeling, not the facts. Look for the emotion behind the words.
- Think about what happened right before. Then change that if you can, for example by lowering the noise or stopping the task.
- Redirect. Offer a snack or a drink, put on music, take a walk, or fold laundry together.
- Use more than words. The NIA suggests other ways to help the person calm down besides speaking, such as gentle touching.
- Take a break. The Alzheimer’s Association says that if the person is in a safe environment and you are able, you can walk away for a moment.
| Instead of | Try |
|---|---|
| “That’s not true, Dad died years ago.” | Respond to the feeling. The Alzheimer’s Association suggests something warm about the person they are asking for, not a correction. |
| Long explanations or several questions at once | Short, simple, one-step instructions. The Alzheimer’s Association asks whether you are asking too many questions or making too many statements at once. |
| Insisting the task must happen now | Stop, wait and try again later. The Alzheimer’s Association suggests scheduling activities for the time of day the person is most alert, often the morning. |
| Raising your voice | A soft, slow tone. The person may pick up on your stress. |
What if my parent fights me over bathing or getting dressed?
This is a common flashpoint. The Alzheimer’s Association lists being asked to bathe or change clothes among situations that can trigger behavior, and the NIA names being pushed to bathe as a cause when the task has become very hard for the person. Try the time of day when the person is most alert, give simple instructions and stop if distress grows. An aide can help; see personal care services.
What daily habits can reduce outbursts?
The NIA recommends keeping a routine, such as bathing, dressing and eating at the same times each day, reducing noise and clutter, playing soothing music, keeping well-loved objects and photos around, and letting in natural light during the day. It also suggests physical activity, which can improve mood and sleep.
If the trouble clusters in the late afternoon or evening, see our guide to sundowning and evening care.
Do medicines help, and who decides?
Non-drug approaches come first. The Alzheimer’s Association says they should always be tried first: look for the cause, adapt the environment and meet the unspoken need. It says medication may be appropriate if those approaches fail when applied consistently, for people with severe symptoms or who may harm themselves or others, and then it is best combined with non-drug approaches.
Whether any medicine is right is a decision for the person’s doctor or other prescriber, not for family members or aides. That is especially true of antipsychotics. Official FDA-approved labeling for these drugs carries a boxed warning: older adults with dementia-related psychosis who take antipsychotic drugs have an increased risk of death, and the drug is not approved for that use. The Alzheimer’s Association says they should be considered with extreme caution, are not to be used to sedate or restrain a person, and need the lowest dose for the shortest time with careful monitoring of side effects.
Bring a full medicine list to the prescriber or pharmacist and ask what each one is for. Do not start, stop or change a dose on your own. See our guide to medication management for seniors.
A note on Lewy body dementia
The NIA warns that people with Lewy body dementia may have severe reactions to antipsychotics, including more confusion, worse movement symptoms, extreme sleepiness and fainting, and says people with this condition should talk with their doctor before reducing or stopping medication. For the types of dementia, see our overview of vascular, Lewy body and frontotemporal dementia and ask the doctor.
What if someone is hitting, grabbing or throwing things?
Your safety counts as much as theirs. The NIA advises staying at a safe distance until the behavior stops, and locking up or hiding car keys and anything that could be used to cause harm, such as guns and kitchen knives. The Alzheimer’s Association says to make sure you and the person are safe and, if the person cannot calm down, to get help from others.
| Situation | Who to contact |
|---|---|
| Someone is in immediate danger or being injured | 911. Say that the person has dementia (NIA, Alzheimer’s Association). |
| Aggressive behavior is new, sudden or getting worse | The person’s doctor, soon. The NIA says to talk to the doctor if aggressive behaviors worsen. |
| A behavioral crisis in New York City that is not life-threatening, such as the person being agitated and unable to be calmed down | 988 (call, text or chat). NYC Health says 988 counselors assess the situation and, if the person is eligible, can refer a mobile crisis team, which respond to referrals placed between 8 a.m. and 8 p.m., seven days a week. |
| You need advice, support or a care consultation at any hour | Alzheimer’s Association 24/7 Helpline, 800-272-3900, free, 365 days a year, with interpreters for more than 200 languages. |
According to NYC Health, mobile crisis teams are for people who do not need immediate hospitalization. Whether a team is sent is decided by 988 after it assesses the situation, and response is generally within several hours of the referral. The city’s FAQ does not single out dementia, so describe the situation. If anyone could be seriously hurt right now, call 911 instead.
