It is common for older adults with dementia to experience feelings of agitation and anxiety as their disease progresses. They may fear their loss of memory and thinking skills, as well as fear of losing who they are. This behaviour can be triggered by a range of factors such as a change in environment, pain, noise or simply a bad day.
What causes anxiety and agitation in someone living with dementia?
Anxiety and agitation in people with dementia can be caused by a number of different factors. A person with dementia is experiencing a profound loss of cognitive skills and being in control of their surroundings. Situations which might provoke agitation include a change in environment, physical factors such as pain or hunger, psychological factors such as frustration, fear of loss, confusion, or unmet needs such as the desire for social interaction. A significant factor relating to their agitation can be their inability to recall events or their friends and family. It is important to identify these early signs of agitation in people with dementia so that you can deal with the cause before any potential aggressive behaviour starts.
How do you calm someone living with dementia?
1. Keep yourself calm
Caring for someone with dementia can be challenging. Remaining calm in a situation where someone is experiencing agitation or aggressive behaviour can be difficult. Psychologists call this phenomenon “mirroring”, which you can flip to use to your advantage. Demonstrate your calm behaviour to your loved one by taking a deep breath. If your loved one can see that you are calm, it will be easier to defuse the situation. It is important to remember that your loved one is not trying to give you a hard time, they are struggling to comprehend their reality.
2. Listen to what they have to say
Your loved one wants to feel listened to and understood. Stopping what you are doing and giving your loved one your full attention can reduce agitation. Listen to what they are saying even if it makes no sense. A person with dementia can become very overwhelmed by overstimulation in unfamiliar surroundings or experience feelings of frustration. By showing them that you care and are listening to them, you can control the situation.
3. Maintain eye contact
Eye contact is particularly important when calming down a person with dementia. Eye contact is a powerful method of showing that you’re listening and that you understand your loved one. Eye contact, while providing reassurance using calm phrases can help a person with dementia relax and feel safer in their environment.
4. Validate their feelings
Validating your loved one’s feelings is a great way of making them feel heard and understood, decreasing their agitated emotions. The validation method is a tool that can be used to improve communication and understand the emotions and feelings your loved one is experiencing. This method enables you to agree with your loved one’s perception of reality without lying. A way of doing this, when talking to someone with dementia, is to ask general questions about what they are saying to you. Examples of bridging phrases include:
- What is that like?
- I’d like to hear more about it…
- I understand why you’re feeling like this, can you tell me more…
- It would be great to do that..
5. Check for underlying causes of discomfort
Fidgeting, restlessness, having trouble getting comfortable, or irritability are all signs of discomfort in someone with dementia. If your loved one is physically comfortable, they are less likely to become agitated and distressed. Signs to be aware of include:
- Are they hungry?
- Are they uncomfortable in their clothing?
- Is there an infection?
- Are they thirsty?
- When did they last have bowel movements?
6. Refocus their attention on something else
If you notice that your loved one is starting to feel agitated or distressed, take note of your current surroundings and what might be triggering the emotional response in your loved one. For example, if a surrounding or conversation is making them feel uncomfortable, refocus their attention to something else.
7. Offer verbal reassurance
It is important to give verbal reassurance to a person with dementia so that they feel understood and listened to. It can be difficult for people with dementia to express their new perception of reality. By offering verbal reassurance, you can respect their feelings and continue to treat them with dignity and respect.
8. Remove any possible triggers
It is particularly important to set your loved one up for success by limiting any distractions and removing any potential triggers from their surroundings. People with dementia can become overstimulated by background noises, clutter, bright lights or a lot of people. Reducing the number of non-essential items is a great way to promote feelings of calm in a home. By creating a calming environment, you will reduce potential restlessness or distress in your loved one and make them feel more comfortable.
9. Take the person to a more calming environment
If you notice your loved one becoming agitated or distressed, it can be helpful to remove them from the situation and bring them to a more calming environment with fewer distractions. For example, a bright room with lots of clutter or distracting patterns can be overwhelming for a person with dementia, while a simplified room with one or two personal pictures can be a much more calming environment.
10. Offer physical touch (such as holding their hand)
It can be difficult to be at the receiving end of your loved ones sudden outburst. However, it is important to remember that your loved one cannot control the intensity of their feelings, whether they feel scared, confused or angry. A great way to connect with a person with dementia is through the senses, such as physical touch. Methods such as brushing their hair, giving them a hug, offering them a massage or taking them for a walk are great ways of connecting and reducing feelings of agitation or distress.
It is inevitable that people with dementia will experience feelings of agitation or restlessness throughout their illness. They are experiencing a new perception of reality which can be overstimulating for them. By being aware of what triggers your loved one and actionable ways to calm them down, you can be prepared to deal with the situation and minimise the risk of them feeling uncomfortable or agitated.
At The Fremantle Trust, we offer tailored dementia care services to support each individual every step of the way. The environment in our nursing homes and residential care homes is designed to be safe, comfortable and enriching to support our individually tailored care plans. Our experienced care home staff are committed to supporting people with dementia to ensure they are listened to, respected and treated with kindness and compassion at all times.