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How to Help Loved Ones With Dementia Avoid Becoming Agitated

People with dementia often become frustrated and agitated, but there are ways to reduce how often this happens, according to Brent Forester MD and Tom Harrison, authors of The Complete Family Guide to Dementia, published by Guilford Press. Here’s some advice from the authors

Tom Harrison & Brent Forester MD
How to Help Loved Ones With Dementia Avoid Becoming Agitated

This article was written by Brent Forester MD and Tom Harrison, authors of  The Complete Family Guide to Dementia: Everything You Need to Know to Help Your Parent and Yourself.

A key reason why loved ones with dementia become agitated is that they have difficulty with communication. It’s very frustrating not to be able to make yourself understood, or to understand others. For this reason, it’s a good idea to try to communicate with them in a way that reduces the likelihood of agitation.

One way to do this is to speak in a calm, measured, even tone. This can be difficult to do, especially if you’re in a hurry, but it’s worth putting in the effort. It’s a bit like acting – you’re adopting the persona of a person who is relaxed, calm, and soothing. 

Since your loved one has difficulty understanding the context of situations, they will look to your manner for clues as to how to feel and respond. If you seem nervous, they’ll likely feel nervous, too. If you seem happy and relaxed, they’ll get the subtle message that there’s nothing to be worried about.

Of course, it can be difficult to remain calm if your loved one does become agitated – or even says things that hurt or upset you – but staying relentlessly calm is the quickest way to defuse the situation.

Watch Your Voice

It can also be good to try to lower the pitch of your voice. Lower-pitched voices are generally perceived as calmer (and in addition they can be easier to understand for people who have mild hearing loss).

Some people approach communicating with dementia sufferers by talking to them in a sing-song way, as though they were a little child. Occasionally this does make people with dementia seem happy. However, if the person becomes worried or agitated, a sing-song manner can make the problem worse by causing them to feel as though they’re being infantilized and not taken seriously. In general, a calm, measured tone works better because it communicates dignity and respect.

Speaking of dignity and respect, some loved ones with dementia become irritated when family members repeatedly supply missing words for them. Most of the time this is helpful, but sometimes people would prefer to be given extra time to remember the word on their own. Being sensitive to your loved one’s preferences – or even asking them in a lucid moment which they prefer – shows respect and can have a calming effect. 

More Tips

Some other tips include:

  • Begin by saying the person’s name (or whatever you normally call them, such as “Mom” or “Dad”), which gives them time to focus on listening to you.
  • Maintain eye contact when speaking. 
  • If possible, be at the same eye level, so you’re sitting if your loved one is sitting, for example. 
  • Approach the person from the front, rather than walking up from the back or the side or calling from another room.
  • Avoid sudden movements, which can be distracting or worrying. 

All of these things demonstrate respect and can help keep your loved one from having the sense that they’re being “managed.”

Be Positive

Another technique to avoid agitation is to couch statements as much as possible in a positive way. For instance, rather than telling your loved one not to do something – which can cause defensiveness – you can redirect them toward something else.

Instead of telling your mother not to go outside, for example, you might say “Let’s go into the living room.” Instead of telling your father not to eat something with his fingers, you might say “Here, it’ll be easier if you use a fork.” Instead of telling a spouse “You’re in the wrong place,” you can smile and say “It looks like you’re looking for the kitchen. Here, it’s this way.”

People with dementia already know that they make a lot of mistakes and they likely feel unhappy and self-conscious about it. Offering a positive alternative rather than suggesting that they did something else “wrong” can go a long way toward keeping them from getting upset.

Make Them Feel Heard

People with dementia will almost always be calmer if they not only are able to understand you but if they feel that you understand them. Thus, it can be a very good idea to summarize back what the person said and ask if you understood correctly. This not only makes sure you did understand correctly, but it also reassures the person that they have been heard. 

Another tip is that there’s seldom a need to tell a loved one in advance about appointments or other upcoming events. Dementia sufferers often retain memories of emotions much longer than memories of facts. As a result, when a loved one hears that they have a doctor’s appointment tomorrow, it’s unlikely that they’ll be able to remember the details, but they might be left with a gnawing worry that there’s something they need to do or something that is expected of them. This can lead to agitation. It’s usually better to simply wait until the appointed time and then say, “Today we need to go to the doctor for a routine check-up.” 

Purchase The Complete Family Guide to Dementia here.

Date posted: Dec 15, 2023
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Tom Harrison & Brent Forester MD

Harrison, a writer and former editor, and Forester, an award-winning researcher, specialize in dementia and mood disorder care. Coauthors of The Complete Family Guide to Dementia.

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