The Alzheimer’s Association also notes that abuse can come from either side. Strained relationships and frequent arguments between a caregiver and a person with dementia can be a warning sign, and no one should live in threat of harm. If you are worried, call its helpline or read our guide to elder abuse in New York.
How do I cope when I am exhausted, or angry myself?
The NIA lists signs of caregiver stress, including feeling exhausted or overwhelmed, becoming easily angered or impatient, trouble sleeping, and feeling lonely or hopeless. It advises not waiting until you are completely overwhelmed.
- Ask for specific help. The NIA suggests a list of tasks that each person can choose from.
- Tell your own doctor you are a caregiver. They may know of support groups and respite care.
- Plan breaks. Our guides to respite care in New York and caregiver burnout explain the options.
- Call the Eldercare Locator at 800-677-1116 (listed by the NIA) to find local services.
When is care at home no longer safe?
There is no single test, and this is a decision to make with the person’s doctor and the family. The Alzheimer’s Association says no one should live in threat of harm to themselves or others. If you or your relative are being hurt, if you are showing the signs of stress listed above, or if no one can be there at the hours when behavior is hardest, raise it with the doctor now rather than waiting for a crisis. Sometimes the answer is more help at home, such as an aide at the hardest hours, an adult day program or overnight cover. Sometimes it is a different setting.
Our guides to when it is time for memory care, home care versus a nursing home and adult day care compare the options. If your relative refuses help, see what to do when a parent refuses home care.
How are professional aides prepared for aggressive behavior?
It varies by agency, so ask directly. Useful questions: How are your aides trained for dementia? Who is the nurse supervisor? If there is a hitting incident, who is told, and is it written down? Can the same aide come each day? Our article on how home aides manage challenging behaviors gives the home care side, and our in-home care page lists our services. Aides do not decide medicine questions: any change in behavior should be passed to the nurse or family so it reaches the doctor.
Calm, routine and rest: advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
You can’t do all of it by yourself. Alzheimer’s and other dementias change the whole family’s life, not only the patient’s. The sooner support is in place, the easier it is to keep a familiar routine and a safe home. Even a few hours of professional home care a week gives relatives time to rest.
Families rarely hear this: don’t argue with the person and don’t keep correcting mistakes. If your mother asks the same question for the fifth time, she isn’t doing it on purpose. A calm voice, a familiar room and a routine she can predict usually work better than long explanations.
Need help at home?
ProLife Home Care is a licensed home care agency in Brooklyn and Queens (New York State Department of Health licence #2572L001). If daily care for someone with dementia is wearing the family down, call (718) 232-2777 or use our contact page. This page is general information, not medical advice.
Checked on 16 October 2026 against nia.nih.gov, alz.org, nyc.gov and the FDA-approved prescribing label cited above. Guidance and city services change, and every person with dementia is different. Confirm what applies to your family with their doctor. Never start, stop or change a medicine without the prescriber.
Frequently asked questions
Why is my mother with dementia suddenly so angry?
There is usually a reason. The NIA lists pain, tiredness, constipation, noise, change in routine, feeling pushed, loneliness and some medications. If the change is sudden, call her doctor, because an infection or a medicine problem can be behind it.
Is aggression in dementia normal?
It is common. The NIA says people with Alzheimer’s may become agitated or aggressive as the disease gets worse. Common does not mean you must put up with it: tell the doctor and look for triggers.
What do I do when someone with dementia hits me?
Step back to a safe distance and stay calm, as the NIA advises, and do not argue. Once things settle, look for what set it off. Call 911 if anyone is in danger, say the person has dementia, and tell the doctor afterward.
Should I call 911 or 988?
Call 911 for immediate danger or injury. In New York City, 988 is for a behavioral crisis that is not life-threatening. NYC Health says counselors assess it and may refer a mobile crisis team that visits between 8 a.m. and 8 p.m.
Will a doctor prescribe medicine for dementia aggression?
Only the doctor can say. The Alzheimer’s Association says non-drug approaches come first and medicine is for severe cases or when someone may be harmed. Antipsychotics carry an FDA boxed warning about increased risk of death in older adults with dementia-related psychosis.
Can I stop my father’s medicine if I think it makes him worse?
Do not stop it yourself. Describe what you see to the prescriber or pharmacist, with dates and examples. The NIA says people with Lewy body dementia should talk with the doctor before reducing or stopping medication.
Where can I get help right now?
The Alzheimer’s Association 24/7 Helpline, 800-272-3900, is free and answers every day of the year. Your own doctor, the person’s doctor and, in an emergency, 911 are the other first calls.
