Aggression in dementia most commonly appears during the middle stages, typically stages 4 to 6 on the seven-stage scale. At this point the person is experiencing significant memory loss, confusion, and frustration but may still have enough awareness to feel distressed by what is happening to them. Physical aggression, verbal outbursts, and resistance to personal care are all common during this period. Aggression is rarely intentional. It is usually triggered by pain, fear, overstimulation, or unmet needs. Understanding the trigger is the key to managing it. Remaining calm, speaking gently, and removing the person from a stressful environment can help de-escalate the situation.