Coping with Agitation and Aggression in Alzheimer's Disease

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People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.

Causes of agitation and aggression

Most of the time, agitation and aggression happen for a reason. When they happen, try to find the cause. If you deal with the causes, the behavior may stop. For example, the person may have:

• Pain, depression, or stress
• Too little rest or sleep
• Constipation
• Soiled underwear or diaper
• Sudden change in a well-known place, routine, or person
• A feeling of loss—for example, the person may miss the freedom to drive
• Too much noise or confusion or too many people in the room
• Being pushed by others to do something—for example, to bathe or to remember events or people—when Alzheimer’s has made the activity very hard or impossible
• Feeling lonely and not having enough contact with other people
• Interaction of medicines

Look for early signs of agitation or aggression. If you see the signs, you can deal with the cause before problem behaviors start. Try not to ignore the problem. Doing nothing can make things worse.

A doctor may be able to help. He or she can give the person a medical exam to find any problems that may cause agitation and aggression. Also, ask the doctor if medicine is needed to prevent or reduce agitation or aggression.

Tips for coping with agitation or aggression

Here are some ways you can cope with agitation or aggression:

• Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
• Allow the person to keep as much control in his or her life as possible.
• Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
• Build quiet times into the day, along with activities.
• Keep well-loved objects and photographs around the house to help the person feel more secure.
• Try gentle touching, soothing music, reading, or walks.
• Reduce noise, clutter, or the number of people in the room.
• Try to distract the person with a favorite snack, object, or activity.
• Limit the amount of caffeine the person drinks and eats.

Here are some things you can do:

• Slow down and try to relax if you think your own worries may be affecting the person with Alzheimer’s.
• Try to find a way to take a break from caregiving.

Safety concerns

When the person is aggressive, protect yourself and others. If you have to, stay at a safe distance from the person until the behavior stops. Also try to protect the person from hurting himself or herself.

For more information about Alzheimer's and agitation and aggression

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017