What to Do When a Person With Dementia is Agitated

Dementia affects people in different ways and experiencing strong emotions like agitation, confusion and aggression are common. Although these behaviours can be challenging and distressing for family members and caregivers, it’s important to know why these behaviours occur and what you can do to help.

Here you’ll learn what to do when a person with dementia is agitated, including plenty of tips from our dementia care experts.

Agitation in dementia

Agitation is a common and challenging behavioural symptom experienced by people living with dementia. It encompasses a range of distressing behaviours, including verbal or physical aggression, restlessness, and increased confusion.

The brain of a person living with dementia undergoes changes that can lead to difficulties in communication and emotional regulation as the condition progresses. As a result, people with dementia may exhibit agitation as a response to their frustration or inability to express their needs effectively.

Understanding the underlying causes of agitation is crucial for caregivers and family members to respond with empathy and appropriate strategies.

How to support someone experiencing agitation

Learn to recognise the signs

Recognising the early signs of agitation in people living with dementia is crucial for timely intervention and providing appropriate support. As caregivers and family members, being attuned to these signs can help prevent escalation and improve the overall well-being of the person living with dementia.

Here are some key indicators to watch out for:

  • Verbal aggression: Pay attention to any sudden outbursts of anger or shouting. Verbal aggression may be a response to frustration or an inability to express needs.
  • Physical tension or agitation: Watch for restless movements, pacing, or fidgeting. People with dementia may express their agitation through their body language, such as clenching fists or furrowed brows.
  • Increased confusion: Notice if the person becomes more confused or disoriented than usual. Agitation can be triggered by a heightened sense of confusion and an inability to comprehend their surroundings.
  • Changes in behaviour: Keep track of any significant changes in their behaviour, mood, or routine. Sudden shifts may indicate underlying triggers.
  • Repetitive behaviours: Look for repetitive actions or statements, as these may be signs of agitation or distress.
  • Verbal cues: Listen to their tone of voice and the content of their speech. Agitated individuals may sound anxious, frustrated, or fearful.

By familiarising yourself with these signs, you can intervene early and implement appropriate strategies to calm agitation and provide comfort and support. Remember: each dementia journey is unique, so understanding their specific triggers and reactions will enable you to tailor your approach effectively.

Look for underlying causes

Most of the time, distressing dementia symptoms like agitation, anxiety or restlessness have an underlying cause. Communication difficulties often lie at the heart of their frustration. They may struggle to articulate their thoughts and feelings, leading to increased agitation as they attempt to make themselves understood.

Unmet needs such as hunger, thirst, or pain, can intensify agitation. Environmental triggers, such as loud noises, unfamiliar surroundings, or abrupt changes in routine, can also contribute.

Some medications prescribed to manage dementia symptoms can have side effects that worsen agitation in certain individuals. If you notice any sudden changes in your loved one’s behaviour, speak to their GP and discuss whether any medications they are taking could be contributing.

Create a calm environment

Creating a calm and soothing environment is essential to manage agitation in people living with dementia. A serene setting can significantly impact their emotional well-being and overall behaviour.

Just remember to always consider the individual’s needs and personal preferences when making changes to the environment. Whenever possible, ask the individual for their opinions and consent before making changes.

Here are some practical strategies you can use to create a tranquil environment:

  • Reduce noise and distractions: Minimise loud noises and clutter that can overwhelm and confuse people living with dementia. Create a peaceful atmosphere by maintaining a noise-free environment, especially during times of heightened agitation.
  • Ensure adequate lighting: Proper lighting is important as dimly lit areas may cause confusion and fear. Ensure that living spaces are well-lit to help them navigate their surroundings comfortably.
  • Familiarity and safety: New or unfamiliar environments can trigger agitation, so try and keep their environment consistent. Surround them with familiar objects, photographs, and cherished possessions to create a sense of security.
  • Avoid overcrowding: Limit the number of people in their immediate surroundings, as crowded spaces can be overwhelming and increase agitation. Encourage one-on-one interactions or small group settings.
  • Use calming colours: Opt for soothing, soft colours in the living space. Avoid bright and contrasting colours, as they can be visually disruptive and unsettling.
  • Personal space and privacy: Respect their need for personal space and privacy. Ensure that they have a quiet area where they can retreat when they desire solitude.

Use positive validation techniques

Validation techniques are powerful tools to help calm agitation. These approaches involve acknowledging and validating their emotions, thoughts, and feelings, without necessarily agreeing with what they are saying.

