What Causes Agitation During Transitions In Dementia
People with dementia often get upset or restless when moving from one activity to another, like going from eating dinner to bedtime or leaving the house for a doctor’s visit. These moments of change, called transitions, can spark agitation because the brain struggles to handle the shift. The person’s memory and thinking skills fade, making it hard to understand what’s happening next, which builds frustration and fear.
Brain changes play a big role. In Alzheimer’s, a common type of dementia, parts of the brain that control emotions, like the amygdala and prefrontal cortex, break down. This makes it tough to manage feelings or impulses, leading to sudden anger or anxiety during changes. Chemicals in the brain, such as serotonin, norepinephrine, and dopamine, get out of balance too. Too much norepinephrine or misplaced dopamine can overstimulate emotions, while low serotonin fails to calm things down. These issues hit deep brain areas for feelings, not just memory spots, so transitions feel overwhelming.https://www.patientcareonline.com/view/understanding-agitation-in-alzheimer-s-why-memory-care-isn-t-enough-with-carolyn-clevenger-gnphttps://optoceutics.com/3-types-of-behavioral-triggers-alzheimers-dementia-disease/
Everyday triggers make it worse. Too much noise, bright lights, or clutter during a transition can flood the senses, causing confusion. Unmet needs like hunger, pain from something like a urinary tract infection, or tiredness add to the stress, since the person can’t easily say what’s wrong. Emotional factors kick in too, such as fear of the unknown or anxiety about losing control. If a caregiver seems rushed or frustrated, that tension spreads.https://optoceutics.com/3-types-of-behavioral-triggers-alzheimers-dementia-disease/https://allaireelderlaw.com/articles/understanding-dementia-related-agitation
Timing matters as well. Late afternoon or evening transitions often trigger stronger reactions, known as sundowning. The brain gets tired after a full day, sleep patterns mix up, and old routines like heading home from work confuse the mind. Overstimulation earlier in the day builds up, turning into pacing or yelling by dusk.https://www.melodiacare.com/understanding-and-managing-sundown-syndrome-in-hospice-care/https://floridaseniorconsulting.com/when-dementia-becomes-dangerous-signs-its-time-for-memory-care/
Task-related issues stand out during transitions. If the next activity feels unfamiliar or unwanted, like bathing or changing clothes, resistance grows into outbursts. The person might wander, yell, or push away because they can’t process the change or express discomfort. When language skills decline, these feelings come out as agitation instead of words.https://allaireelderlaw.com/articles/understanding-dementia-related-agitationhttps://australiancarersguide.com.au/how-does-dementia-cause-changes-in-behaviour/
Sources
https://www.patientcareonline.com/view/understanding-agitation-in-alzheimer-s-why-memory-care-isn-t-enough-with-carolyn-clevenger-gnp
https://optoceutics.com/3-types-of-behavioral-triggers-alzheimers-dementia-disease/
https://allaireelderlaw.com/articles/understanding-dementia-related-agitation
https://floridaseniorconsulting.com/when-dementia-becomes-dangerous-signs-its-time-for-memory-care/
https://www.melodiacare.com/understanding-and-managing-sundown-syndrome-in-hospice-care/
https://australiancarersguide.com.au/how-does-dementia-cause-changes-in-behaviour/
