Activities for Agitation for Middle-Stage (Moderate) Alzheimer’s Dementia
Caregivers report that some of their greatest challenges come from the mood, personality, and behavioral changes that can occur in their loved one with Alzhemier’s.
Agitation is a common symptom of dementia and can be distressing for both the person experiencing it and their caregiver*. You might notice signs such as restlessness, irritability or even verbal outbursts. Engaging in stage appropriate activities can help reduce distress and restore a sense of comfort for your loved one. The following are some stage appropriate activities for loved ones in the middle-stage of dementia where they tend to need direction for most activities throughout the day. (Separate conversations are available for those with early or late-stage illness.)
Music Therapy:
Do you have a favorite song that immediately takes your mind elsewhere? Music is a universal language and can help an individual with Alzheimer’s disease, too. It is often effective in the moderate stage while long-term memory is still strong. Create a playlist of favorite songs and have them ready to play using a stereo speaker or headphones. If you prefer to sing, write out the lyrics and sing together. Research shows that listening to music or singing reduces agitated behaviors in people with dementia.
Reminiscence Therapy:
I call this “change the subject”. While you always want to validate any emotion, someone with Alzheimer’s disease may need gentle prompting to stop their brain from dwelling on the upsetting event or issue. Consider, “I don’t blame you for being upset about that, but I was thinking of that trip to the Grand Canyon. Did you like the hike we did? Asking a leading question, you know will bring up happy memories and can redirect anxiety into calm. You might need to have some questions ready, or you can have a stack of photo albums or old family videos ready to use to move those upset emotions to a better place. While formal evidence on agitation is limited, reminiscence therapy has shown benefits like reducing depression and improving quality of life in people with mild-to-moderate dementia.
Animal-Assisted Therapy (Pet Interaction):
Are you pet people? Multiple studies have found that engaging with animals significantly reduces agitation and aggressive moods. And even if you aren’t “pet people,” since the brain is changing, you may still want to try it. Supervised interaction is best even with a family pet since someone with Alzheimer’s disease may have difficulty knowing what to do if the animal does something unpredictable. There are also “therapy” animals, typically dogs and cats, who have trained owners skilled in creating positive interactions.
Montessori-Based Activities:
The Montessori method involves adapting activities to the person’s ability at the time to give a sense of purpose and success. Researchers found it led to a significant decrease in agitated behaviors. The tasks need to be straight-forward and “failure-free” (to the extent possible) for this current stage tasks tailored to their interests – for example, sorting coins, folding towels, sweeping a small area, sorting recipe cards or family photos with a written 1 page of instructions to guide the task. Think of “hands-on/upset off” and find activities that require focus and repetition for the best results.
Aromatherapy (Calming Scents):
First, an important note when this might not work: some individuals with Alzheimer’s disease, their sense of smell is reduced, and for others, allergies make this unwise. However, using soothing aromas in the environment has been shown to calm agitation for others. For instance, diffusing lavender essential oil in the afternoon or applying a lotion with lemon balm oil has been effective for dementia behaviors. To try this, use a few drops of lavender oil on a cloth or an aromatherapy diffuser to promote relaxation.
*For a general understanding of why moodiness is so common and how to manage it, see this article: https://nanforcaregivers.com/resources-blog/managing-difficult-behaviors
Remember, your NAN Navigator is here to support you and is available to guide you through the process.