Here are some effective validation techniques and how you can use them:

  • Active listening: Give your full attention and actively listen to what the individual is expressing, either through words or body language. Avoid interrupting or dismissing their concerns.
  • Empathetic responses: Respond with empathy and compassion. Use phrases like, “I understand you are feeling upset,” or “I’m here for you”.
  • Reflective statements: Reflect their actions back to them to show that you understand their feelings. For example, “You’ve just raised your voice to me – are you frustrated or upset about something?”.
  • Avoid contradiction: Refrain from correcting their statements or arguing with them. Instead, focus on connecting with their emotions.
  • Validation without agreement: You can validate their emotions without agreeing with the content of their statements. For instance, “I can see that you’re feeling angry, even if I don’t fully understand why.”
  • Physical contact: Offer comforting touch, such as holding their hand or giving a gentle pat on the back, but only if it is appropriate and well-received.
  • Reminisce and share memories: Engage in reminiscence by sharing positive memories or asking about their past experiences. This can help redirect their focus and bring comfort.
  • Distraction and diversion: Divert their attention to a different topic or engage them in an activity they enjoy to help alleviate agitation.
  • Use simple language: Communicate using simple and clear language, avoiding complex or confusing statements that can escalate agitation.

Focus on physical and mental health

When trying to manage behaviours that challenge like agitation, it can be helpful to prioritise your loved one’s holistic health—both physical and mental. From nutrition and physical activity to mindfulness and social interaction, each aspect plays a vital role in creating a supportive environment for those living with dementia.

Engaging in regular exercise has many benefits for people with dementia. Exercise releases endorphins, natural mood boosters, and promotes better sleep, which in turn reduces the risk of agitation. Simple activities like walking, gentle stretching, or chair exercises can be adapted to the person’s abilities and contribute to their physical and emotional well-being.

Caffeine and sugary foods can negatively impact individuals with dementia. Caffeine may lead to restlessness and increased anxiety, while blood sugar fluctuations can affect mood and behaviour. Instead, caregivers should opt for healthier alternatives and maintain a balanced diet to support stable energy levels and emotional well-being.

Avoid triggers

Agitation often arises from environmental factors that lead to frustration, confusion, and heightened emotions. Creating a calm and familiar environment can help reduce potential triggers.

Minimising loud noises, maintaining a clutter-free space, and ensuring a consistent daily routine contribute to a sense of security and stability. Sudden changes or unfamiliar settings can also provoke agitation, so providing a predictable and familiar environment is essential.

Overstimulation can also exacerbate agitation in people with dementia. Large crowds, noisy gatherings, or excessive social interactions can overwhelm their senses and lead to distress. Opting for quieter and more intimate interactions can ensure the individual feels more at ease and less prone to agitation.

Establish a daily routine

Creating a structured and consistent daily routine is a powerful tool for managing agitation and enhancing the overall well-being of people living with dementia. Routines provide predictability and a sense of security, which can help reduce anxiety and confusion.

Here are essential tips for establishing a daily routine:

  • Consistency: Maintain a consistent schedule for daily activities, such as mealtimes, personal care routines, and leisure activities. Consistency helps people living with dementia feel more in control and reduces the likelihood of agitation caused by unexpected changes.
  • Include familiar activities: Incorporate activities that the individual enjoys and is familiar with. Familiar tasks can provide a sense of accomplishment and contribute to feelings of comfort and contentment.
  • Balance activities: Strike a balance between physical, cognitive, and social activities throughout the day. Engaging in a variety of activities can prevent restlessness and promote a positive mood.
  • Optimise peak times: Schedule more challenging tasks or activities during the person’s peak cognitive hours. Typically, people with dementia experience better cognitive functioning at certain times of the day.
  • Allow for flexibility: While routine is essential, allow some flexibility to accommodate the person’s preferences and needs. Being too rigid can lead to frustration and agitation.
  • Offer visual cues: Use visual cues, such as calendars or task lists, to help the individual understand the day’s schedule and upcoming events.
  • Limit overstimulation: Avoid overloading the daily routine with too many activities or appointments. Overstimulation can lead to fatigue and increased agitation.
  • Prioritise rest and sleep: Ensure that the daily routine includes ample time for rest and quality sleep. Fatigue can exacerbate agitation, so prioritising adequate rest is essential.
  • Monitor and adjust: Continuously observe how the individual responds to the established routine. Be prepared to adjust and tailor the routine as needed to suit their evolving needs and preferences.

Music therapy

Music therapy’s non-invasive and enjoyable nature makes it accessible and beneficial at all stages of dementia. By harnessing the power of music, caregivers can create positive experiences and promote a sense of joy. Whether through group singing, playing musical instruments, or simply listening to familiar tunes, music therapy offers a profound means to manage agitation and enrich quality of life.

Through its emotional and cognitive benefits, music therapy offers a powerful way to manage agitation. Music can evoke memories and emotions, even in those with limited verbal communication. Calming and familiar tunes can reduce stress and anxiety, providing comfort during distressing moments. Music even engages various brain regions, promoting cognitive stimulation and memory recall.

Dementia care in your own home

At Oxford Aunts, we understand the challenges faced by people living with dementia and their families. Our one-to-one, live-in dementia care provides compassionate and personalised support in the comfort of your own home.

Whether it’s medication management, engaging activities to stimulate the mind, or assistance with daily living, our experienced carers are here to enhance the quality of life of your loved ones.

Contact Oxford Aunts today to find out how our dedicated team can provide the support and care your loved ones deserve in the familiar surroundings of home.


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