Some individuals with Alzheimer’s or another form of dementia can become apprehensive and agitated. In some cases, they may feel frustration, anger and anxiety because of deteriorating memory and communication abilities.
If your family member has Alzheimer’s, you may find that he or she at times misunderstands things people say and, as a result, becomes disturbed or suspicious. Inhibitions may be lowered due to the disease, and the individual may display undesirable behavior such as laughing in inappropriate situations, yelling or even acting violently.
The Alzheimer’s Association notes that such agitation also may manifest as an individual seeming restless, pacing or moving around, and appearing to be upset in certain situations and locations.
Aggression among dementia patients is relatively common, with up to half of the 4.5 million Americans diagnosed with the disease annually displaying agitated behaviors at times. For family members, it’s important to understand why agitation can be a hallmark of dementia and steps they can take to keep their relative calm.
Why Does Agitation Accompany Dementia?
Medical experts cannot cite with certainty the reasons that some people with dementia become agitated, but research has shown that recognition of problems — such as forgetting information that used to be known — plays a significant role. Individuals often become frustrated as they notice the progressive loss of previous faculties like memory.
Physical symptoms also can bring on agitated behaviors. For instance, some individuals with Alzheimer’s or dementia may exhibit agitated or violent behaviors due to medication side effects, including nausea, headaches and constipation. In individuals who are unable to communicate, combative behaviors may become even more pronounced as part of an effort to show discomfort.
Medical problems other than medication side effects also can cause problems. In addition, changes in environment — such as traveling or moving in with a family member — can cause agitation and anxiety.
In some cases, understanding exactly what triggers episodes of agitation or lashing out may be extremely difficult and may require patient observation and advice from a medical professional.
Responding to a Family Member’s Discomfort
The first step in calming down a relative with dementia or Alzheimer’s is determining the source of the discomfort. Could the individual be hungry, thirsty, cold or otherwise physically uncomfortable? Has something in the environment changed that could be causing the disturbed state?
In some cases, an individual may remember a danger from a previous time in life and lash out in self-defense without realizing the safety of the present moment.
If your friend or family member becomes upset, hostile or abusive, you can consider a variety of techniques for making her feel calm. Understanding the disease process and how to approach individuals with dementia can help you gain control of the situation. Organizations like the Alzheimer’s Association can provide support.
Always approach your loved one in a calm manner and use a quiet speaking voice. If the individual is extremely agitated, consider leaving the room for several minutes after making sure he is safe. When you return, use a calm, positive greeting and start the conversation again.
In addition, consider strategies including:
- Identifying common situations, people and places that lead to anxiety in your family member. Once you know these common triggers, you can try to make the transitions less jarring. For instance, if your relative does not like going to the doctor, you can ease into the trip with a series of small steps.
- Using a gentle approach, including telling your relative that her feelings are okay. Smile, use soft touches, and try to appear kind and relaxed to the person to signal that everything in the environment is fine.
- Making signs and labels to indicate the use of various rooms and household items, along with names of visitors.
- Implementing a regular schedule to curtail unexpected trips and other potentially stressful events.
- Playing familiar music, including classical pieces or old show tunes. Experts say that music can help control many behavioral issues and may be especially useful during meals or baths. You can either play recorded music or sing.
- Leaving the room during angry outbursts, taking care that the individual will not harm herself.
- Keeping your sense of humor. If you’re providing care for a relative with Alzheimer’s or dementia, you no doubt will experience highs and lows. By preserving your patience and your sense of humor, you’ll better deal with problem behaviors. Don’t forget that the disease — rather than your relative — is causing the agitation and unpleasant behaviors.
Diagnosing Underlying Mental Health Conditions
Although there are numerous steps you can take to deal with agitation once it occurs, you also can consider measures that can help minimize the chances of any negative feelings or behaviors developing.
In many cases, an individual may be suffering from a mental health condition such as depression or anxiety as the dementia begins to take its toll. As many as 40 percent of individuals with Alzheimer’s are likely to suffer from depression at some point.
While some anxiety and agitation can result from the sense of loss of faculties including memory, the condition is more complex. Alzheimer’s causes physical damage to the brain cells that influence moods, and feelings of anxiety and depression can result. Because the feelings occur directly from physical changes due to the disease, prevention of anxiety, depression and resulting agitation may not be possible in all cases.
In the case of clinical depression, getting the right medical diagnosis isn’t always easy because symptoms — including loss of interest in previously enjoyed activities, sleep problems, and isolation — can mimic those of dementia itself. In addition, someone with dementia may not retain the full ability to express feelings.
To help avoid agitation and acting out, it’s important to work with a trusted doctor who can accurately diagnose any underlying depression or anxiety.
Stopping Agitation Before It Starts
Once you and your family member’s doctor have identified and treated any underlying mental health issues that may be contributing to hostile feelings and behaviors, you can take preemptive steps to help your relative to remain calm. The best time to implement preventive measures, when possible, is before negative behaviors begin.
As you begin implementing measures to keep your family member calm, constantly evaluate the situation. How is the individual’s demeanor? Do certain activities or locations seem to trigger apparent anxiety? How does the individual behave when different people enter his dwelling?
Remain watchful for any signs that your relative is uncomfortable. Is she hungry or thirsty? Does she need to visit the toilet? Look for any signs of illness, including irritated skin or infections. Keep her room at a temperature that is not too hot nor cold, and talk to her calmly if she seems to be fearful or frustrated.
If your relative is physically able, try to get out and exercise. For example, you can go for short walks in a natural environment like a park, work in a garden, or even dance to favorite music.
After an incident of agitation or hostility, take time to consider the possible causes so you can prevent a similar situation in the future. If your own emotions contributed, consider how you can react differently the next time. With patience and practice, you can learn how to keep situations in which your relative is upset under control and help him remain calm in different settings and with different people and activities.
Aggressive Behaviors May Subside
In some dementia and Alzheimer’s patients, hostile behaviors represent a phase that will pass in time. While dementia can’t be cured, some individuals suffering with the disease do move past aggressive feelings and actions.
However, feelings of agitation and related behaviors may last for several years, which can cause significant strain for family caregivers. Many families look to memory care communities for a compassionate, supportive environment.
Maryland Memory Care
Gull Creek offers an intimate memory care neighborhood setting to provide needed support for individuals with Alzheimer’s and other forms of dementia. Highly trained, compassionate staff members provide assistance as residents enjoy a secure environment that promotes independence and vibrant living. To learn more about memory care in Berlin, Maryland, please contact us today.