Supporting those living with dementia

Understanding agitation and frustration

Agitation is a feeling of frustration, annoyance, nervousness and restlessness. Reasons for these feelings can be real or imaginary. The body reacts by increasing your breathing and heart rate, and your body can become restless, where you can’t keep still. The person may not understand what is happening to them and can experience high levels of stress. This can affect all aspects of their life and can stop them from enjoying things they used to do. ¹

Feeling of stress and frustration can be increased if they also have difficulties with memory and concentration. Frustration can turn to anger, however a person with dementia may be unable to express this with words or they may be unaware of the appropriate time or way to express it. A person with dementia can become aggressive and verbally abusive, but it is important to remember that the person has reduced control over their words and actions. ¹

Caring for someone with dementia

It is common for the carer or family member caring for the person with dementia to be at the receiving end of the verbal or physical frustration. The family member/carer must not take this personally even if it seems that the aggression is personal and done purposefully, it is not. However, this can be a cause of distress for both the person with dementia and their carer/family.

Supporting the person with dementia can be challenging at times, but your knowledge of the person means you know how to help the person relax. Consider the activities they used to enjoy before they developed dementia, i.e., music, art, exercise, special places, interacting with pets.

Remember PAL to help support the person with dementia:

Prevent

Action

Learn

Prevent

Prevention is better than cure!

• Establish a routine in their daily life. This can help with memory skills and will prevent feelings of confusion and anxiety.
• Identify any signs that the person is experiencing pain or discomfort. If the person is verbal and can understand, ask them. If the person is non-verbal or you are still concerned:
• Look at their facial expression
• Look for any physical signs i.e., redness, swelling, long/ingrown toenails, constipation, strong smelling urine
• Ensure the person is not sitting stationary for too long, movement is key. Either with assistance and passively using a hoist or tilt in space.
• Identify any triggers that increase feelings of anxiety or frustration. Keep a diary of any time the person experiences frustration, noting time of day, what happened just before the event, and how you managed it.
• Try not to argue. It is not important to correct the person or prove that you are right.
• Adapting the environment. Is the surrounding familiar to the person, is it too noisy or over-stimulating?
• Help to keep the person stimulated throughout the day. Assist them if necessary with activities they used to enjoy, encourage other family members or friends to visit or engage in activities.
• Reminisce. Discussing events from their past can help trigger memories and bring joy, whilst reinforcing the person’s sense of identity and belonging.
• Exercise is proven to reduce frustration. Invite the person to go for a short walk, or chair exercises, depending on their ability.

Action

• If the person has signs of illness, such as a cough, infections, constipation or dehydration, it is important to have them seen by a doctor as soon as possible. Physiological problems can cause confusion and behavioral issues, due to symptoms of pain and discomfort.
• If the person is becoming aggressive;
• Keep yourself safe and identify an escape route.
• Ensure the person is safe by removing any objects in their environment that could cause injury.
• Use distraction by bringing out their favourite magazine or singing their favourite song.
• Remain calm and try not to react.
• Ask them what you can do to help?

It is important to remember not to take the aggression personally and to try identify which solutions work best for the person. The person’s behaviours can change over time as the dementia progresses, and what are triggers now may not be triggers in the future.

Learn

Learning about dementia and the changes that are happening for the person helps you to understand how to manage frustrations.

• Dementia is a illness, not a normal part of the aging process
• Reflating on how you are reacting and responding to the diagnosis and the change in behaviour
• Identifying triggers and ways to help manage the persons’s behaviour
• Understanding how sensory interventions can help the person with dementia
• Learn about support organisations and contact them for advice and services if required

Support Organisations

Find Support Near You

www.dementiauk.org/

www.agespace.org

www.understandtogether.ie

www.livingwellwithdementia.ie

www.dementia.ie

Author

Kirsty O’Connor

Occupational Therapist and Clinical Training Manager

References

Alzheimers society of Ireland (2023) ‘I am a carer/family member’, [online], available: https://alzheimer.ie/living-wi... [accessed 20th June 2023]