Calming someone living with dementia when they become agitated

It’s not uncommon for people who are living with dementia to become visibly upset, anxious and agitated when something is troubling them.

There are many situations that may trigger someone with dementia to become upset and agitated, and it can be distressing for carers and loved ones to witness.

People living with dementia may be experiencing feelings of profound loss because of their condition, and they may be feeling deeply frustrated by their loss of ability, changes in personality, or their reduced ability to reason.

On top of this, people with dementia are less able to perceive how threatening a situation is, so they may act powerfully if they perceive even a small degree of threat.

They may be stressed by moving to a new residence such as an aged care facility, they may be feeling uncomfortable about the presence of a new person such as a new carer, they may believe that someone is a threat to them, or they may simply be frustrated by dealing with a world that no longer makes sense to them.

In these situations, it’s important that carers calm the person, but they should also to try to identify what might have caused the anxiety to arise in the first place, so that they can prevent the same issue from arising again in the future, and to share the experience with others.

Calming someone with dementia: a case study

Imagine this. You are busy going about your daily business, when a woman approaches you. You know that this woman is living with dementia. She is clearly upset – she is pacing in front of your. She is talking so quickly and with such a muffled voice that it’s impossible to understand what she is saying. She is shaking her hands, as though in anger.

She is obviously feeling very troubled.

What can you do in situations like these, which are not uncommon in aged care facilities or in any dementia care situation?

• The first thing you can do is talk to the person. Listen to what they are saying. Acknowledge their feelings and frustrations. Ask them if it’s okay for you to help them, use positive language to reassure, guide, and soothe.

• Use a calm, quiet voice. Don’t act surprised or offended by what they are doing or saying.

• Get physically down on their level. Make sure they can see you clearly. Don’t make any sudden movements that may alarm them.

• Reassure the person. Use phrases such as, “I’m sorry you’re feeling angry/upset/frustrated”, “You’re safe now”, “I’ll stay with you until you feel better”.

• Breath deeply and slowly, and encourage them to do the same. Focus on a slow exhalation. If they can take deep breaths, they will take in more oxygen which could help them to feel better.

• Ensure the environment is calm, for example by lowering noise levels or taking them to a quieter place.

• Try to divert the person away from what is frustrating them and towards an activity that can engage them. For example, would they like to go for a walk, do they want to join in a group activity, or would they like to sit down with an activity?

Preventing a reoccurrence

After an incident such as the above, it’s a good idea to follow up on what happened.

Speak to a doctor. Doctors can identify if the person may be experiencing pain, or they may even be unwell.

Doctors might also look at the person’s medication to determine if that could be causing the person to experience an increase in anxiety and agitation.

Talk to others about what happened. Let them know the person behaved this way, and what you did to calm the situation. Perhaps others may have different ideas about how they would have handled the situation, or they might learn from what you did.

Think about what triggered the incident, and how you can avoid triggers in the future. Make sure the person’s environment is calm, and consider simplifying their routine.

Lastly, provide an opportunity for more exercise. Perhaps take the person for more regular walks, or put on some music you know is popular and encourage them to get up and dance!