Coping with Agitation
Dear Caregivers,
Alzheimer’s is a complicated disease. The symptoms we see in our loved ones reflect damage to different parts of their brain, including areas other than those involved with memory and thinking clearly. For example, areas that can also be compromised include those that control emotion, and those that are responsible for creating a person’s personality. This damage can result in unusual and unexplained feelings of fear and irritation in your loved one. Worse yet, the ability for your loved one's brain to rationally cope with those emotions become hampered, weakening the “emotional brakes” that can help control a bout of anger, anxiety, or impulsive behavior.
Bouts of agitation can come unexplainably and without warning, or they might be triggered by lack of sleep, the pain from an infection, side effects from medication, or environmental stressors such as loud noises and bright lights.
The strategies for dealing with agitation include:
Practice Prevention: Take steps to prevent the triggers that might cause agitation in your loved one, such as keeping a regular routine and striving to remove any potential environmental triggers such as loud noises or flashing lights.
When agitation occurs, validate your loved one’s feelings: Calmly address their concerns by focusing on the emotion, and not on the facts of the matter. For example: If your loved one is upset and worried about a missing wallet, focus on consoling them and showing empathy that a wallet has been misplaced by saying, for example, “I understand, Mom. It is important to know where your wallet is.” The actual process of finding the wallet can take place later.
Always keep safety in mind, for you and for your loved one: In some cases, it may be better to let your loved one be upset for a bit without trying to intervene, and the emotion will sometimes pass. But also be aware of the potential for the agitation to be sometimes directed at a certain person, including you, and be prepared with a plan of action.
Your NAN navigator can give you expert advice on how to address the specific ways agitation may be impacting your loved one, and how to cope.
Through it all, keep in mind that your loved one’s agitation is not a manifestation of their simply “being difficult”; rather, it is due to the damage to the parts of their brain that control their emotions. Your loved one may be having difficulty understanding something, or may be having a thought that is completely mistaken, but nonetheless the situation is causing them to be upset. Whatever the case, when they also lack the means to express what that may be feeling, a display of irritation or agitation may be the result. Empathy, not frustration, is a key to weathering their emotional storm.
Here are some more resources on how to cope with bouts of agitation:
Activities for Agitation for Early-Stage (Mild) Alzheimer’s Dementia:
Agitation is a common symptom of dementia: In the early stages, you might notice signs such as increased irritability, unexplained anxiety, restlessness, and rapid mood swings. Here’s guide to activities that can help reduce distress and restore a sense of comfort for your loved one.
Activities for Agitation for Middle-Stage (Moderate) Alzheimer’s Dementia:
Agitation can be distressing for your loved one and for you. Symptoms include restlessness, irritability, and even verbal outbursts. Engaging in appropriate activities can help reduce distress and restore a sense of comfort for your loved one. Here’s how to cope.
Activities for Agitation In Late-Stage (Severe) Alzheimer’s Dementia:
In the late stages of Alzheimer’s you might notice signs such as increased restlessness, shouting, pacing, aggression or rapid mood swings, or less obvious clues such as tugging at sheets or clothes. Any one of these signs can be of concern, and here are some calming activities you can implement to help minimize your loved one’s distress.
Best,
Rosemary D Laird, MD, MHSA
Founder and Chief Medical Officer
“He who angers you conquers you."
— Elizabeth Kenny
