Caregivers Can Help Reduce Agitation
Agitation can occur at any point during Alzheimer’s but is the most difficult for caregivers to manage in the mid to later stages. When we see someone with Alzheimer’s in an agitated state we have to remember there can be a number of overlapping causes. Their physiology (the way our body parts function), their mental state as well as social and environmental issues may all or in part contribute to their agitation and then the way they behave. That makes your job harder and can make solutions difficult. You, the caregiver, are going to have to become a detective!
You are going to have to work out, with medical help at times, what works best to make your loved one’s life and yours easier. You are going to have to be flexible because like anyone, causes of agitation and moods change. Alzheimer’s is a degenerative disease so their brain damage increases as time passes.
Lets look at some of the main causes.
Dealing with agitation caused by physical Issues
People with Alzheimer’s are often older so can have co-existing illnesses that can cause agitation. Heart, liver and kidney disease, breathing difficulties, infections such as urinary tract and respiratory infections are just some of the causes of agitation. Pain and physical discomfort is also an important cause. There is evidence that people with cognitive disabilities may have an even higher risk of being under-medicated for pain. Dehydration, poor diet, constipation are also common causes especially constipation.
Action! Medical treatment of disease can cure or improve levels of agitation. Remember people with Alzheimer’s get sick too.
Does you loved one require medication to help deal with their agitation?
Medication can be very effective in treating agitation but requires frequent evaluation by the patient’s medical team. A lot of information is available to show that elders are more sensitive to toxic side-effects and to drug interactions that can cause agitation too.
Treating agitation in the mostly elderly group of people who suffer from Alzheimer's or other types of dementia is very difficult and you need to work with the doctor. Tranquilizers and antipsychotic medications have very powerful sedative effects so your job will be to monitor their mental and physical reactions to the drug so that you can get the balance right.
Environment and social triggers to agitation
Identifying stressful situations or events known to cause arousal that leads to agitation can significantly help people with dementias like Alzheimer’s. Social and environmental causes of agitation can often contribute to psychological distress and this is something you can do something about.
Create routine in everyday life. Routine gives them security and can contribute to some sense of order in their lives. Bathroom trips, times for meals, activities, bedtimes all help create this order.
Prepare them for visits outside the home with simple explanations. Sometimes you may have to rearrange appointments and social situations if their agitation is too acute. If you make visits out part of their daily lives it may be easier for them to deal with changes.
Keep the layout of their rooms the same and make their environment safe to accommodate mobility problems. Valued objects, warmth and comfort all help.
Psychological causes of Agitation
Confusion is a significant cause of agitation and is one of the main symptoms of dementia. Medication may help but so does routine that we talked about before. Touch, an activity they previously enjoyed, a walk in the garden can all help alleviate their distress. Improved communication can help.
Sleep problems, for example sleep deprivation can make agiation even worse and can be very hard to cope with if their levels of arousal are high. Bedtime routines, a bath, food before they retire can all help. Here is a link for caregiver tips on coping with sleep problems and Alzheimer’s
Agitation is associated with paranoid psychosis in about 35 to 50 percent of cases. His or her doctor needs to evaluate any paranoid symptoms your loved one is expressing.
Stress and depression can be a cause of agitation in people with dementia and reducing these symptoms can significantly improve the situation. It may mean you need to reduce visits to or from friends and family temporarily. It can be very stressful for caregivers too getting their loved ones cooperation for doctor’s appointments and procedures like washing and escorting the person to the bathroom.
Frustration and disempowerment can be a cause of agitation
People with dementia are often assumed to be unable to communicate their needs. Institutions and medical care facilities are frequently guilty of this assumption. Try to accommodate any requests and try to encourage their contributions to decisions about clothing, food and activities.
I hope that by identifying some of the issues around agitation that I have given you some ideas. Don’t try to deal with this alone if possible. Medical care, relatives and creating time out for yourself is important so you can stay strong. People with Alzheimer’s will not stay agitated forever. It is just a phase of the illness and it will change. I can give you no timeframe for their agitation but it may help to know that it does subside.