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My dad has Alzheimer's and always seems agitated. How can I help calm him?

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Updated July 10, 2010

Question: My dad has Alzheimer's and always seems agitated. How can I help calm him?
Answer:

Though caring for any individual with any need can be stressful, caring for someone with dementia can be more so, as it brings with it behavioral problems that can compound the stress. In fact, your loved one's agitation and aggression may even lead you to what feels like a breaking point, when you throw up your hands and say you just can't do it anymore.

There are many causes of agitation and aggression in people with dementia. They may include medical causes (like infections, pain, constipation, and recent medication changes), environmental causes (like too much noise or stimulation, new or unfamiliar situations, tasks that are too overwhelming, or being alone), and sensory factors and other unmet needs (like hearing or visual loss, hunger, thirst, ill-fitting clothing, or boredom.)

While anti-Alzheimer's medications such as Aricept, Exelon and Namenda may help to some degree, non-drug approaches are always worth trying.

In addition to the classic principles of behavior management, many other strategies can be used successfully. The following are all helpful and relatively easy to do. Trying a few may help you better manage your loved one's agitation, hopefully leading to less stress for you.

  • Capture the person's attention; stay in view
  • Limit the number of choices you give
  • Approach in a calm manner
  • Use distractions: food, drink, music, conversation
  • Match what you say with a corresponding action
  • Maintain eye contact and a comfortable posture
  • Identify what is triggering the behavior and modify the environment
Because dealing with an agitated person can be taxing, you may sometimes feel that lying is the easiest route to take. And it's, of course, not uncommon to feel pangs of guilt for doing it, let alone considering it. The truth is that lying to an individual with Alzheimer's can be an appropriate route to take sometimes. You may feel guilty, and that's understandable, but consider the good.

For example, when driving through a part of town, an Alzheimer's sufferer may -- with long-term memory still intact -- insist on stopping in to see an old friend, though you well know that that pal has passed on. In the moment, you might say that you know the friend is on vacation and divert attention toward going for lunch. Without that distraction, frustration could mount.

Other available approaches that have been shown to help with dementia-related agitation and aggression include art and music therapy, exercise, bright-light therapy and aromatherapy.

Sources:

de Quetteville, Harry. "Fake bus stop keeps Alzheimer's patients from wandering off." Telegraph.co.uk, June 3, 2008. Accessed: April 4, 2010.

Teri, Linda et al., "Nonpharmacologic treatment of behavioral disturbance in dementia" Med Clin N Am 86 (2002) 641-56.

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  6. Alzheimer's and Agitation - Tips to Deal with Agitation and Aggression in Alzheimer's Disease

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