When a loved one who has been diagnosed with Alzheimer’s disease or another dementia becomes agitated, anxious or aggressive, it can be alarming and challenging for family caregivers. Becoming aware of the potential triggers and the types of calming techniques that can help refocus the individual is important for the comfort and safety of all involved.
Potential Causes of Anxiousness, Agitation or Aggression
- Pain, depression or stress
- Excessive noise, including television, radio, people, etc.
- A sudden change in a familiar place, routine or well-known person
- Moving to a new residence
- Constipation
- Soiled underwear or adult diaper
- Lack of sleep or too much sleep
- A change in caregiver
- Fear and fatigue
- Feeling pressured or rushed to remember something or to perform a task
- Loneliness
- Medication interactions or reactions
- A feeling of loss – this may include a person, an activity or a responsibility
- Houseguests
- Travel
- Hospitalization
Note the environment and what was happening before the undesired behavior occurred. If you understand the cause, you may be able to take steps to avoid the behavior the next time. Also, be sure and mention these behaviors to your loved one’s physician, as they may be caused by another undiagnosed condition, or the result of a reaction to medication(s).
How to Respond
- Listen to the person’s frustrations and concerns, and don’t discount these feelings
- Provide reassurance – you are safe here; everything is under control; I know it’s hard; I’m sorry you are upset
- Speak in a calm tone
- Do not show alarm or offense
- Do not criticize, ignore or argue
- Use positive statements
- Slow down, avoid rushing
- Be sensitive to perceived fears and threats
- Ask for permission
- Be understanding
- Start from a place of compassion
It’s important to remember that the triggers for anxiety, agitation and aggression can be as unique as the person. Keep a journal, noting what immediately preceded the episode, and what strategy helped in calming the person down.
Strategies to Prevent and Reduce Anxiousness, Agitation or Aggression
- Create a calm environment, which may include moving the person to a quieter room
- Limit caffeine, sugar, and other “junk food,” providing nutritious meals and snacks instead
- Monitor personal comfort – pain, hunger, thirst, toileting needs, fatigue
- Maintain a simple daily routine and simplify tasks
- Play soothing music
- Go for a walk or simply into the yard for a change in perspective
- Redirect the person to an activity she/he typically finds enjoyable – a movie, a TV show,
looking through a photo album, discussing a subject of interest, or having a snack - Keep the room at a comfortable temperature and keep the person dressed appropriately for the weather
- Build quiet time into the day
- Read aloud from a book to the person
- Surround the person with familiar objects that may provide reassurance or comfort
- Provide opportunities for the person to feel in control by presenting simple, directed choices
- Reduce clutter
- Reduce background distractions – people, noise, etc.
- Incorporate a simple exercise or stretching routine into the person’s weekly schedule
- If the person is a pet lover, help him/her interact with a friendly cat or dog
- Take the person to a neighborhood park, museum, or other location for a fun outing
- Involve the person in activities around the house – sorting or folding laundry, assisting with meal prep, listening to a grandchild read aloud
- Promote hobbies
For more information on Alzheimer’s/dementia care, call (619) 487-9000 for professional in-home care services from caregivers specially trained in sensitive and patient care for persons with dementia.
Sources: Alzheimer’s Association; National Institute on Aging
