S3 Ep 13 - When Love Hurts: Navigating Aggression in Dementia Care

Welcome back to the Caregiver Secrets Podcast! If you’re here, it means you’re showing up—day after day—for someone you love, and that’s no small thing. This podcast is all about giving you practical strategies, heartfelt stories, and the encouragement you need to keep going. Caregiving isn’t easy, but you don’t have to do it alone. Together, we’ll navigate the highs and lows with grace, resilience, and maybe even a little humor along the way.

Before we dive in, let me remind you: this is not medical, financial, or health advice. Please consult with the appropriate professionals for specific concerns. My role is to inform and support you as best I can, but ultimately, the choices you make are yours. With that said, let’s get started.

I hope this story resonates with you.

Mark had always been a patient man. His wife, Janine, was the love of his life—his best friend, his confidante, and the person who could always make him laugh, even on the worst of days. They had built a life together, raising two daughters and enjoying the kind of partnership that made people say, That’s what love looks like.

But now, things were different. Janine had been diagnosed with Alzheimer’s three years ago, and lately, something had changed.

At first, it was just a few rough evenings—Janine getting restless around dinnertime, pacing from room to room, mumbling about needing to go home, even though they were home. Then came the agitation—raising her voice at him, calling him by her father’s name, pulling away when he tried to guide her to bed.

Then, one evening, as the sun dipped low and cast long shadows across their living room, Janine turned to Mark with an expression he had never seen before—one of sheer panic.

“Who are you?” she asked, her voice trembling. “Where’s Mark? What have you done with him?”

Mark’s heart shattered. He opened his mouth, but no words came. How could he explain to his wife of forty-two years that he was Mark? That he had done nothing but love her through every stage of this disease?

She backed away, her body rigid with fear, and Mark knew that logic wouldn’t work. His Janine—the woman who had once debated philosophy with him at the kitchen table—was trapped in a moment of terror that he couldn’t pull her out of with words alone.

He took a deep breath. He had been reading about aggression and fear in dementia patients. He knew that, right now, her brain was in survival mode, responding to an overwhelming sense of threat. His first instinct was to reassure her, to argue, to beg her to remember. But instead, he took a step back.

“Okay, sweetheart,” he said softly, keeping his voice calm. “I’ll be right here if you need me.”

And then, he did something that went against every instinct in his body—he left the room.

He stood just outside the doorway, his hands shaking. He counted to sixty, then to ninety. Finally, he heard the rustling of movement inside. When he peeked in, Janine was sitting in her chair, her fingers tracing the pattern on the armrest, her breathing slower now.

Mark walked back in, this time with her favorite blanket in his hands.

“Hey, honey,” he said gently, draping it over her shoulders. “It’s getting chilly in here.”

She looked up at him, and though there was still a hint of confusion in her eyes, the fear had passed. She reached for his hand. “Oh, Mark,” she whispered. “You’re here.”

He squeezed her fingers. “Always.”

Physical aggression is one of the toughest challenges a dementia caregiver can face. And if you’re dealing with it right now, I want you to hear me: You are not alone.

Aggression in dementia can be terrifying—not just because of the physicality of it, but because of what it represents. When the person you love most lashes out at you, whether it’s with fists, harsh words, or even just the sheer force of their fear, it can make you question everything. Am I doing something wrong? Why is this happening? How do I stop it?

But here’s the truth: aggression isn’t personal. It’s not about you—it’s about the disease.

Dementia-related aggression is often triggered by three things: fear, pain, or frustration. Your loved one may not have the words to express what’s wrong, so their body does the talking for them. That’s why trying to reason with them in the moment rarely works.

Instead, here are some strategies that might help:

1. Identify the Trigger

Pay close attention to what happens right before an aggressive episode. Were they startled? Did something in their environment change? Are they in pain? Many caregivers find that certain triggers—like a loud noise, a confusing situation, or even hunger—can set off an outburst.

2. Remove Yourself (If You Can)

Like Mark did in our story, sometimes the best response is no response at all. If your loved one is physically aggressive, step back. Give them space. Let the moment pass. Often, they just need a few minutes to self-regulate.

3. Speak Softly, Move Slowly

Fast movements and loud voices can escalate aggression. When you re-enter the space, move calmly. Keep your voice low and soothing. Instead of correcting them—No, I’m Mark, I’ve been here all along!—meet them where they are. “You seem scared. I’m right here.”

4. Create a Safe Environment

If aggression is a frequent issue, look around the space. Is there too much noise? Too many shadows? Harsh lighting? Small environmental changes—soft music, familiar objects, and a clutter-free space—can make a big difference.

5. Prioritize Prevention Over Reaction

It’s easier to prevent aggression than to de-escalate it. That means making sure your loved one is comfortable, pain-free, and not overstimulated. Regular routines, familiar faces, and soothing activities can help minimize episodes.

And finally—remember to take care of yourself. Dealing with aggression is emotionally and physically exhausting. Reach out for support. You don’t have to do this alone.

I’d love to hear from you. Have you ever had to navigate aggression in caregiving? What worked for you? Share your story in the comments or email me. And if this episode resonated with you, don’t forget to subscribe and share it with another caregiver who might need it today.

And don’t forget to join our Facebook community at bit.ly/CaregiverSecretsOnFacebook, where we share stories, tips, and encouragement. Together, we can build a village of support and make this journey a little lighter.

Finally, I’d love for you to grab a free copy of my book, Get Risen. I wrote it as a long-time family caregiver for other family caregiver, and you can get it at bit.ly/GetRisen.

Take care of yourself, and I’ll see you in the next episode.