“AGITATION: A condition in which a person is unable to relax or be still. They may be tense and irritable and may be easily annoyed by small things.” Sound familiar? If you’re in the world of a dementia caregiver, you probably could write a book about agitation and the experiences you are having or have had with the loved one you’re caring for. 

 The other night I saw an advertisement to help at home caregivers of those with dementia, to better cope with agitation. I couldn’t help but ask myself why they chose this particular characteristic of the disease. After all, there is a rather long list of issues they can present with.  I reviewed my own fact sheet for the top ten warning signs  of dementia; agitation didn’t make the top 10. The closest to it was “Changes in personality” but even then they mentioned confusion and suspicion, not agitation.

In all fairness, if you’re the informal caregiver and you’re dealing with agitation on a regular basis, it doesn’t matter to you where it is on the list. It’s certainly affecting your quality of life and theirs. 

I’ve seen agitation described as “one of the most distressing behaviors your loved one can have.” Remember that there are different types of agitation e.g verbal, physical, and restlessness and there are things you can do to reduce the presence of this unfortunate behavior.

To better understand what’s going on with your loved one you have to go back to understanding the basics of the illness and the toll it is taking on your loved one. They can no longer reason away fear and anxiety, they’ve lost the ability to reason, processing is very difficult for them and the illness can or will take the “boss from their brain” that would tell you and I that what we were about to do, would be inappropriate.

Here is a brief list of just some of the things that could cause your loved one to become agitated.

• Pain they are not able to articulate.
• A change in their environment or an environment with too much stimulation that they can’t process.
• Too little sleep.
• A sudden change in routine.
• A feeling of loss. A deceased spouse or sibling caregiver or a loss of freedom when they can’t drive.
• Side effect of Medications
• Fear of bathing, leaving the house, strangers in the house (a well meaning caregiver)
• A medical issue e.g. an infection or Urinary tract infection.

One this last one, I want to share a quick story. I received a phone call from a daughter in Illinois that was caring for dad. To say the problem was agitation would be an understatement. He was not only being verbally abusive to his daughter but also physically abusive. He did have dementia but it turned out this appalling behavior was the result of a raging UTI. Dementia is a slow moving , progressive illness so when you see a quick and radical change, it’s usually something else.

So what can you do? Keep them in their happy place. Keep well loved items and photographs around the house to show and divert them. Appropriate touching and kind looks and words can help to assure them all is well. Do they have favorite music or a favorite TV show they like? Take them for a walk if they’ll feel safe and you can handle them if they decide they don’t want to go home when it’s time. Be sensitive to their environment and the stimulation they’d be subjected to. Finally, don ’t be afraid to take them to their Doctor. They can often prescribe a “little something” that can really help.

The opening definition suggested they can become easily annoyed by “small things.” Don’t ever forget that, to them, they’re never small things. It’s important to always validate their concerns. 

Questions? Email me at repe@careforcaregivers.org.