How to calm someone down that has dementia?

Research from organizations like the Alzheimer's Association highlights that a calm and compassionate approach is key to reducing agitation in people with dementia. Learning how to calm someone down that has dementia involves understanding their unique needs and responding with empathy and patience, rather than with frustration or correction.

Quick Summary

Caregivers can de-escalate difficult situations by first staying calm, then validating the individual’s feelings, rather than arguing with their reality. Effective strategies include using simple, clear communication, creating a predictable and soothing environment, and employing gentle distraction techniques to redirect focus and provide reassurance.

Key Points

• Stay Calm: Your own calm demeanor can help de-escalate the situation and prevent mirroring of frustration.

• Validate Feelings: Acknowledge the emotion behind the agitated behavior instead of correcting the facts of their reality.

• Check for Triggers: Investigate underlying causes like pain, hunger, fatigue, or environmental overstimulation before reacting.

• Redirect and Distract: Gently shift focus to a calming, familiar activity or object to divert attention from the source of distress.

• Simplify Communication: Use short, clear sentences and yes/no questions to minimize confusion and frustration.

• Create a Safe Routine: Maintain a consistent daily schedule and a predictable, clutter-free environment to increase comfort and security.

• Prioritize Self-Care: Caregivers must manage their own stress and fatigue to effectively provide patient and compassionate care.

Understand the Root Cause of Agitation

Before attempting to calm someone, it is crucial to understand that their agitation often stems from confusion, fear, or an unmet need rather than deliberate behavior. Triggers can include physical discomfort, environmental overstimulation, or changes in routine. By identifying potential causes, caregivers can respond more effectively and proactively prevent future episodes.

Physical and emotional triggers

Agitation can often be a signal of an underlying issue that a person with dementia cannot express verbally. Common triggers include:

• Physical Pain or Discomfort: The person may be hungry, thirsty, in pain, too hot or cold, or need to use the bathroom.
• Fatigue: Exhaustion can increase irritability, especially during the late afternoon, a phenomenon known as 'sundowning'.
• Emotional Distress: Feelings of loneliness, fear, loss of control, or frustration with communication can manifest as agitation.
• Medication Side Effects: Some medications can cause confusion or restlessness. Consult a doctor to rule this out.

Environmental triggers

The physical environment plays a significant role in a person with dementia's emotional state. Minimizing stressors can help maintain a sense of calm:

• Noise and Clutter: Loud noises or a cluttered space can be overwhelming and disorienting. Keeping the environment tidy and quiet is beneficial.
• Lighting: Harsh lighting, shadows, or glare can cause misperceptions and fear. Soft, natural lighting is best.
• Unfamiliarity: Changes to the home, new people, or unfamiliar places can trigger anxiety.

Master Communication Techniques

How you communicate is more important than what you say. A calm and reassuring tone of voice, positive body language, and simple language can make a huge difference.

The power of a calm presence

Your own demeanor can mirror the person's mood. If you appear stressed or upset, they are likely to feel the same. Taking a moment to breathe deeply and ground yourself before responding can help you project a calm and reassuring presence.

Use validation, not confrontation

It is unproductive to argue or try to correct a person with dementia, as their perception of reality is altered. Instead, validate their feelings and respond to the emotion behind their words. For instance, if they say they want to go 'home' even while in their own house, acknowledge the feeling by saying, 'I understand you feel like you need to go home. Tell me more about that.'

Simple, clear messages

People with dementia have a reduced ability to process complex information. When communicating:

• Use short, simple sentences.
• Ask yes or no questions instead of open-ended ones.
• Speak slowly and clearly.
• Maintain gentle eye contact.

Implement Calming Strategies and Distraction

Once you have identified the likely trigger and are communicating calmly, you can introduce calming strategies and gentle distractions to redirect their focus.

De-escalation techniques: A step-by-step approach

1. Assess the Situation: What might be causing the distress? Is it a physical need or an environmental issue?
2. Ensure Safety: Remove any objects that could cause harm. If they are in a potentially dangerous area, gently guide them to a safer space.
3. Validate and Reassure: Use a calm voice to acknowledge their feelings. 'I see you're upset. It's okay. I'm right here with you.'
4. Redirect with a Familiar Activity: Gently shift their attention to something simple and enjoyable. This could be a favorite song, a photo album, or a soft blanket.
5. Change the Environment: If possible, move to a quieter room, or if they are open to it, suggest a short walk outside to change the scenery.

