The angry elderly patient. An approach to understanding

Management of an angry or violent elderly patient can be difficult. It is most helpful to understand that the cause of the combatant behavior can be physical, psychologic, or drug-related. If the patient is approachable, immediate management involves sitting down with him or her to calmly discuss what happened. If the patient is unapproachable, a gentle but firm show of force and administration of a sedative is required. All patients with dramatic change in behavior should receive a complete physical examination to rule out a reversible cause. Long-term management may be arduous but is worthwhile.