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 behaviorsstart. 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, sugar, and “junk food” 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.

Taking regular breaks helps caregivers reduce stress and avoid burnout. Learn more by reading our interview on The Value of Respite Care to Help a Stressed Caregiver.

Additional Resources for Dementia Caregivers

Caring for someone with Alzheimer’s disease can be emotionally and physically demanding. Learning more about dementia care strategies can help caregivers respond with greater confidence while improving the quality of life for their loved one.

• Learn about person-centered dementia care in our Alzheimer’s Disease Bill of Rights.
• If medication has been recommended to manage behavioral symptoms, read our guide to Psychotropic Medications for Dementia.
• Create a calmer home by following these tips in Creating a Manageable and Engaging Environment.
• For additional caregiving advice, visit More Pointers on Caring for Someone with Dementia.
• Improve communication techniques by reading Reality Orientation.

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.

Read about this topic in Spanish. Lea sobre este tema en español.

When Professional Dementia Care May Help

If agitation or aggressive behaviors become difficult to manage safely at home, professional dementia care may provide additional support. Senior Care of Sacramento helps families explore compassionate care options based on their loved one’s individual needs.

Learn more about our Residential Care with Dementia Services.

For More Information About Alzheimer’s and Agitation and Aggression