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The challenges of caring for someone with Alzheimer’s disease can be daunting and leave you searching for answers. One common complication of Alzheimer’s disease that can be challenging is agitation, feelings of anxiousness, and anger that are accompanied by aggressive words and behaviors.
If you’re a care partner, you may be looking for ways to help prevent episodes of agitation and calm a person if agitation does set in. Exploring different resources and strategies can help you better navigate your role as a caregiver.
Boredom is often at the root of agitation, especially for people with Alzheimer’s disease who are confined to a skilled nursing facility and spend much of their time in their own room. Consider occupying a person’s time and attention with household tasks (folding clothes, watering plants, etc.), walking and other exercises, reading, hobbies, and other activities.
A 2021 study suggests that a combination of different activities may be more effective in curbing agitation than focusing on one or two activities only.
In 2023, the Food and Drug Administration (FDA) approved the first medication specifically meant to treat agitation in people with Alzheimer’s disease or other types of dementia. The oral medication is brexpiprazole. It works by helping restore balance to certain brain chemicals involved with mood regulation, such as serotonin and dopamine. Consult with a doctor to see whether brexpiprazole may be a safe and effective treatment.
Other medications, including antipsychotics and antidepressants, may be helpful in reducing episodes of agitation.
3. Keep it simple and on schedule
Because someone with Alzheimer’s disease can feel easily overwhelmed by too many choices and too much activity, do what you can to streamline their daily routines. Give the person more either/or choices for what to wear or what to eat, rather than a long list of options.
And having a routine is also helpful as it gives the person a sense of security and predictability. If exercise time is right before lunch, do what you can to stick to that schedule. If the routine has to change, for a doctor’s appointment or other reason, remind the person that this is a minor schedule change just for the day.
A 2022 study suggests that insomnia and other sleep disturbances are associated with worsening Alzheimer’s disease symptoms, including agitation. To the extent possible, try to help the person in your care get sufficient sleep quality and quantity. That may mean investing in a new, comfortable mattress and creating an environment conducive to better sleep — cool, dark, and quiet.
5. Get to the root of the problem
In some cases, agitation and anxiety seem to spring up from nowhere. However, the National Institute on Aging suggests that there are usually reasons for the change in mood and personality. By paying close attention and asking questions gently and not demanding answers, you may be able to identify underlying problems and either address them in the moment or make changes to prevent future moments of agitation.
Some common agitation triggers include:
- change in the schedule
- clutter
- feeling overly tired or fatigued
- hunger
- noise
- pain
- soiled or wet underwear or diaper
- thirst
- too many visitors or people around
- unfamiliarity with surroundings
At the first signs that agitation may be taking over, try some proven calming strategies, such as playing favorite music or taking a walk outdoors for some fresh air and sunlight. Reacting before a person becomes too upset may prevent an especially difficult episode. Be aware, however, that sudden changes in activities or location may not go over well, so ease into a change if possible.
With so much of your focus on the person in your care, it can be easy to overlook the stress on your own health and well-being.
A 2022 report gathered data via a survey from 200 caregivers for individuals with Alzheimer’s. The results indicated that almost 48% of the care partners reported becoming sleep-deprived, while 43% reported they have become more socially isolated from friends and family after taking on their caregiving duties.
Given these and other concerning statistics, researchers emphasize the importance of building a support system for you — the caregiver.
Do not hesitate to reach out to friends and family members for help, either to assist with tasks you can’t make time for or to take on some of the caregiving responsibilities if appropriate. You can use any freed-up time for self-care activities or to attend local or virtual caregiver support groups.
Agitation and aggression, especially coming from a person who may have been quiet and gentle before Alzheimer’s disease developed, can be an upsetting development. However, if you can help someone get through those periods or create daily routines that make those moments less likely to occur, you will be doing so much for the well-being of the person and yourself.
The National Institute on Aging also provides a wealth of resources for caregivers, including home health services and ways to create a support plan for yourself and the person in your care.
The Alzheimer’s Association is also an excellent resource for information about Alzheimer’s disease, treatments, and coping strategies for agitation and much more.