Dementia causes the loss of cognitive functions such as memory, thinking, and reasoning. Agitation is a common symptom and may involve trouble sleeping and hallucinations. Although dementia is progressive and currently has no cure, some treatments may help manage agitation.
According to a 2020 research review, 90% of people with dementia eventually experience agitation or other behavioral symptoms. Dementia agitation treatment can help.
Agitation can happen for many reasons. It is important for caregivers to view agitation as communication, especially in people who are experiencing confusion or are no longer able to speak. Agitation is not a diagnosis but rather a symptom of something else, such as discomfort, fear, or confusion.
Addressing these issues may help ease agitation. When doing so does not work, agitation may be the product of the brain damage dementia inevitably causes. It is also important for caregivers and family members to get support for themselves when caring for a person with dementia who experiences agitation.
This article will explain what dementia agitation is and how to treat it.
Dementia is a chronic, progressive condition that currently has no cure. While dementia medications, especially cholinesterase inhibitors,
Treatment and management of anxiety
Environmental changes may make anxiety worse. Therefore, it is important to
Medication to ease anxiety can help when other interventions fail. However, benzodiazepines may make anxiety and agitation worse in people with dementia.
Depression related to the prognosis for dementia may cause agitation early in the disease. And as dementia progresses, changes in the brain may trigger depression, even in someone with no history of depression.
Certain antidepressants, such as sertraline, may specifically reduce agitation and aggression in people with dementia.
Treatments for sleep disturbances
People with dementia commonly experience sleep issues such as difficulties falling or staying asleep. Fatigue can intensify agitation and anxiety. Helping a person get a good night’s sleep is important.
Sleep hygiene — which includes having a cool, dark, comfortable sleep space and going to bed and waking at the same time each day — may help. Avoiding caffeine is also important.
Sleep medications may help when other interventions fail. It is important to start with a low dose and to use these drugs for only a brief time.
Some people with dementia
However, such drugs can increase the risk of dying, and their effectiveness in older people can be weak. The safest option is to try other strategies before using antipsychotics. When a person does take antipsychotics, caregivers and healthcare professionals should closely monitor their symptoms and response.
- social skills
The specific symptoms of dementia vary. For example, Alzheimer’s disease tends to affect short-term memory first, while behavioral symptoms might not appear until much later. Frontotemporal dementia, however, causes early changes in behavior and mood followed by later difficulties with daily functioning and memory.
Dementia can change behavior in several ways, such as:
- Reaction to the dementia diagnosis: Early in the disease, when a person understands that they have dementia, their behavior may change in response to the diagnosis. They may be angry or scared and may change their habits.
- Loss of cognitive abilities: A person’s behavior changes when their cognitive abilities do. People who can no longer dress themselves may act differently. The inability to understand what is happening can lead to fear, panic, and changes in behavior.
- Changes in emotions and mood: The brain plays an important role in emotions. Changes in the brain due to dementia may lead to depression, anxiety, or personality changes that may affect a person’s behavior.
- Loss of communication skills: In the later stages of dementia, a person may be unable to speak or communicate. They may not understand communication, either. This may cause agitation and other behavior changes.
- Fear and anxiety: People at all stages of dementia may feel afraid, alone, uncertain, or depressed. This may change their behavior in many ways.
Treatment options for dementia-related behavior changes include:
- Antidepressants: When depression triggers behavioral shifts, antidepressants may help. Some antidepressants are less safe in older people, so it is important to consult a doctor about starting with a lower dose.
- Antianxiety medications: Some antianxiety medications may ease anxiety and agitation. However, benzodiazepines may actually
triggeranxiety and agitation in people with dementia, so most guides recommend avoiding them.
- Identifying causes of delirium: Sudden agitation may be a symptom of delirium. This is a decrease in cognitive ability that can occur as a result of a new environment, a reaction to stress, or an illness. Treat this as a symptom of a medical problem. A person may have a urinary tract infection or another issue requiring medical care.
- Environmental changes: Reducing stress in the environment may help with behavior problems. Avoid forcing or coercing anything that is unnecessary, such as bathing, medical screenings, or specific activities.
- Antipsychotic drugs: Antipsychotics may ease hallucinations that cause agitation, but they can cause serious side effects in older people. A doctor should prescribe them only if all other interventions have failed.
- Sleep medication: When a person cannot sleep, they may become agitated. Sleep medications
may helpwith symptoms, but it is important to monitor their use since these drugs can be habit-forming.
Common behavior changes a person might experience
- hallucinations that cause a person to believe or experience things that others do not
- suspicion of loved ones
- depression and anxiety
- violent behavior, especially when afraid or threatened
- communication difficulties
- obsessive or compulsive behaviors
There is no universal dementia experience, and various types of dementia can manifest differently. A person’s behavior may change with time, and behaviors may disappear and return later.
Common triggers for agitation
- Alcohol and other drugs: Consider removing alcohol from the home of a person with advanced dementia.
- Hospitalization: Avoid long-term hospital stays unless absolutely medically necessary.
- Fear: Feeling afraid or out of control may trigger agitation. Medical exams, unfamiliar settings, and uncomfortable grooming are common culprits. Try to avoid forcing a person into any of these situations. While medical tests would usually be important, the value of these tests may diminish when one considers that dementia is a terminal illness.
- Changes in routine: Work to maintain a consistent environment and minimize chaos.
The following strategies may be helpful for people with dementia:
- Develop a care plan for when a person can no longer care for themselves, which may help with peace of mind.
- Find a therapist who specializes in treating people living with dementia.
- Talk with caregivers about what to do when the person who has dementia feels agitated. Favorite music, shows, or a calm environment may help.
- Discuss long-term care values and preferences, such as whether they want to avoid hospitalization even when unwell.
The following strategies may help caregivers:
- Remember that a person with dementia is not a child who needs to learn — they are a person with a serious illness. Avoid trying to punish or change their behavior.
- View behavior as communication and consider what unmet need it might represent.
- If possible, get support from other family members or hire in-home care.
- Join a caregiver support group.
- Work with an older adult care coordinator to identify care and support options.
Supporting someone with dementia-related agitation can be difficult, especially when they have difficulty communicating. But agitation is a sign of distress, not bad behavior or a deliberate attempt to harm others.
If a person with dementia is able to articulate their wishes and needs, loved ones and caregivers should work with them to develop a care plan. A doctor, social worker, or older adult care coordinator may also be able to help identify support options. Agitation is manageable, so seek help early.