Caring for someone with dementia can be challenging, and trying to ease & prevent dementia anxiety and agitation can be difficult as a number of things may be causing it like pain, confusion, fear, frustrations etc being felt by your loved one with dementia and as a result of changes happening in their brain.
It’s hard as dementia caregivers not to feel like whatever you do isn’t helping and blame yourself. There isn’t one thing that can help, it’s figuring out what the trigger is and trying various things to help provide comfort and reassurance to your loved ones.
Avoid transferring your anxiety through your body language by remaining calm and understanding.
Differentiating Dementia Anxiety from Agitation
While anxiety and agitation may appear similar, it is important to understand the differences between the two in the context of dementia.
Dementia anxiety is often characterised by feelings of unease, worry, and fear, while dementia agitation involves restlessness, irritability, and heightened reactivity.
By recognizing the distinctions, you can respond appropriately and provide targeted support to alleviate distress and promote a sense of calm.
Here are several practical tips to ease anxiety & prevent agitation in dementia care:
Manage Triggers Proactively
Make a note of situations where behaviour begins to change. Is there a pattern or recognisable cause. What is your loved one experiencing before the behaviour? Tired, overstimulated, discomfort, the environment? Put yourself in their shoes!
Is there something that needs to change to prevent & ease dementia anxiety and agitation?
Note situations that commonly precede changes in behaviour of your loved one with dementia. Hunger? Fatigue? Overstimulation? Discomfort? Identify and minimise these triggers Then address that need before anxiety escalates.
These can vary greatly between individuals but may include certain times of day, too much noise, or specific activities. Avoiding or preparing for these anxiety triggers can help your loved one feel secure.
Use Non-Verbal Cues
Is your loved one becoming anxious or agitated because they’re being ignored, not listened to, feeling a loss of control or frustration from living with dementia?
Imagine being told you can’t drive anymore because of your dementia after years of being a driver, you’d be frustrated, agitated, itching to get out. Are they fidgeting a lot, walking restlessly, looking for their keys, patting their pockets, getting up and sitting down multiple times. What’s the cause?
Identify that, maybe we need to find an alternative to driving, getting the bus instead, going for long walks, joint tandem bikes.
Pick up on the cues before they escalate and then brainstorm remedies. (use whatever support you have forums, social media, friends, family.)
MOST IMPORTANTLY talk to your loved one with dementia about their agitation or anxiety to find a solution together during calmer times.
Use simple words and sentences. Speak slowly, maintaining eye contact. Stop asking questions when you see irritability, being asked questions you can’t answer would irritate the hell out of me.
Avoid arguing or trying to reason with the person if they are confused. Instead, validate their feelings and redirect the conversation to a more comforting topic.
Make sure to leave room for silence, time for self expression or sort out what your loved ones might be trying to communicate to you.
Non verbal communication can also be helpful touch, reassuring smiles, and the use of calming tones can be very effective in reducing anxiety. Sometimes, a gentle touch on the hand can be more comforting than words.
Use Distraction Techniques
When agitation arises, try to redirect the person’s attention to a different, more pleasant activity. Sometimes, changing the environment (e.g. Moving to a different room or place) can also help.
Simple, enjoyable hobbies divert attention from worries, like folding laundry, cooking dinner, looking at family albums etc. Turn to activities you know that immerse your loved one and match their interests and abilities to help ease and prevent dementia agitation and anxiety.
Offer comforting words and reassurance if the person feels lost, scared, or confused. Knowing they are not alone and, are cared for, can be very soothing. Use words, like I’m here, you’re safe.
Anxiety I know for my mum is caused because she is scared, not necessarily of me but from hallucinations she may be experiencing. Holding mum’s hand was something she disliked but now needs to feel secure.
Monitor Personal Comfort
Check for discomfort, mum is used to not drinking to avoid having to rush to the toilet especially if we go out (before being wheelchair bound), so your loved one might have a reason for not drinking for example and feel discomfort from being thirsty?
Is the discomfort more urgent e.g needing the toilet, or experiencing some level of pain (dental, physical, neuropathic etc). Any form of discomfort can increase agitation and anxiety in a person with or without dementia, so identifying that need and addressing it can have a positive impact.
Maintain a Calm Environment
Create a peaceful and stable environment with recognizable objects, music, photos and rooms to orient them. Reduce noise, clutter, and the number of people coming and going as much as possible.
Play their favourite music in the background, introduce calming colours into the environment, lighting that’s functional but not abrasive. By having what’s familiar and comforting surrounding your loved one you can help reduce anxiety and agitation.
Minimise Changes & Establish Routines:
Try to keep the environment and daily routines as consistent as possible. Frequent changes can be confusing and distressing. When changes are necessary, introduce them gradually.
Establishing routines using consistency and structure can be very reassuring. Try to keep daily routines predictable, including meal times, bedtime, and activities. This predictability can help reduce anxiety.
Encourage Movement, Activity & Engage the Senses
Encourage participation in activities that the person enjoys and can manage successfully. This can include simple household tasks, puzzles, or gentle exercise. A short walk helps relieve restlessness. Fidget toys can keep hands busy. Dancing to a favourite track or stretching can all help to improve the mood & reduce anxiety
Activities like aromatherapy, gentle massages, or music engage the senses to produce relaxing endorphins to calm anxiety. Textures to touch or snacks to taste work too.
Practice Relaxation Techniques
Hold hands and take deep breaths together. Gentle stretches release tension. Lavender essential oils evoke calming scent association. Massages ease rigid muscles associated with anxiety.
Deep breathing, stretching, yoga, meditation or tai chi shift focus to the present. The repetition can distract from anxious thoughts. This also reduces muscle tension.
Promote Sleep Hygiene
Ensure the person follows a regular sleep schedule, and create a relaxing bedtime routine. Sleep disturbances can worsen agitation and anxiety. Such an important step that was highlighted to me through Admiral Nurse Lyons, part of Dementia UK Admiral Nurse network that helps caregivers and loved ones with dementia.
If anxiety and agitation is worsening, consult a professional like your doctor or memory clinic. They can assess whether there is a medical cause for the behaviour, such as pain, UTI or medication side effects, and suggest appropriate treatments.
Managing anxiety and agitation in dementia requires patience, compassion, and flexibility. Each person is unique, and what works for one individual may not work for another. You also need to remember that what may have worked one day may not necessarily work the next day.
It’s important to learn what seems to help the person you’re caring for and adjust your approach to match their needs. As dementia caregivers, it’s essential to understand and address the underlying cause that can ease & prevent dementia agitation and anxiety and try to create a calm environment that works for them.