How Caregivers Can Handle Patient Combativeness With Compassion

by | Oct 22, 2019

How Caregivers Can Handle Patient Combativeness With Compassion, Cherished CompanionsWhen you walk into a patient’s home, you don’t always know what kind of reception you’re going to get. Will the patient be glad to see you? Will they know who you are? Will they be irritable, uncooperative, and frustrated? Perhaps the most challenging patients to deal with, however, are those who become combative toward you. Combative patients may be physically aggressive and may begin hitting, pushing, grabbing, or spitting.

The key to dealing with patient combativeness is to remember that they are still people in need of compassionate caregiving. In some cases, you’ll be able to calm the patient down using careful conversation and reassurance. Other times, however, the patient will suddenly snap and refuse to respond to your efforts to calm them. That’s why you need to be prepared for any scenario so that you can protect both yourself and the patient.

Why Patients Become Combative and What You Can Do To Help

Combativeness in a patient can be caused by many things including physical conditions, dementia, and Sundowner’s Syndrome. Sometimes, the patient is generally unhappy with their circumstances, they don’t want to admit that they need help, or they have become depressed. Combative patients will act or respond differently based on their specific circumstances. Here are some of the types of patient combativeness you may encounter.


Patients with dementia often become confused about their surroundings and the people they are interacting with. They may not recognize you or they may not understand what you want them to do. In these cases, the patient may become frustrated and try to push you away.

What You Can Do: Remain calm. Speak to the patient in a reassuring voice and explain what you are trying to do. You can also use visual cues such as pointing or demonstrating to help the patient understand.

What Not To Do: Don’t become frustrated or argue with the patient. Even if they are wrong, arguing will only escalate the problem. Instead, play along and work to guide them using the scenario they have created.


How Caregivers Can Handle Patient Combativeness With Compassion, Cherished CompanionsOver 2 million senior adults suffer from depression in the United States. Depression can manifest as anger and frustration just as often as it causes sadness and tears. In some cases, the person may just be generally unhappy as opposed to clinically depressed.

What You Can Do: If you suspect that your patient may be depressed, talk to the family about seeking medical treatment. If general unhappiness is the cause, work with the patient to create positive associations and build a relationship that they enjoy. It’s also important to treat all patients with respect. Kindness and humor can also go a long way toward creating a positive relationship and relieving tension.

What Not to Do: Don’t ignore signs of depression. It is essential that seniors get the treatment they need, so bring your concerns to the attention of someone who can help.

Violent Combativeness

Take precautions if you are working with a patient who has a tendency toward violence. Violence may be triggered by a certain event or an underlying health condition such as pain, lack of sleep, medication side effects, frustration or overstimulation. Whatever the cause, it’s important that you make safety your top concern.

What You Can Do: Prioritize your own safety. If the patient seems violent or you fear they will try to harm you, wait outside until the person has calmed down or call someone and ask for help. As you interact with the patient, use his or her name and talk in a quiet, soothing voice. In addition, pick your battles carefully. If the task is something that can wait, don’t insist on it.

What Not To Do: Don’t put yourself or your patient at risk of injury. You may need to call someone for help or leave and come back later.

Uncontrollable Patients

The worst-case scenario is when you have a patient that cannot be controlled. In these cases, you may need to come up with an emergency plan for times when the patient threatens you or will not allow you to do what you need to do.

What You Can Do: Talk with the family or with your supervisors about what steps should be taken to help the patient. Try to identify any triggers that may precede the behavior. Give them an opportunity to vent, and then speak calmly and explain what you are doing and why. In some cases, a patient may need additional care services that support their needs more effectively.

What Not to Do: Don’t argue with the patient or try to appear dominant over them. Instead work with them through the problem, show them you care, and try to help them understand what you need to do. 

The Difference Compassionate Caregivers Can Make

One of the most important ways to help combative patients is to remember that they are most likely experiencing significant changes in their health and life circumstances and treat them kindly. You may not know what they have experienced or what is happening inside their brain, but you can remain compassionate and try to help them. At Cherished Companions, we value compassionate caregivers because they can help improve the quality of life for even the most challenging patients.

If you would like to know more about joining our team of caregivers, download your free copy of our Guide to Becoming a Caregiver today!

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