Agitation In Dementia: What Works & What Doesn’t
According to Alzheimer’s Disease International, “someone in the world develops dementia every three seconds.” There is an estimated one in nine people living with dementia, and the prevalence is predicted to increase in the coming years. As the population ages and dementia becomes more common, learning how to provide effective, compassionate care is more important than ever.
This article explores what causes agitation in dementia and which caregiving strategies help, as well as those that may make things worse.
To learn more about caring for a loved one with dementia and connect with other caregivers, check if you have free access to Trualta.
What Is Dementia?
Dementia is a progressive neurological disease affecting the brain, most often in older adults. It makes it difficult for brain cells to communicate with each other and with the body. This condition leads to a mental decline that can impair a person’s ability to complete daily tasks, communicate, and live independently.
There are four main types of dementia:
- Alzheimer’s Disease
- Lewy Body Dementia
- Frontotemporal Dementia
- Vascular Dementia
Behavioral symptoms for dementia can vary from person to person. Symptoms often begin mildly and worsen as time goes on. Someone with dementia can experience some or all of the following:
- Memory loss
- Agitation and aggression
- Difficulty communicating
- Wandering
- Trouble with daily activities
- Difficulty recognizing familiar faces or places
- Confusion or disorientation
Why Does Agitation Occur With Dementia?
Agitation can result from environmental triggers, the person’s physical or emotional condition, or chemical changes in the brain.
Some triggers for agitation include:
- The environment. Loud, overstimulating, or unfamiliar environments can be a common cause of agitation and confusion.
- Personal unmet needs. If someone with dementia is hungry, over-tired, or has to use the bathroom, they can become agitated.
- Psychological stress. Anxiety, fear, and depression can lead to agitated episodes.
- Frustration with communication. As the disease progresses, language may decline or become more difficult for them to use, leading to frustration and agitation.
- Medical problems. Any major change in a medical condition can lead to increased agitation. For example, if your loved one is in pain, constipated, or becoming sick, they may have a hard time communicating these feelings. This may lead to increased episodes of agitation.
If you’re a caregiver for someone with dementia, it’s likely that at some point you will encounter agitated behaviors. Knowing different skills and strategies allows you to try different techniques to manage these behaviors.
Managing Agitation In Dementia
Managing agitation in dementia involves several key areas: communication, environment, daily routines, and sometimes medication.
Communication Strategies
Verbal and nonverbal communication with your care recipient plays a big role in keeping them calm. The way you speak to your loved one can have a big impact on reducing fear, confusion, and anxiety.
| What Works | What Doesn’t Work |
| Use a calm and relaxed tone. Maintain eye contact. Speak slowly and directly. Ask them to tell you how they’re feeling. This will allow them to name their emotions and try to express themselves. Validate what they’re feeling, even if it’s not real.When needed, repeat information clearly and concisely. Give your care recipient time to respond. Maintain a relaxed and calm body language. Stand at an angle to them. Do not block them when you are speaking to them.Sometimes, gestures can be helpful in conveying a point. For example, if your loved one is confused about their daily routine when it’s time to get cleaned up, gesturing to the shower can help communicate what is happening next. | Avoid yelling or arguing. Don’t speak over them.Be careful not to talk in a way that sounds mean or controlling.Avoiding open-ended questions can be helpful. For example, give them choices like “Would you like to take a shower or a bath?”Don’t use complex directions.Don’t ignore them. Acknowledging that they’re upset is key. Do not use threatening nonverbal behavior, such as making a fist with your hands or getting in their face when they’re upset. |
The Environment
As humans, we all take cues from our environment. This is especially true for people with dementia, who can be easily overstimulated or overwhelmed by their surroundings.
