5 Step Framework to Understand and Manage Aggressive Behaviors in Dementia

Living with a loved one suffering from dementia can be challenging, especially when it's your spouse who's physically stronger and displaying aggressive behaviors. It can indeed be scary. But understanding how to respond to these situations can make a world of difference. 

I want to share with you a simple, five-step framework that you can turn to every time to understand why your loved one might be getting aggressive.

Aggressive Behaviors in Dementia

I've made a mnemonic to make it easy to remember:


Each letter stands for a key factor that influences behavior in people living with dementia.

P - Person with dementia:

Check in with your loved one's physical and emotional state. Are they tired? Hungry? Overwhelmed?

E - Environment of care:

Evaluate the environment around them. Is it too loud, too cold, or too hot? Are there distractions, like a noisy TV or traffic sounds that their brain can't filter out?

A - Activity Engagement:

Pay attention to what happens right before your loved one gets aggressive. Are they overstimulated, bored, or fatigued?

C - Care partner:

Reflect on your own emotional state. Your emotions and actions can influence your loved one's behavior. For instance, my dad used to get upset every time I visited him right after taking his car away. If I didn't take the time to center myself beforehand, it always made things worse.

E - Educate:

Spread awareness and understanding about dementia to everyone around your loved one. It helps to create a supportive environment.

Aggressive Behaviors in Dementia

When I didn't consider these five factors, I inadvertently made situations worse. We must remember that individuals with dementia are emotional sponges. Your emotions can greatly influence theirs. So, being mindful of your feelings and reactions is essential.

And most importantly, you can change how you respond, but they can't. We need to adapt our responses for them since they can't change theirs. Understanding and following the PEACE framework can significantly help decrease most aggressive behaviors by controlling the factors around the person with dementia.


I hope you find this framework helpful. For more insights and information, please subscribe to my YouTube channel, Think Different Dementia. Stay blessed and continue to make a difference in your loved one's life.

Remember to always consult a healthcare professional for any questions or concerns you may have about your loved one's health.

Read More:

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About the author

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

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