Agitation and aggression are common symptoms of dementia, and can be extremely challenging to manage, not only for the person experiencing the symptoms, but also for families and carers. But new research is shining a light on this complex field, and has revealed that non-pharmacological interventions, such as touch therapy, outdoor activities, and music, can be more effective in managing agitation and aggression than medication.
Researchers say that up to 70 per cent of people living with dementia experience agitation or aggression at some stage of the disease’s progression. The symptoms have also been associated with lower quality of life and shorter life spans.
Agitation and aggression can also be distressing and overwhelming for carers to deal with, and at times, can even put them at risk of injury.
There is a growing awareness that, when someone living with dementia lashes out, it is an expression that their social, emotional or physical needs are not being met.
As dementia progresses, the person’s symptoms change. They may find it more difficult to formulate their thoughts and to communicate, to let others know how they are feeling, to tell their carer they’re uncomfortable, they’re thirsty, they want to go outside, they’re scared. They may also simply be unhappy with their situation.
Lashing out is not something the person chooses to do, it’s not a reflection of who they are – it usually comes from a place of deep frustration.
Developing an understanding of what the person needs, when their frustration arises, and what triggers it, is usually the key to preventing agitation and aggression in people living with dementia.
According to new research, non-pharmacologic interventions, such as music, touch therapy, massage, and recreation therapy, are more effective than medication for reducing aggression and agitation in adults living with dementia.
The study looked at 23,000 people with a range of different types of dementia over an 11-week period.
Dr Sharon Straus, a geriatrician at St. Michael’s Hospital, said “This study shows us that multidisciplinary care is efficacious, and that is consistent with a person-centred approach to care.”
“It points to evidence of the benefit of supporting multidisciplinary teams providing care to patients in the community and nursing home settings,” she said.
Another study has looked at the effectiveness of a specialised touch therapy, Compassionate Touch®, in treating aggression and agitation in people living with dementia.
A pilot study in the United States found that use of Compassionate Touch resulted in the reduction of dementia-related symptoms, such as verbal and physical expressions, by up to 40 per cent.
The study, in which 1,917 nursing homes staff across 59 nursing homes received the Compassionate Touch training, also found the use of antipsychotic medication declined by 17 per cent over the course of the trial.
More than four in five – 83 per cent – of the staff who took part in the pilot said Compassionate Touch made them feel more effective in dealing with residents living with dementia who might lash out, and also made them feel calmer and better able to engage with residents.
As the training program was rolled out across the facility, staff were able to educate more carers, families, and other members of the community, including volunteers.
The staff provided the researchers with positive feedback about Compassionate Touch.
As one explained, “We have one resident who becomes very anxious at the same time each morning. Using these techniques with her has allowed our staff to be able to communicate more effectively with the resident, and now she smiles, and it’s almost as if she looks forward to the interaction each day.”