Caring for someone with Alzheimer’s who’s agitated can be stressful. It's normal to feel frustrated or angry. Worse, agitation can turn into aggressive behavior like hitting, pushing, cursing, or screaming. If you think your loved one could hurt themselves, you, or someone else, try these things to help keep everyone safe:
- Keep dangerous things like guns, knives, glass, and sharp or heavy objects out of the house or locked away.
- If you can't calm your loved one down, stop what you're doing and give them space.
- Consider asking someone nearby, like a neighbor, to be ready to help if needed.
- Talk to a doctor or counselor for advice.
It’s a good idea to ask a doctor or counselor for guidance or tips, or get support from others. Your local Area Agency on Aging, Alzheimer's Association chapter, or caregiver support group also might be helpful.
Find Emotional Triggers
To help avoid future episodes, look for possible causes. What happened right before your loved one got agitated?
Were they uncomfortable, in pain, or sick? This could include being:
- Hungry, thirsty, cold, hot, tired, or in need of a bathroom
- In pain
Was there too much or too little activity? They might be:
- Worried about being alone
- Asked to do too much
- Thinking they need to do something because of a memory or something they saw or heard
Were they confused? Did they:
- Have their personal space threatened by a care activity, like bathing or dressing?
- Think something was happening that wasn’t? For example, did they accuse you of things that aren’t true, like having an affair or stealing?
- Forget where things were around the home?
- Not understand what you were saying or what was happening?
- See or hear things that weren’t there?
Did their surroundings or changes in routine upset them? Were they:
- In a noisy room?
- With a lot of people they didn't know?
- Using alcohol, caffeine or drugs?
- Having a change in their normal routine?
- Responding to your emotions?
- In uncomfortable clothes or furniture?
- In a room with too little light?
How to Prevent Future Problems
Once you have an idea of what might be causing the agitation, make a plan and see if it helps. You might need to try several things, and no one plan will always work. If nothing you try seems to help, talk to a doctor or counselor.
- Distract them by going for a walk, giving them a snack, or asking them to help you with something.
- Play their favorite music.
- If they let you touch them, hold their hand, hug them, or give them a massage.
- Let the behavior continue if they’re comfortable and not disrupting others.
- Make changes so the behavior is more acceptable. For example, if they like looking through drawers, put things in the drawers that are safe to sort through.
If they get agitated during personal care activities:
- Slow down.
- Explain what you are doing and why.
- If they can do some things themselves, involve them.
If they’re uncomfortable:
- See if they're hungry, thirsty, hot, cold, tired or in need of a bathroom.
- Make sure their hearing aids are working and they're wearing glasses if they need them.
If they’re in pain or sick:
- Give them acetaminophen or any other medication that a doctor has approved for them.
- If you use acetaminophen, don’t give them more than 3,000 milligrams per day. Ask the doctor first if the person has liver disease.
- If an activity like bathing is painful, give the medicine 2 hours beforehand so that it has time to work.
- Look for signs like weakness, tiredness, not eating, or just not acting like themselves. Check their vital signs at least twice a day. If they are different than usual, talk to a doctor.
If they’re bored or don’t spend enough time with others:
- People with dementia often find it hard to start activities on their own. It helps to plan things for them to do.
- Think about activities linked to their interests and past experiences.
- Try going for a walk, singing with others, listening to favorite music, and looking at old photo albums or catalogs.
If there was too much or too little activity:
- Don’t rush or correct them.
- Stay away from busy, crowded, and strange places.
- Keep activities short, and give them time to rest afterward.
If they’re confused:
- Put labels and pictures around the house to help them find things, like the bathroom.
- Use short, simple sentences, and give them time to respond.
If their agitation is caused by their surroundings:
- Speak as softly and calmly as you can. If it’s safe, step away for a few minutes if you need to.
- Turn off outside noise like the radio or TV when talking with them.
- Help your loved one stick to a daily routine and sleep schedule as much as possible.
- Help them limit or avoid alcohol and caffeine.
- Use brighter lighting indoors, especially at night.