Calm Compassion – Managing anxiety-related behaviors in dementia

Dementia can cause changes in a person’s behavior and personality.  Pain or infections can also contribute to these changes.  While some medications may help with specific behavior changes, others, like wandering or pacing, may not be treatable with medicine.

When dealing with agitation in seniors with dementia, it’s essential to approach the situation with compassion and understanding.  People with dementia often struggle to describe or explain their feelings.  They may express themselves through angry outbursts, disinterest in activities, or reduced activity.

Scenario 1:  The person with dementia follows you around and gets upset when they can’t see or hear you.
What to do–Environmental strategies

1. Use a calm voice to reassure the person.
2. Reduce background noise and remove clutter to prevent disorientation.
3. Create a calming atmosphere with soft music, gentle lighting, and familiar objects.
4. Set up a “personal station” with water, snacks, books, or activities near their favorite spot.
5. Engage them in enjoyable activities like painting or puzzles to redirect their focus.
6. Encourage physical activities like walking to release nervous energy.

Scenario 2:  The person with dementia constantly asks the same questions.
What to do–Listening and Speaking Strategies

1. Listen attentively and confirm their feelings or thoughts, even if they appear irrational.  For example, “The boy is stuck under the chair.  he’s hurt.”  Express empathy and confirmation by saying, “I understand; the boy is trapped under the chair, and it seems like he’s hurt.”
2. Respond with clear, short sentences to reduce worries.  For example, “Let’s call XX to help him out.”
3. Use eye contact and a calm voice to prevent misunderstandings.
4. Employ humor if it helps.  For example, “Uh-oh, looks like we have a chair-loving acrobat playing crazy moves.”
5. Create scripted responses for everyday interactions.
6. Establish a daily schedule to reduce confusion.
7. Keep yourself calm to help the person stay calm, using deep breaths as a tool.

Scenario 3:  The person with dementia becomes distressed and inconsolable.
What to do–Tone it down or get support

1. Take deep breaths and keep yourself calm first.
2. Reduce background noise and dim lights.
3. Offer affection through holding hands or hugging.
4. Distract them with favorite treats like cookies.
5. Call a relative or someone familiar to distract or reassure them.
6. Avoid physical restraint or arguing; show contentment in your demeanor.
7. Call 911 if there’s immediate danger.
8. Contact your loved one’s doctor for an urgent appointment to rule out medical issues.
9. Reach out to the Alzheimer’s Association Helpline at 1-800-272-3900.