Common triggers for aggressive behaviour in Dementia patients on your ward

Better Dementia Care For Everyone Logo

Aggressive behaviour from patients living with Dementia can be troubling. So what do you do?

The important thing to remember is that this behaviour is not their fault. It’s simply an expression of their feelings of anxiety or fear. Which means there is usually an underlying cause that can be addressed. And in doing so, you can help alleviate these feelings of anxiety and fear.

So what are the more common causes of aggressive or negative behaviours for those living with Dementia?


Communication for those living with Dementia can sometimes be challenging. Meaning they may find expressing when they are in pain difficult, especially if they don’t understand what might be causing this pain.

The point is they are in hospital because something is wrong, so could this, or the treatment involved be causing them pain? And what can be done to alleviate it?


They may also have trouble communicating if something is making them uncomfortable. The problem is there are so many factors that could cause such feelings. So for you, it then becomes a process of elimination. Are they thirsty? Hungry? Tired? Lonely? And so on.

Once you know this, you can make a judgement on how best to proceed.


Restlessness is another common response to anxiety. It’s not usually a problem if they have space and opportunity to react to this.

The problem is when they don’t. Providing patients with the means to take exercise or activities to help respond to these feelings is important. However, this is dependent on why they are in hospital in the first place, and certain injuries and illness make this difficult.

Here’s where you might need to be a little more innovative. Consider smaller activities like listening to music or having Ensign Care’s Dementia Support Workers keep them company. Where activities are limited keeping them engaged and reassured is key.


Conversely, becoming tired can also pose problems, from simple agitation to Sundowning. Here, there are a number of factors to consider, from age to over stimulation in such a busy environment.

If this appears to be the case, try to encourage more rests throughout the day. By taking breaks more regularly, you can help them control their anxieties.


Hospitals are busy places. Bright, noisy and full of activity. This can understandably make patients restless and uncomfortable. And if it continues without any respite that will only compound these feelings further, which could cause them to react negatively.

So what can you do? There’s no simple fix, but small considerations about the patient’s surroundings can hugely impact their time in hospital. Try to consider their particular needs and make them as comfortable as possible. What can you do about lighting, noise, temperature, etc.? Can a side room be made available for this patient for the benefit of all?

Unfamiliar routines

Routines are important for those living with Dementia. They’re also essential for running a hospital. The problem is, these are two very different things. And this change in the person’s routine can be a great cause of frustration to them.

However, a ward can’t run around a single patient, but that’s not the only answer.

What is their usual routine and what can you manage? Can their meal times be changed? Can any activities or hobbies be encouraged? The smallest variations in a hospital’s routine can make a large difference to these patients. Going for a walk, discussing memories, can all help.


Some people living with Dementia can find certain tasks more challenging than others. The types of challenges vary from person to person.

This difficulty in completing tasks they know they’ve done before can cause them to become frustrated. But it’s essential to remember they also don’t want you to do these tasks for them. That may only add to the frustration.

So how can you help? It’s really about being there to support them should they need it. Helping only when required, and letting them do what they set out to do to avoid these feelings of frustration. Talk to them and understand their frustration. Try to find out what they want to do and assist them.


The only thing more frightening than unfamiliar places is unfamiliar people. So during their stay continuity of staff can be extremely beneficial.

Even more so is one-to-one support. However, resources don’t always allow this, as you have many other patients. This is why it’s always worth considering Ensign Care’s Dementia Support Workers or similar support to help support them, increase patient engagement through therapies and games and increase patient safety throughout their treatment on your ward.

These are by no means the only causes of negative reactions while in a hospital, but they are usually the best places to start. Helping to remove the causes of these behaviours, instead of focusing on them will be far more beneficial to the patient’s wellbeing and recovery.

If you are interested in finding out how Ensign Care can support your ward then call us on 0345 25 76 104 or fill in the form below.

We are an approved supplier on the NHS National Clinical Staffing Framework