15 helpful hints to prevent agitation in people living with alzheimer disease and related dementias

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I believe in calling a spade a spade, and in giving kudos if and when they’re due. Lately, I’ve been finding a lot of solid, practical and person-centered care tips, tools, and strategies on the Alzheimer Societies’ sites in Canada and the United Kingdom, as well as the Alzheimer’s Association site in the USA, which is where I sourced the list below. The fact that these organisations are upping their games with good information is a great thing because these organisations and their sites are often the first places new care partners go to find information.

Here’s the list of 15 ways to help prevent agitation:

A) Create a calm environment 

1 ) remove stressors, triggers or danger
2 ) move person to a safer or quieter place
3 ) change expectations
4 ) offer security object, rest or privacy
5 ) limit caffeine use
6 ) provide opportunity for exercise
7 ) develop soothing rituals
8 ) use gentle reminders

B) Avoid environmental triggers

9 ) reduce noise
10 ) lower glare
11 ) make “insecure” spaces secure
12 ) get rid of background distractions (TV, loud radio, too much talking)

c) Monitor personal comfort

13 ) check for pain, hunger, thirst, constipation, full bladder, fatigue, infections, and skin irritation
14 ) ensure a comfortable temperature
15 ) be sensitive to fears, misperceived threats, and frustration with expressing what is wanted

I’ve also put together a lengthier and more detailed list of potential sources of discomfort that many find helpful, as well as a list of 20 questions to help prevent aggression, and free 50-minute webinar with tips based on my own experience.

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2 Comments

  1. how do you know what to do when u don’t know if it is aggitation or something else when they can’t talk only babble

    • Susan Macaulay on

      Hi Ann,

      When someone is agitated, whether they are living with dementia or not, it’s caused by something. The trick is to find out what the cause is and then to address the cause. So to use a simple example, someone may become agitated because they are too hot or too cold, in which case the solution if they are too hot is to lower the temperature (or remove blankets or clothing), and if they are too cold, to increase the temperature (or put on more blankets or clothing).

      But how do you know if they are too hot or too cold if they can’t tell you? Well, you can ask them. Are you hot? They may not be able to answer verbally, but perhaps they can give you a signal somehow by nodding or shaking their head, or through other body language. Then you could follow with the question: “are you cold?” And again tried to gauge their response. You could also touch their skin to see if they feel hot or cold to the touch.

      One thing I found with my mother, who had Alzheimer disease is that it took her a lot longer to process the answer to a question, so I had to be patient and wait sometimes for a minute or two before she would answer. There’s no point in asking another question while you’re waiting for an answer because that just becomes more confusing to the person and yourself because once they do get to answering it’s hard to know which question they are answering.

      I also became very good at interpreting what to other people sounded like gobbledygook, but to me made perfect sense when I really listened not just with my ears but with my heart. Also, my mother used “substitute” words when she couldn’t find the exact words that she wanted. For example, one time she said to me “I can’t sing my song,” which in the context of the conversation, I interpreted to mean “I can’t live my life the way I want to, I can’t do what I want.”

      Here is a list of 101 things that may cause someone to feel agitated: http://myalzheimersstory.com/2017/11/25/101-potential-causes-of-behaviours-by-people-living-with-dementia-that-institutional-care-staff-may-find-challenging/

      If they can’t tell you, it’s a matter of going down the list and testing each one. This may sound onerous, but really there aren’t that many things when you think about it. For example, if a baby cries, which is a clearly a sign that she or he is agitated, there are only so many possibilities as to what might be causing the agitation.

      With respect to “babble,” I don’t know what you might mean by that, or how severe it is. If it’s not too severe, then this link on aphasia might help: http://myalzheimersstory.com/2016/09/19/ted-aphasia-video-great-for-dementia-care-partners-2/

      Also, with respect to language, here is part of my experience: http://myalzheimersstory.com/2014/03/04/alzheimers-alphabet-soup-is-a-sentence/

      I hope some of this is useful. Good luck.

      Susan

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