Managing Agitation in Alzheimer's Disease Patients - Caregiver Tips

Understanding and Handling Agitation in Alzheimer's Patients

Agitation is a common symptom of Alzheimer's disease and other dementias that can be highly distressing for both patients and caregivers. Learn what causes agitation, strategies to prevent and manage episodes, and when to seek medical assistance.

What Causes Agitation in Alzheimer's?

Agitation refers to inappropriate verbal, vocal, or motor activity resulting from confusion, anxiety, anger, or hyperarousal. Possible triggers include:

• Trying to express unmet needs the person can no longer articulate
• Overstimulation from too much noise, activity, or interactions
• Pain, discomfort, illness, or medication side effects
• Frustration, boredom, or feeling a loss of control
• Changes in environment, caregivers, or routines
• Difficulty recognizing familiar people or places

Agitation often arises when the person feels overwhelmed and lacks effective coping methods to calm themselves down.

Signs of Agitation to Watch For

Notice these common signs of rising agitation:

• Restlessness, pacing, fidgeting
• Repetitive motions like hand-wringing
• Aggressive behaviors like hitting, grabbing, biting
• Yelling, screaming, moaning
• Rummaging through drawers searching for unknown items
• Tearing tissues or clothes
• Pressured, fast, loud talking

Early intervention can prevent episodes from escalating. Pay attention to nonverbal cues as well as actions.

Strategies to Manage Agitated Behavior

Try these methods to help calm an Alzheimer's patient experiencing agitation:

Remove Triggers

Eliminate overstimulating factors like loud TVs, clutter, many people talking. Shift to a quiet room with familiar objects.

Offer Reassurance

Speak gently, make eye contact, and remind them where they are and that they are safe. Repeat as needed.

Play Soothing Music

Calming music engages without overstimulating. Classic songs from their youth can connect to memories.

Provide Activity

Folding laundry or looking through old photos redirects energy in a purposeful, familiar way.

Offer Snacks or Hydration

Hunger, thirst, or medication side effects could be irritating. Offer a small snack and drink.

Use Touch

Hand massages or gentle hugs can comfort without overwhelming personal space.

Shift Conversation Topic

If communicating is causing frustration, redirect to a preferred subject or activity.

Take a Walk

Guide them in walking around the block or house to provide sensory stimulation.

Avoid Restraints

Don't forcibly restrict movement unless absolutely needed for safety. This can increase agitation.

How Caregivers Should Handle Agitated Behavior

The caregiver's response can help diffuse or escalate an agitated Alzheimer's patient. Follow these do's and don'ts:

Do

• Stay calm and use a gentle tone
• Listen and acknowledge their feelings
• Use simple phrases and yes/no questions
• Respect their personal space
• Project confidence and reassurance

Don't

• Raise your voice, argue, or criticize
• Overwhelm with too much stimulation
• Show fear, anxiety, or impatience
• Respond aggressively or make sudden movements
• Touch without permission

Responding with empathy, patience, and care can often quickly diffuse agitation. Yelling or reacting angrily will likely make the episode worse.

Medical Interventions for Managing Agitation

When behavioral approaches aren't resolving agitation, consult the doctor about possible medical interventions like:

Treating Underlying Causes

Manage causes like pain, infection, depression, sleep issues, or medication effects contributing to agitation.

Prescription Medications

Drugs like antidepressants, antipsychotics, sedatives, and anticonvulsants may sometimes be used short-term to control agitation.

Sensory Stimulation

Music, aromatherapy, pet therapy, or light therapy may have a calming influence.

Equipment Adjustments

Specialized chairs, mobility aids, or adaptive devices could help minimize restlessness and agitation.

Weigh the risks and benefits of any medical approaches. Non-drug methods should be tried first when possible.

Creating a Low-Stimulation Environment

Adapting the home to reduce excessive stimulation can help prevent or minimize agitated episodes:

Reduce Clutter

De-clutter rooms and walkways to minimize disorientation and restlessness.

Post Cues and Reminders

Use signs, notes, and visual cues to help orient them to their location and routine.

Establish Quiet Zones

Provide a designated low-noise, low-activity space the person can retreat to when overstimulated.

Limit Rearrangements

Keep furniture consistent and make gradual changes to maintain familiarity.

Create Wandering Paths

Set up circular paths they can pace around safely without getting lost.

Ensure Good Lighting

Minimize shadows and glare that could create confusion or hallucinations.

Regulate Sensory Input

Avoid TVs and radios blaring constantly in the background.

A calm, simplified environment reduces the sensory overload that often triggers agitation episodes.

When to Call the Doctor About Agitation

Contact the physician right away if the person exhibits:

• Sudden onset of agitation or aggression
• Significant behavior changes or worsening symptoms
• Delusions, hallucinations, or paranoia
• Inability to be consoled lasting over an hour
• Putting themselves or others at risk of harm
• Refusing to eat or take medications

Seek emergency care for uncontrolled, severe agitation accompanied by chest pain, trouble breathing, high fever, profuse sweating, or head injury.

Caregiver Support for Handling Agitation

Caring for someone with Alzheimer's can be exhausting even without agitation episodes. As a caregiver, prioritize your own self-care with help like:

Respite Care

Arrange for temporary relief through adult day programs, in-home care, or short-term institutional care.

Caregiver Support Groups

Connect with other dementia caregivers to share advice and understanding.

Individual Counseling

Work through emotional and psychological pressures of caregiving.

Medical Check-Ups

Stay on top of your own health with regular provider visits and screening tests.

Stress Management

Make time for relaxation practices like exercise, meditation, massage, or hobbies.

Caring for your own needs helps you manage the demands of supervising an Alzheimer's patient prone to agitation.

Creating an Agitation Prevention Plan

Having a proactive plan can help minimize agitation episodes:

Identify Triggers

Track episodes to detect patterns identifying specific triggers to avoid.

Note Effective Responses

Record successful calming strategies tailored to the person's needs.

Train Caregivers

Educate family members and professionals on the prevention plan.

Plan Engaging Activities

Schedule routines involving sensory, cognitive, and motor skills to reduce restlessness.

Ensure Proper Medication Use

Work with the doctor to provide medications appropriately addressing agitation if needed.

Identify Next Steps

Have guidance in place for when to call the doctor, use PRN medications, or transition to higher care levels.

Customizing a plan based on the individual's needs and history can help minimize episodes proactively rather than just reacting after one occurs.

When to Consider Specialized Alzheimer's Care

If severe, frequent agitation persists despite focused efforts, specialized Alzheimer's care facilities may be needed. Consider this if:

• Episodes escalate to violence or self-harm
• Medical and lifestyle approaches have failed
• Caregiver exhaustion is overwhelming
• Wandering or nighttime agitation increases risks

Alzheimer's care facilities offer trained staff, secure environments, activities, and often access to counseling, support groups, and medical care.

Coping With Agitation

Learning to understand, prevent, and calmly respond to agitation can help reduce distressing episodes for the Alzheimer's patient and yourself as the caregiver. But even with excellent care, agitation symptoms may persist or worsen over time as the disease progresses.

In these cases, remind yourself it is the illness causing the behavior changes. Don't take episodes personally. Seek support from loved ones, professionals, and community resources to avoid caregiver burnout.

With preparation, understanding, patience and care, you can help create an environment that minimizes agitation and provides the person with Alzheimer's disease a better quality of life.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.