When someone with Alzheimer's becomes agitated it is good to have a number of strategies and activities on offer. Highly focused tasks such as baking, crafts or art work, tend not to work because trying to keep someone with Alzheimer's 'on task' usually increases their tension and anxiety. Frequent re-direction may be seen as highlighting their deficits, being bossy, or it just adding to their confusion of what is happening to them and around them.
If there appears to be no apparent cause of physical of their agitation such as illness or pain, the need to go to the bathroom, constipation, or other issues such as incontinence, hunger, thirst, too much noise or discomfort from being too hot or too cold, then it may help to use a calming strategy. Here are 10 options:
1. Reassurance is one of the most important caregiver tools. Make them feel safe and loved.
2. Soft talk and brief sentence content. Effective communication is another central caregiver tool to help reduce agitation.
3. Distraction activities. Do activities you know they'll enjoy but that are not too challenging. If one activity is not working try another. If it is still not working it may be over-stimulating and adding to the problem. Here is some more information on making therapeutic activities work better for people with Alzheimer's.
4. Offer tasty foods and drinks. Sweet food and drink that you know they enjoy is very effective. If their agitation means they are on the move a lot they need more calories. Try to get them to sit down in a comfy chair for their snack to prevent exhaustion and help them relax. Offering a selection of stronger tasting foods in small pieces can make the activity last longer.
5. Soothing touch such as hand massage, hair brushing, pats and stroking can all help people with Alzheimer's feel more relaxed and safe.
6. Gentle walk in the garden (weather permitting). Exercise with a caregiver or friend often works very well. Dress them to suit the conditions and for comfort. Go into the garden rather than to a busy area where noise and movement may increase agitation.
7. Play gentle music and sing. Familiar songs that people will often be able to recall even when their Alzheimer's is in its later stages can work very well. It promotes a feeling of wellbeing and the social interaction between the caregiver and the agitated person is often therapeutic for both parties.
8. Help them have a bath. Use bubbles and nice smells if they like them. A warm bath before bedtime is sometimes enough to calm them and promote a good night's sleep.
9. Animal interactions: There are numerous sources of anecdotal information and research material that show animal petting can help people with a number of different neurological conditions. I have worked in facilities that used placid and friendly dogs and cats to reduce agitation, increase verbal and social interaction in people who had many different types of brain damage with very positive results. This type of soothing activity is one that caregivers can easily do using family pets.
10. Encouraging rest or naps. Obviously this can be a difficult soothing activity to promote. Agitation can be the result of disrupted sleep patterns. Exhaustion from too much physical activity can also be a problem so if you can encourage them to sit down and take a short nap it may help. Improving their patterns of sleep may be the answer. Consult his or her doctor for help if you think this seems to be the problem. Medication may help.
Medical Help for Agitation
Agitation is very common in people with Alzheimer's. Over time agitation usually reduces but can be very difficult for caregivers to cope with. Caregivers must always seek help if the agitation is a new 'symptom' to discount a disease or condition. Many if successfully treated can lessen or stop behavioral problems.
Constipation is one of the most common and easily treated cause of agitation, as are urinary tract and chest infections.
Cantley C. (2001)The Handbook of Dementia. Open University Press. Philadelphia
Chandler C.K. (2005) Animal Assisted Therapy In Counseling Taylor Francis