| What Works | What Doesn’t Work |
| Keep their living space tidy and free from clutter. Choose calm lighting and make use of natural daylight when you can.Minimize background noise, including television, radio, or loud noises. Display personal, meaningful items that bring comfort, like photos of loved ones or a comforting blanket. Activating their senses can help maintain a relaxed demeanor. This includes using things like candles that have a scent they like, using a weighted blanket, or soft slippers to create calmness. | Avoid overcrowded and overstimulating places. Avoid sensory overload with loud noises or too much background noise.Don’t use bright lights. Avoid extreme temperatures, like too hot or too cold. |
Daily Routines
A routine provides needed structure and expectation throughout the day that can comfort someone with dementia. Unpredictable schedules and chaotic daily routines can stir up agitation in the person you care for.
| What Works | What Doesn’t Work |
| Create a morning routine that is comforting and meaningful. For example, if they love their morning coffee on the porch, try incorporating it into the morning routine. Try to have meals at the same time each day to have a predictable schedule. Incorporate daily physical activity like walking, stretching, or even tai chi if cleared by a doctor. Engage their senses in daily routines. Use calming music or even aromatherapy to promote a sense of peace.Pay attention to signs indicating a medical change in your care recipient. Agitation can sometimes occur if a urinary tract infection (UTI) is starting or a small pressure wound is forming. A visual schedule can be a good way to make their routine known.Choose meaningful tasks for them to complete during the day. For example, folding towels or watering the garden are small tasks that give your loved one a sense of purpose and contribution to their day. | Don’t make sudden changes to their daily routine. Avoid skipping their nap or rest time. They often need this to recharge during the day. Don’t be impatient or rush them if they ask questions or need reminders about their day. Don’t ignore their basic needs, such as hunger, fatigue, or bathroom needs. Often, these are a source of their agitation, and once they’re addressed, they’ll calm down. |
Medication
If your care recipient often has strong and frequent episodes of agitation, medication might be needed to help manage their behavior. It should only be used after trying other non-medication approaches and must be closely monitored by a healthcare provider.
| What Works | What Doesn’t Work |
| Work with the care recipient’s medical team to select the most appropriate medication safely.Start with the lowest effective treatment dose. Document how your loved one responds and any side effects. Provide the medication as prescribed by a doctor. Keep a log of how much and when you provide the medication. | Do not use medications as a first-line defense or “quick fix” to agitation.Do not adjust the medication dosage without the medical team’s approval.Avoid oversedating your loved one. Don’t stop the medication without the approval of a doctor. |
Caring For Yourself
A final strategy to manage agitation in dementia patients is to take care of yourself as a caregiver. When caregivers are burned out or chronically stressed, the person you care for can feel it. You may be more frustrated responding to your care recipient or less observant in meeting their needs.
Here are some suggestions:
- Prioritize your sleep and rest.
- Get trained to use good body mechanics to assist with transfers or mobility.
- Make time to schedule and attend your own doctor’s appointments.
- Movement and physical activity are key practices to minimize stress.
- Look into community resources or support groups for caregivers.
Conclusion
Managing agitation for dementia patients requires a multi-modal and patient-specific approach. There is no one-size-fits-all plan for managing agitation outbursts, but there are strategies that you can learn to minimize them. By implementing techniques discussed in this article, you can keep your loved one safe, maintain a calm environment for them, and optimize their overall well-being.
For more tips, check if you have free access to Trualta.
References
- Alzheimer’s Disease International. (n.d.). Dementia statistics. Retrieved July 5, 2025, from Alzheimer’s Disease International website
- Alzheimer’s Association. (n.d.). Alzheimer’s & dementia: Facts & figures. Retrieved July 5, 2025, from Alzheimer’s Association website
- National Institute on Aging. (n.d.). Understanding different types of dementia. Retrieved July 5, 2025, from National Institute on Aging website
- Alzheimer’s Association. (n.d.). Communications. In Daily care. Retrieved July 5, 2025, from Alzheimer’s Association website
- Alzheimer’s Association. (n.d.). Caregiver stress.
- Cleveland Clinic. (2023, June 21). Caregiver burnout: Symptoms, causes & prevention.
- NHS. (2023, October 24). Home environment.
- NHS. (2023, October 24). Communication.
- Alzheimer’s Association. (n.d.). Medications for memory.