Comparison of Communication Approaches

Arguing (Ineffective)	Validating (Effective)
"You're in your own home. What are you talking about?"	"It sounds like you want to go home. I can understand that."
"You're wrong; we did that yesterday."	"Let's talk about something else. What's this picture of?"
"Just calm down! You're making a fuss."	"I can see this is upsetting for you. I'm here to help."
"I told you already..."	"Let me tell you again, just so we're clear."

Create a Soothing Environment and Routine

Consistency and comfort are powerful tools in preventing agitation. A predictable routine and a soothing environment help ground a person and reduce anxiety.

Sensory engagement

Engaging the senses can provide a powerful sense of comfort and familiarity:

• Music Therapy: Play music from their younger years. Familiar songs can tap into memory and evoke positive emotions.
• Aromatherapy: Calming scents like lavender or chamomile can help promote relaxation. Use a diffuser or lightly scented lotion.
• Tactile Stimulation: Offer a soft blanket, a fidget toy, or gentle hand massage. The feeling of touch can be very reassuring.
• Reminiscence Therapy: Look at old photographs or talk about happy memories. This provides a positive distraction and validation.

The importance of routine

A predictable daily routine provides structure and security, reducing the fear of the unknown. Try to schedule meals, bathing, and bedtime at the same time each day. Any necessary changes should be introduced gradually.

Prioritize Caregiver Self-Care

Caring for someone with dementia is incredibly challenging. Your own stress and fatigue can impact your ability to respond with patience. Acknowledging your feelings and taking steps to manage your own well-being is vital.

• Take Breaks: Schedule regular breaks and seek respite care from family or professional services.
• Seek Support: Join a support group for caregivers. Sharing experiences and strategies with others can be invaluable.
• Practice Stress-Relief: Use mindfulness, exercise, or hobbies to manage your own stress.

Conclusion

Navigating the challenges of dementia-related agitation requires a flexible, compassionate, and patient approach. By understanding the potential triggers, employing gentle communication, creating a calming environment, and prioritizing self-care, caregivers can significantly improve the quality of life for both themselves and their loved ones. Remembering that the behavior is a symptom of the disease, not a reflection of the person's character, is key to offering the best possible care. For further resources and detailed guides, visit the Alzheimer's Association.

Frequently Asked Questions

What should I do first when a person with dementia becomes agitated?

First, stay calm yourself. Your tone and body language can influence their mood. Then, ensure the person is safe and not in danger. Try to identify the immediate trigger for their agitation, such as noise, discomfort, or confusion.

Is it okay to use physical touch to calm someone with dementia?

Yes, for many people with dementia, a gentle, reassuring touch, like holding a hand or a comforting pat on the shoulder, can be very soothing. However, always be mindful of their reaction; if they pull away or seem more agitated, respect their space.

How can I tell if a person is agitated due to pain?

Since they may not be able to express pain, look for nonverbal cues. These can include grimacing, guarding a part of their body, restlessness, or moaning. If you suspect pain, try to comfort them, and consult a doctor to investigate further.

What is 'sundowning' and how do I manage it?

Sundowning is increased confusion and agitation that occurs in the late afternoon or evening. To manage it, try to maintain a consistent daytime routine, ensure they get plenty of natural light, and reduce stimulating activities during the evening. Providing a comforting nighttime ritual can also help.

Should I argue with a person with dementia if they are saying something that isn't true?

No, arguing is counterproductive. Their perception of reality is altered, and reasoning will only increase their frustration and agitation. Instead, validate their feelings by responding to the emotion, not the incorrect facts. For example, 'I see you're feeling worried,' is more helpful than correcting them.

Can music really help to calm someone with dementia?

Yes, music therapy is a very effective tool. Music from their past can evoke positive memories and emotions, providing a powerful distraction and sense of comfort. Creating a playlist of their favorite songs can be incredibly beneficial.

What if my best calming techniques don't work?

If your usual techniques are ineffective, it may be a sign of a new or different underlying cause. Check for signs of illness or side effects from new medications. It may be time to consult their healthcare provider to discuss the change in behavior.