Responding to Agitation in Dementia
Medically reviewed by Huma Sheikh, MD
Agitation is a general term to describe excessive physical movement and verbal activity. Agitation often develops in the middle stages of Alzheimer’s disease and other types of dementia and can include restlessness, pacing, verbal aggression, combativeness, calling out and crying, and wandering.
Prevalence of Agitation in Dementia
Statistics vary, but one review of research found that the estimated prevalence of agitation ranged from 5% to 88% of people with dementia overall. Estimates of prevalence ranged from 6.9% to 86% among people with dementia living in the community, and 24% to 88% among people with dementia who were in nursing home care.
How to Respond to Agitation
Investigate the Cause
The cause is the most important factor to consider if you see someone with dementia who is agitated. We know that most behaviors that we see as challenging in someone with dementia are really an effort to communicate something. You are charged with figuring that “something” out.
The cause can range from boredom to pain to a need for exercise. Research suggests that discomfort, pain, and loneliness are associated with verbal agitation (such as calling out) in nursing home residents with dementia. Non-aggressive physical behavior (such as restlessness) may relieve boredom.
Other causes may include environmental changes, routine changes, unfamiliar caregivers, fear, and fatigue. Review these possible causes:
Individualize It
Your response should be tailored to the particular person you’re working with. Once you’ve determined the likely cause, you can choose an appropriate response to that person. It may be as simple as helping them change positions because they are in pain, or going for a walk with them because they’re feeling restless.
How you respond to someone who is agitated should depend on which behaviors they are demonstrating, possible reasons they might be agitated, what has worked well in the past when they’ve been agitated, and their personality, abilities, preferences, and needs.
What Research Says Is Effective
While each person is different, here are few research-proven interventions to try when a loved one or patient is agitated:
Addressing Unmet Needs
Making sure you’ve met the needs of someone who is hungry, tired, bored, lonely, or in pain is paramount. Remember that the agitation is likely there for a reason, and be certain to meet the need it may be expressing.
Music
Both singing and listening to music have been shown to decrease agitation and even improve cognition in persons with dementia.
Physical Touch
Don’t underestimate the importance of physical touch. A little tender loving care goes a long way. Research has demonstrated that appropriate physical touch can diminish agitation.
Physical Exercise
Work it out. Physical exercise can help decrease challenging behaviors and improve cognitive ability, among other benefits.
Pet Therapy
Research has shown that animal-assisted therapy can improve mood and nutrition, as well as decrease agitated behaviors in people with dementia.
Caregiver Training
Several research studies have tested whether spending time on teaching caregivers (both family members and professionals) makes a difference in coping with and responding to agitation levels in people who have dementia. Research shows that education for caregivers benefits both the caregiver and the family member with dementia by decreasing caregivers’ stress levels and enabling them to respond better to their family members, as well as decreasing the agitation in the person with dementia.
Helpful Medications
The short answer? There are occasionally times when psychotropic medications might be helpful and appropriate, but they should never be the first thing that you try. They also can cause a number of side effects and drug interactions. Many times, a person’s agitation can be reduced simply by employing some of the strategies listed above.
If you are not able to determine a reason for the agitation and it is causing the person distress (for example, they are experiencing frightening hallucinations or significant anxiety), you can ask their physician if medication might be appropriate.
Read the original article on Verywell Health.
