Lewy body dementia (LBD) is a progressive condition that affects memory, thinking, movement, and behaviour. For many families, one of the most difficult aspects to cope with is behaviour change. These changes can include agitation, delusions, or aggression.
This article explains how aggressive Lewy body dementia can be, the types of behaviour changes you might expect, and practical ways to cope with them.
Understanding aggression in Lewy body dementia
Aggression in Lewy body dementia is one of several behaviour changes that can appear as the condition progresses. It can take the form of verbal outbursts, emotional distress, or physical actions. These behaviours are not intentional. They are caused by changes in the brain linked to the disease.
Aggression in dementia may be triggered by:
- Fear or confusion, such as not recognising familiar people or surroundings
- Hallucinations or delusions, which are common in Lewy body dementia
- Frustration during personal care tasks like bathing or dressing
- Physical discomfort, such as pain, infection, or side effects of medication
- Changes in routine or unfamiliar environments
Aggressive behaviour in Lewy body dementia can include:
- Shouting or swearing
- Hitting, kicking, or pushing
- Refusing personal care or becoming distressed when being helped
- Sudden mood swings or irritability
Not every person with Lewy body dementia will show aggression. For some, symptoms are mild or occasional. For others, aggression may become more persistent as the disease progresses.
Other behaviour changes that may occur
Aggression is only one of the possible changes linked with Lewy body dementia. Families often notice a combination of behaviours that can vary from day to day. Some may be subtle at first, while others are more obvious.
Hallucinations and illusions
Hallucinations are very common in Lewy body dementia. They are often visual, such as seeing people, animals, or objects that are not there. Illusions are misinterpretations of real objects, such as mistaking a coat for a person. These can cause fear, anxiety, or confusion.
Delusions
Delusions are strongly held false beliefs. In Lewy body dementia, these are often paranoid in nature. A person may believe their food is poisoned, that a partner is unfaithful, or that loved ones have been replaced by impostors.
Agitation
Restlessness and agitation are common. This can include pacing, fidgeting, or repeatedly asking the same questions. Some people try to leave the house or wander during the night.
Apathy
Apathy is a lack of motivation or interest in usual activities. The person may withdraw from family and friends, avoid hobbies, or show little emotion.
Depression and anxiety
Mood changes are frequent. A person may feel sad, hopeless, or anxious, and may lose pleasure in activities they once enjoyed. Anxiety can lead to repeated worry or fear of being left alone.
Disinhibition
Some people may act in ways that are out of character, such as saying inappropriate things, showing impulsive behaviour, or displaying risky habits.
These behaviour changes can be difficult for families to witness. Understanding that they are symptoms of Lewy body dementia, not deliberate actions, can make them easier to manage with patience and support.
Coping with aggression and behaviour changes
Aggression and behaviour changes in Lewy body dementia can be very challenging, but there are ways to manage them. The goal is to reduce distress for both the person with dementia and their family.
- Stay calm and patient: Aggression in dementia is not deliberate. Staying calm and avoiding confrontation can help prevent the situation from escalating.
- Avoid arguing or correcting: Trying to reason or correct delusions and hallucinations rarely works and may increase agitation. Instead, gently redirect the person or offer reassurance.
- Look for triggers: Aggressive behaviour often has a cause, such as pain, hunger, fatigue, or overstimulation. Identifying and removing triggers can reduce episodes.
- Keep routines familiar: A predictable daily routine provides comfort and reduces confusion. Familiar activities, meals, and surroundings can make the person feel more secure.
- Ensure safety: If behaviour becomes physical, make sure the environment is safe. Remove sharp objects or hazards and create space to move away if needed.
- Seek medical advice: Doctors can check for underlying causes such as infections, pain, or side effects of medication. In some cases, treatments may help manage aggression or agitation.
Support for care partners
Caring for someone with Lewy body dementia can be demanding, especially when aggression or behaviour changes are present. Looking after your own wellbeing is just as important as supporting your loved one.
- Be honest with yourself: Recognise the challenges and do not feel guilty about finding aspects of care difficult.
- Stay connected: Lean on family, friends, or support groups who understand what you are going through. Sharing experiences can ease feelings of isolation.
- Take breaks: Respite care or short periods away from caring responsibilities can give you time to rest and recharge.
- Look after your health: Eat well, keep active, and find time for sleep and relaxation. Your wellbeing directly affects your ability to provide care.
- Seek professional support: Healthcare professionals can advise on managing behaviour, adjusting care routines, or providing extra help at home.
What to expect as Lewy body dementia progresses
Lewy body dementia is a progressive condition, which means symptoms usually become more noticeable over time. The way it develops will vary from person to person, but behaviour changes such as aggression, hallucinations, or delusions may increase as the disease advances.
In the earlier stages, symptoms may be mild and come and go. Families might notice memory lapses, confusion, or changes in mood that are sometimes mistaken for ageing or stress.
As the condition progresses, difficulties with movement, communication, and behaviour often become more frequent. Aggressive outbursts, agitation, or restlessness can appear alongside challenges with daily activities such as eating, bathing, and mobility.
In the later stages, care needs are usually more complex. Round the clock support may be required to manage both medical needs and personal care. At this point, families often rely on a combination of professional carers, healthcare teams, and support networks.
Every person’s experience of Lewy body dementia is different. Planning ahead and understanding what to expect can help families feel more prepared and ensure the right support is in place when it is needed most.
Specialist dementia care at home
At Prestige Nursing & Care, we understand the unique challenges of dementia. That’s why we provide compassionate, tailored dementia care in the comfort of home, so your loved one can continue to enjoy familiar surroundings, routines and relationships.
From support with daily activities to specialist dementia care plans, our experienced carers are trained to communicate with patience, compassion and respect, ensuring safety and emotional wellbeing at every stage of the condition.
Take the first step towards support
For over 80 years, Prestige Nursing & Care has provided bespoke care at home, for all of life. Our home care services are designed to support individuals in maintaining greater independence and improving their quality of life in their own homes.
Call us on 0808 239 1525 and our friendly care experts will discuss your care and support needs. You can also fill out our online enquiry form or email info@prestige-nursing.co.uk. We provide impartial guidance and advice, so you can make the right choice for you and your family.
