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Approaches to Agitation and Aggression with Dementia

During late stages of dementia, a person may experience agitation that can be caused by anything from a reaction to medication to a change in caregivers or environment. 

According to the Alzheimer’s Association, possible causes of agitation in someone with dementia include:

  • Moving to a new residence or nursing home

  • Changes in environment, such as travel, hospitalization or the presence of houseguests

  • Changes in caregiver arrangements

  • Misperceived threats

  • Fear and fatigue resulting from trying to make sense out of a confusing world

  • Different medical conditions

  • Medication interactions

When symptoms of agitation appear in someone with dementia get them in for a medical checkup. It is important to eliminate any treatable medical reason as the cause of their agitation. Once the sources are better understood, then measures can be taken to reduce the behavior.

The Alzheimer’s Association recommends that caregivers and loved ones of people with dementia maintain a calm and relatively quiet environment to prevent or reduce agitation. Also, check on the personal comfort of this individual—are they hungry? Thirsty? Tired?

People with dementia may go from agitated to aggressive to those around them as a lack of addressing causes of agitation can be a source of aggression. The causes for aggression are the same as agitation and therefore the checklist for alleviating this symptom is similar.

Furthermore, do a self-check on your own communication with this person. If you are stressed and irritable the person with dementia may be picking up on that. If you are asking too many questions or repeating the same statement, this can cause aggression. Any instructions you give should be simple and easy to understand. It may be important to use pictures to convey your message as the disease progresses, for example if it is lunchtime, showing a picture of lunch may help convey the message that it is time to eat.

Solving the mystery of what is causing agitation and aggression is the first step in reducing this symptom of dementia.