Start with a calm, practical plan: identify and treat possible causes, use simple reassuring communication and routines, reduce triggers in the environment, offer gentle activities and comfort measures, and involve health professionals if agitation does not respond to these steps. [3]
Why agitation happens and what to check first
– Agitation is often a reaction to unmet needs, discomfort, infection, pain, dehydration, medication side effects, or environmental triggers rather than deliberate behavior[3][6].
– Before trying behavioral strategies, rule out physical causes by checking pain, fever, constipation, thirst, recent medication changes, or signs of infection and seek medical review when needed[3][6].
How to communicate and respond in the moment
– Speak slowly, use short simple sentences, and keep your tone calm and reassuring; avoid arguing or correcting the person[1][3].
– Use validation: acknowledge feelings rather than insisting on factual accuracy (for example, say “You look upset, I am here with you” instead of “That is not true”), which reduces anxiety and conflict[4].
– If an episode is escalating, move slowly, keep eye contact at their level, and offer a concrete redirection such as a drink, a familiar object, music, or a short walk[1][3].
Practical home changes to lower baseline agitation
– Maintain a predictable daily routine for meals, bathing, medication, rest, and activities; consistency reduces anxiety[1][7].
– Create a calm environment: reduce noise, dim harsh lighting, remove clutter, and provide comfortable seating and familiar items[1][3].
– Minimize triggers: avoid crowded or noisy places, keep transitions slow and explain one step at a time, and break tasks into small, manageable parts[3].
Comfort measures and nonpharmacologic strategies
– Use familiar music, photo albums or reminiscence to soothe and connect[1][2].
– Offer easy sensory activities: folding towels, stroking a soft blanket, gardening tasks, or simple puzzles depending on ability[1][2].
– Encourage gentle physical activity such as walking or chair exercises to reduce restlessness and improve mood[2][3].
– Ensure sleep hygiene: daytime activity, limiting caffeine, and a calm bedtime routine help lower evening agitation (sundowning).
Safety and de-escalation techniques
– If the person becomes aggressive, prioritize safety: step back, keep a calm voice, remove potential hazards, and if needed move yourself to a safe place[3].
– Do not restrain unless absolutely necessary and trained to do so; restraint and force commonly increase fear and escalation[3].
– Have emergency plans and numbers accessible and discuss with other caregivers how to respond so approaches are consistent[3].
When medication or professional help is needed
– Nonpharmacological approaches are the first line; medications are considered when agitation is severe, dangerous, or not responding to other strategies and must be managed by a clinician because of risks and side effects[6][2].
– Review current drugs with a clinician or pharmacist since side effects or interactions can cause agitation; adjust or address reversible causes where possible[6][3].
– Consider specialist input (geriatrician, psychiatrist, occupational therapist) for persistent problems, and join caregiver support or training programs to learn techniques like validation therapy[4][8].
Support for caregivers
– Caregivers commonly feel overwhelmed; seek support, respite, and education because caregiver stress worsens outcomes for both the caregiver and the person with dementia[5].
– Keep notes of when agitation happens, what preceded it, and what helps; this log helps clinicians identify patterns and effective strategies[3].
Sources
https://healthathome.care/blog/how-to-care-for-a-senior-with-dementia-at-home/
https://www.carehome.co.uk/advice/effective-dementia-treatments-medications-and-therapies
https://www.dementia.org.au/living-dementia/mood-and-behaviour-changes/agitation-and-aggression
https://www.seniorliving.org/health/validation-therapy/
https://www.agingresearch.org/alzheimers-agitation/
https://www.droracle.ai/articles/536902/what-is-the-best-approach-to-manage-agitation-in
https://doralhw.org/daily-routines-for-dementia-how-a-simple-schedule-can-cut-anxiety-and-agitation-in-half/
https://my.clevelandclinic.org/health/diseases/9170-dementia
https://www.hmpgloballearningnetwork.com/site/pcnpi/how-i-treat-agitation-versus-mania-alzheimer-disease-due-medication-side-effects
