People with Alzheimer’s disease can get anxious or upset easily. They might be restless, unable to sleep, or pace back and forth. These problems, called agitation, can keep them from a normal day-and-night routine and might become harmful for your loved one or her caregivers.
Often, change is the biggest trigger of agitation. It might be a difference in her routine, surroundings, or the caregivers she sees. Sometimes, it comes from fear or fatigue, which are common with Alzheimer’s. In some cases, agitation can happen because of an infection or another medical problem.
Sundowning, or sundown syndrome, affects some people who have Alzheimer's disease and dementia. People with dementia who "sundown" get confused and agitated as the sun goes down -- and sometimes through the night.
Sundowning may prevent people with dementia from sleeping well. It may also make them more likely to wander. Due to the stress it puts on caregivers, sundowning is a common cause of caregiver burnout.
If your loved one is agitated and you can’t figure out the reason, take her to the doctor to see if he can find the cause.
You may be able to lessen the agitation by simplifying her routine or distracting her from the stress that caused the problem. A few things to try:
Create a calm place for her. Cut out background noise from the TV or radio, clear away clutter, and make her daily tasks as simple as possible.
Check for physical reasons she might be agitated, like hunger, thirst, needing to use the bathroom, or being too hot or cold.
Exercise can ease anxiety and stress. Take her for a walk, do some gardening, or put on her favorite music and dance.
Use low lighting or night-lights to help her feel less confused and afraid at night.
Keep your emotions in check. You may feel frustrated, but try to keep your voice calm and steady and avoid arguing or criticizing her.
If you can’t stop her agitation on your own or the problem is very severe, the doctor may recommend medications that can help.
The drugs he prescribes will depend on your loved one’s symptoms. But common ones that can ease agitation include:
Medicines that treat paranoia and confusion, called neuroleptics or antipsychotics. Examples of these are aripiprazole (Abilify), haloperidol (Haldol), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). These drugs can cause side effects, like drowsiness, rigidity, and unusual movements. Studies have linked some of these to a higher risk of death for people with dementia. The FDA has placed a "black box" warning on these drugs describing the risks. Ask the doctor if they’re a good choice for your loved one.