People who have Alzheimer’s often go through changes in their emotions and behavior as the disease progresses. Agitation is very common. They may be restless and worried at times, both because of physical changes in their brain and also as an expression of frustration and anxiety about their condition. It can be disruptive and hard on you as a caregiver. But there are ways you can prevent it and manage it when it happens. 

Something physical could be causing your loved one’s behavior symptoms, like a urinary tract infection or a bad reaction to a medication. Make an appointment to have their doctor examine them, especially if the agitation is new or has come on suddenly. If there’s a medical problem, treatment for it could resolve the behavior.

Take time to notice what things trigger agitation in your loved one, and try to avoid them. Is it noise? Boredom? Make their home a calm, soothing environment without things that cause stress. Surround them with familiar objects and family photographs. Try turning off the TV. Once you’ve identified triggers, get their other caregivers on the same page, so they know what to watch out for and what works to calm agitation. 

Life may be easier for someone with Alzheimer’s if the day’s activities are on a predictable schedule. Sometimes a break in the routine can’t be helped. But try to prepare your loved one if you’ll be taking them to an unfamiliar place or meeting new people.

Your loved one may not be able to communicate to you when something doesn’t feel good, so it helps to anticipate what can make them uncomfortable. Make sure they’re eating, drinking, and using the bathroom regularly. Check for tight clothing or anything else that might cause pain. Keep the temperature comfortable, and build in plenty of time for rest in their daily routine.

Sometimes the person you’re caring for just won’t cooperate. If it’s possible, try to go with the flow. Do they really need to get dressed right now, or can they stay in pajamas a few more hours? Make tasks as easy as possible, and offer simple choices to help your loved one keep a sense of control. Memory loss can be frustrating for both of you, but don’t try to push them to remember something. You may only make the situation worse. 

Agitation can stem from boredom. Physical activity can help, like taking a walk outside, working in the garden, or dancing. So can creative activities like art. Your loved one may miss getting together with friends and could benefit from a social outing. For times when you’re stuck somewhere – like a long car ride or a doctor’s waiting room – a box of small, meaningful objects they can hold and handle can be a good distraction. 

Too much caffeine can make even healthy people cranky and restless. The science is mixed on caffeine and dementia. There’s some clinical evidence it could help protect against cognitive decline and slow the progression of Alzheimer’s, but it can also increase symptoms like anxiety. In the middle to late stages of Alzheimer’s, anxiety may show up as agitation. If the person you care for drinks a lot of coffee, it’s worth cutting back to see if it helps.

Be on alert for signs that your loved one is getting agitated, and step in quickly so it doesn’t get worse. Try to stay calm and positive. Slow down whatever is happening. If you’re in a crowded place, it may help to move somewhere quieter. See if you can distract them by talking about something pleasant. A gentle touch or massage may soothe agitation. 

When your loved one becomes agitated, try talking to them to see if they can express why they’re upset, and whether it’s something you can fix. Understand that they may not be able to explain what they’re feeling. In that case, try to reassure them that they’re safe, and let them know that it’s OK to be sad or frustrated. 

You may already turn to music to boost your mood or help yourself relax. Several studies have looked at its effects on people with cognitive impairment, like Alzheimer’s. They’ve found that whether it’s formal music therapy or just listening to favorite tunes, music can reduce agitation. 

If your loved one is agitated often and has become very disruptive or even dangerous, you may need to try a medical option. The antipsychotic drug brexpiprazole (Rexulti) became the first medication specifically approved to treat agitation in people with Alzheimer’s dementia in May 2023. Other antipsychotics and certain antidepressants are sometimes used. But be aware that some drugs can raise the risk of falls, heart problems, and stroke. And antipsychotics carry a black box warning for an increase in the risk of death in older patients with dementia. 

While it’s understandable to be frustrated with your loved one’s behavior changes, it won’t help to lose your cool. Remind yourself that they can’t help what’s happening. Get backup care lined up so you can take a break when you need to. A support group, either in person or online, can give you a place to vent and pick up tips on dealing with certain situations.