10 strategies for managing agitation in people with dementia
Evidence-based techniques for responding calmly and effectively when your loved one experiences episodes of agitation or restlessness.
Agitation is one of the most common behavioral symptoms in people with dementia. It can manifest as restlessness, irritability, verbal or physical aggression, wandering, or resistance to care. For families and caregivers, these episodes can be confusing and emotionally exhausting.
The good news is that most episodes of agitation have an identifiable cause and can be managed with practical, evidence-based strategies. Here we share 10 techniques you can start applying today.
Important: These strategies are intended as guidance. If agitation episodes are frequent, intense, or pose a risk, we recommend seeking a professional behavioral assessment to design a personalized plan.
Understanding agitation
Before addressing the strategies, it is essential to understand that agitation rarely occurs without a reason. People with dementia often cannot communicate what they feel with words, so behavior becomes their way of expressing discomfort, confusion, pain, or unmet needs.
Behavior is communication. When a person with dementia becomes agitated, they are trying to tell us something. Our job is to decipher that message.
The 10 strategies
Identify triggers
Observe what happens before each episode. It could be a loud noise, a change in routine, a specific time of day (such as sundown), hunger, thirst, pain, or the need to use the bathroom. Keep a brief journal to detect patterns. This will help you anticipate and prevent future episodes.
Stay calm and lower your tone
Your emotional state directly influences the person. Take a deep breath before responding. Speak in a soft, slow, and clear tone. Avoid correcting, arguing, or reasoning. A calm presence can de-escalate the situation faster than any words.
Simplify the environment
Reduce stimuli that may cause overstimulation: turn off the television, lower the music, dim harsh lighting. A calm and predictable environment significantly reduces the frequency of agitation episodes.
Validate their emotions
Instead of saying "nothing is wrong" or "calm down," try phrases like "I can see something is bothering you" or "I understand you feel uncomfortable." Emotional validation tells the person that you hear them and respect them, which can be profoundly comforting.
Use redirection
Gently shift attention toward something pleasant: a favorite song, looking at family photos, going for a walk, offering a snack or a warm drink. Redirection works because dementia affects short-term memory, allowing the emotional state to change.
Establish consistent routines
Predictability creates a sense of safety. Try to maintain regular schedules for meals, bathing, activities, and sleep. When the person knows (even unconsciously) what to expect, anxiety decreases significantly.
Check for physical causes
Many times agitation is caused by pain, constipation, urinary tract infections, hunger, thirst, or feeling too cold or too hot. If agitation appears suddenly, rule out a medical cause first. Something as simple as a change of position or a glass of water can make all the difference.
Offer simple choices
Instead of open-ended questions, offer two concrete options: "Would you like to wear the blue shirt or the white one?" rather than "What do you want to do?" This reduces the frustration of making complex decisions and gives the person a sense of control.
Incorporate music and sensory activities
Music, especially from periods that are meaningful to the person, can have a powerful calming effect. Other sensory activities such as stroking a soft fabric, smelling lavender, or holding a familiar object can also help regulate emotions.
Take care of the caregiver
You cannot give what you do not have. If you are exhausted, stressed, or without support, your ability to manage these episodes diminishes. Seek help, take regular breaks, and remember that asking for support is not weakness — it is wisdom.
When to seek professional help
These strategies are an excellent starting point, but there are situations that require specialized support:
- Agitation episodes are daily or very frequent
- There is a risk that the person may harm themselves or others
- Strategies that used to work are no longer effective
- The caregiver feels overwhelmed or emotionally exhausted
- There are sudden changes in behavior that are not easily explained
At BehaCare, our team of behavior and dementia specialists can conduct a comprehensive behavioral assessment to identify the specific causes of agitation and design a personalized intervention plan for your family.
Remember: You are not alone on this journey. Dementia is a condition that affects the entire family, and seeking professional support is one of the greatest acts of love you can do for your loved one and for yourself.