When people with Alzheimer's have regular or severe periods of agitation it can put unbearable strain on already stressed family relationships. Agitation is very common in people with dementia. Sixty to 80 percent of people with Alzheimer'swill experience it at some point in their illness. Although agitation can be seen at any stage of the disease, it is most common in the moderate stage and tends to decline as Alzheimer's moves into the severe stage.

Early treatment and appropriate medical backup is important. It reduces caregiver burden and can help make significant economic savings as it prevents early hospitalisation and placement in nursing and care homes.

What is Agitation?

The way in which agitation manifests itself is highly individual. The term is used to describe a variety of inappropriate verbal, vocal, and/or physical behaviors. It includes verbal or physical aggression, assault and/or abuse. Examples include; cursing, yelling, screaming, making insulting remarks, grabbing, kicking, hitting, spitting, biting, and destroying property. Also quite common are disinhibited forms of behaviour such as public masturbation, groping or fondling others, public nudity, taking off clothing, swearing and making obscene comments.

Agitation Causes and Triggers

Agitation can be the result of specific or several factors. Identifying situations or events known to cause arousal can help you make adjustments to arrangements in order to prevent or lessen the severity of agitation and its effects on others.

The major causes of agitation include:

• Alzheimer's and the associated physical damage that is occurring in the brain.
• Illnesses such as heart, liver and kidney disease, chest and urine infections, breathing difficulties, malignancy.
• Delirium.
• Post operative states.
• Pain and physical discomfort.
• Medications.
• Sleep problems.
• Psychiatric illnesses. Agitation is associated with paranoid psychosis in about 35 to 50 percent of cases
• Stress. This can include social situations such as visits, appointments and family celebrations. Procedures such as nursing and caregiver procedures like washing, changing clothes, baths and showers or escorting the person to the bathroom.

Treatments for Agitation:

Get professional medical help. They will diagnose and treat any

underlying illnesses or conditions. A team approach is often the most effective. The team may include doctors, nurses, psychologists, neuropsychologists, an occupational therapist and, most importantly, you, the caregiver.

Assess behavior to identify any triggers to the agitated behavior. A thorough assessment of behaviors may help. Use the ABC approach-The ABC's of Managing Challenging Behavior in Alzheimer's Disease. Behavioral treatment approaches are often the most effective. Behavior plans can be carried out by all caregivers involved with the person will Alzheimer's. Consistency is often the key to effective behavioural responses and changes.