Quick answer
Anger or agitation in dementia is usually a response to something the person cannot easily express or manage — such as pain, fear, confusion, discomfort, overstimulation, or difficulty communicating. Staying calm, looking for triggers, reducing stimulation, reassuring the person, and redirecting attention can often help. Sudden or severe changes should be discussed with a healthcare professional.
What might be causing the agitation?
Before assuming the behavior is simply part of dementia, consider what the person may be experiencing.
- Pain or physical discomfort
- Hunger or thirst
- Constipation or needing to use the bathroom
- Fatigue or lack of sleep
- Fear, anxiety, or confusion
- Being too hot or cold
- Difficulty seeing or hearing
- A new medication or medication side effect
- Too much noise, activity, or stimulation
- Changes in routine or unfamiliar surroundings
- Difficulty communicating what they want or need
A sudden or significant change in behavior may have a medical cause and should be discussed with a healthcare professional.
What should I do when agitation happens?
Start by slowing the situation down. Keep your voice calm and avoid arguing, correcting, or trying to convince the person that they are wrong. Give them extra time to process what you are saying.
1Stay calm and avoid arguing
Keep your voice low and steady. Arguing or correcting the person often increases distress. A calm presence can help the person feel safer even when they cannot say so.
2Look for what happened right before
Try to determine what occurred immediately before the agitation began. Was the room noisy? Were you asking them to do something they did not understand? Could they be uncomfortable, tired, hungry, or in pain?
3Reduce stimulation and move to a quieter space
If possible, lower the noise, turn off the television, reduce activity, and move to a calmer environment. A quieter setting can help an overwhelmed brain settle.
4Reassure them that they are safe
Let the person know you are there to help. Simple, repeated reassurance — such as "You are safe" or "I'm here with you" — can be more helpful than detailed explanations.
5Redirect with something familiar or comforting
Try familiar music, a favorite snack, a short walk, photographs, or another activity the person usually enjoys. Redirection can shift attention away from the source of distress without making the person feel corrected.
Look for patterns
One difficult episode may not tell you very much. Several episodes can.
Keep brief notes about what happened before, during, and after the agitation. Include the time of day, activity, environment, sleep, meals, medications, and anything else that seems relevant.
Over time, patterns may emerge. For example, agitation may happen more often when the person is tired, during bathing, in noisy environments, or at a particular time of day.
Recognizing these patterns can help you anticipate triggers and adjust the person's routine or environment before distress escalates.
Remember: behavior can be communication
As dementia affects language and reasoning, a person may have increasing difficulty explaining what is wrong.
Instead of being able to say, "I'm overwhelmed," "I'm hurting," "I don't understand what you're asking me to do," or "I'm scared," distress may appear through behavior.
Rather than asking only, "How do I stop this behavior?", try asking: "What might this behavior be telling me?" That small shift can help caregivers respond to the person's underlying need rather than only reacting to the behavior.
When should I contact a healthcare professional?
Contact the person's healthcare professional if agitation is new, suddenly worse, unusually severe, or accompanied by other physical or behavioral changes.
Sudden changes can sometimes be associated with pain, infection, medication effects, sleep problems, or other health conditions and should not automatically be attributed to dementia.
How DemiHelp can help
DemiHelp can help caregivers record behaviors and observations as they happen, identify patterns over time, and ask questions using the person's routines, preferences, history, and documented care information as context.
Instead of trying to remember several difficult incidents weeks later, caregivers can build an ongoing record that may help them better understand what is changing and prepare useful information to discuss with family members and healthcare professionals.
Personalized Guidance for Your Loved One
Every person living with dementia is unique. While this article provides evidence-informed guidance, DemiHelp helps you apply that guidance to the person you love.
Describe what happened, ask questions about your loved one's specific situation, and receive personalized support based on their routines, preferences, behaviors, communication style, and changing needs. Over time, DemiHelp also helps you keep track of what works, making future caregiving decisions easier and more personalized.
References
For informational purposes only. Not medical advice. Consult healthcare professionals for medical decisions.