Try: Possible causes italic text 1 physiological or medical causes – fatigue at time of request activity or event disruption of sleep pattern day and night reversal causing sleep deprivation physical discomfort such as pain fever illness constipation fecal impaction expressed as anger loss of control over behaviors due to physical changes in the brain adverse side effects of medications such as psychotropics sedatives or tranquilizers impaired vision or hearing causing the older adult to misinterprets sights and sounds hallucinations 2 environmental causes sensory overload such as noise activity or clutter or too many people in environment unfamiliar people place or sounds sudden movements startling noises feeling lost insecure forgotten when familiar person is out of sight the older adult may feel abandoned difficulty adjusting to darkness from well lighted area and vice versa 3 other causes being asked to respond to several questions or statements at once responding to arguments between other people response to caregiver’s impatience stress irritability person scolded confronted contradicted surprised by unexpected physical contact inability to perform what was once a simple task buttoning clothing instructions unclear or too complicated change in schedule or routine attention span too short for task task not broken down into manageable steps activity perceived as too childlike insulting coping strategies italic text 1 begin with medical evaluation to rule out physical and or medication problems 2 discuss possible adverse side effects of current medications with physician 3 have vision and hearing checked 4 alternate quiet times with more active periods 5 plan outings activities when person is rested 6 make sure person is comfortable – clothes are not tight older adult is not too hot or cold 7 simplify environment by reducing noise number of people and clutter 8 keep daily routine consistent if a change in routine in necessary determine an appropriate amount of time for the older adult to adapt to the change 9 keep furniture and objects in the same place at all times 10 orient older adult to time by using calendars and large numerical clocks as the person may lose a sense of time because of the disease 11 make sure the person is protected from hurting him herself remove sharp utensils tools and objects from the environment 12 remove the person from stressful situations 13 distract the older adult with favorite food or activity to reduce agitated feelings distraction and avoidance are often the most useful approaches to handling agitated or angry behaviors 14 exercise regularly such as walking or dancing to help in reducing stress 15 music massage and quiet readings may be used in calming the older adult 16 use gentle physical touch to clam person holding hands and hugging may be comforting for some people with dementia but perceived as restraint by others 17 some communication techniques to try include the avoidance of questions that rely on memory try not to reason with the older adult reasoning or rationalizing with the person frequently leads to frustration and anger try not to express your anger or impatience speak slowly and clearly approach the person slowly and from the front approaching from side or behind can startle the older adult 18 use repetition frequent clearly stated reminders are needed to reassure the person with dementia 19 for tasks or activities try to allow adequate time for the older adult to respond to directions requests etc limit choices such as with food activities or clothing give clearly stated directions for each step other considerations italic text 1 it is important to recognize that angry or agitated behaviors are often symptoms of dementia and are not deliberate responses 2 sometimes keeping a log or a journal can be helpful in identifying why the person becomes angry or agitated 3 the way in which caregivers approach the older adult with dementia is a critical part of avoiding angry behaviors a gentle supportive simple approach will almost always be more successful than commands or rationalizing dementia victims will often sense a caregiver’s frustration or anger and become anxious or angry themselves 4 anger and rage are often signs than the person is feeling loss of control of his her life calmly acknowledge feelings even when you do not understand what is being said or why the person is angry 5 medications can often reduce agitated behaviors for some patients with dementia however medications can have adverse side effects or can cause agitation 6 if you feel your physical safety is threatened 7 after episode is passed try not to remind person of incident he she will probably soon forget caregivers should carefully consider what can be changed to avoid another reoccurrence in addition caregivers should work out an emergency procedure for themselves in the event of physical danger
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Categories: Behavior Challenging, Cognitive Intellectual
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*This information is listed as a Fact Sheet and is not explicitly medically licensed