How to cope with agitation in your loved one who has Alzheimer’s

 by: William G. Hammond, J.D.

Many times, understanding the meaning of a word can give us great insight into the issue at hand.

What is agitation?

• Extreme emotional disturbance. (The American Heritage Dictionary of the English Language)

• A stirring up or arousing; disturbance of tranquility; disturbance of mind that shows itself by physical excitement. (Webster’s Revised Unabridged Dictionary).

• A mental state of extreme emotional disturbance, the feeling of being agitated; not calm. (WorldNet 1.6).

Many Alzheimer’s patients experience agitation in addition to memory loss. In the early stages of the illness, people with Alzheimer’s may encounter changes in their personality, such as irritability, anxiety or even depression. But as the disease progresses, these symptoms can worsen and become more difficult to live with. They may include sleep disturbances, delusions and hallucinations. Many times Alzheimer's patients cannot get in touch with or express their feelings. So when they experience agitation, it is often difficult for the caregivers to understand and to help.

When a person with dementia displays agitation or other “symptoms,” you must try to determine what they are trying to communicate.

Good communication is an important part of any relationship. When caring for a person with dementia, the ability to communicate becomes more and more difficult. Both expressing and processing information becomes impaired. This inability to express and process can be frustrating and can manifest itself as agitation.

Following are some suggestions that may allow you to improve your communication with your loved one who has Alzheimer's:

• Approach from the front to prevent startling him or her.

• Maintain eye contact.

• Lower the tone of your voice. A high pitch may indicate that you are upset.

• Smile and be pleasant.

• Talk with a calm presence.

• Speak slowly, clearly and directly.

• Identify yourself.

• Use short, simple sentences.

• Ask one question at a time.

• Eliminate background noise.

• Give plenty of time to respond.

• If he/she cannot find words, sometimes it helps if you finish the sentence.

• Repeat information when needed – repetition is good.

• Frequently affirm/praise him/her, even for the smallest things, i.e. “Good job,” “Thank you,” “You’re the best!”

• Validate feelings.

• Use touch. Touch the shoulder, knee, back, hand.

• Give hugs many times a day.

• Don’t argue – you’ll never win.

• Laugh together.

• If your talk becomes “heated,” stop. Go back and try again later.

• Don’t talk down. Respect him/her as an adult.

• Don’t’ correct him/her.

• Don’t demand. Ask nicely.

• Don’t take adverse behavior personally.

• Slow down! Hurrying increases frustration.

Another issue in agitation is non-verbal communication. Non-verbal communication is important to be aware of, both in what we are communicating to our loved ones, and what they are communicating to us. Non-verbal communication is expressed by persons with dementia through body languages, facial expression and tone of voice. At times, the Alzheimer's patient can look into your eyes and seem to read your soul, almost like a “sixth sense.” They are sensitive and intuitive to people and things around them. They know when someone is being sincere or not. Body language is as important as their facial expressions. For example, if your loved one suddenly gets up and walks around, that may indicate the need to go the bathroom. Be alert to those signs and give big hugs as much as possible. A gentle touch will make their life much easier and relaxed.

Environment can also cause agitation. Examples would be where temperatures are too cold or too hot, or lights too strong or too dim. Try to set up an environment that is relaxing for your loved one. It will make his or her life easier. And as your loved one with Alzheimer's relaxes, so will you.