Behavior shifts are often the loudest clue something is wrong—spot the trigger, steady the moment, and protect both your loved one and the caregiver.

People with Alzheimer’s disease can get anxious or upset easily. They might be restless, unable to sleep, or pace back and forth. These problems, called agitation, can keep them from a normal day-and-night routine and might become harmful for your loved one or their caregivers.

Often, change is the biggest trigger of agitation. It might be a difference in their routine, surroundings, or the caregivers they see. Sometimes, it comes from fear or fatigue, which are common with Alzheimer’s. In some cases, agitation can happen because of an infection or another medical problem.

If your loved one is agitated and you can’t figure out the reason, take them to the doctor to see if they can find the cause.

Caregiving Tips

You may be able to lessen the agitation by simplifying their routine or distracting them from the stress that caused the problem. A few things to try:

Create a calm place for them. Cut out background noise from the TV or radio, clear away clutter, and make their daily tasks as simple as possible.

Check for physical reasons they might be agitated, like hunger, thirst, needing to use the bathroom, or being too hot or cold.

Exercise can ease anxiety and stress. Take them for a walk, do some gardening, or put on their favorite music and dance.

Use low lighting or night-lights to help them feel less confused and afraid at night.

Keep your emotions in check. You may feel frustrated, but try to keep your voice calm and steady and avoid arguing or criticizing them.

Medications

If you can’t stop their agitation on your own or the problem is very severe, the doctor may recommend medications that can help.

The drugs they prescribe will depend on your loved one’s symptoms. But common ones that can ease agitation include:

Medicines that treat paranoia and confusion, called neuroleptics or antipsychotics. Examples of these are aripiprazole (Abilify), haloperidol (Haldol), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). These drugs can cause side effects, like drowsiness, rigidity, and unusual movements. Studies have linked some of these to a higher risk of death for people with dementia. The FDA has placed a "black box" warning on these drugs describing the risks. Ask the doctor if they’re a good choice for your loved one.

Antidepressants can help if your loved one is depressed and irritable. Options include citalopram (Celexa), fluoxetine (Prozac), nortriptyline (Pamelor), paroxetine (Paxil), and sertraline (Zoloft). Side effects of these medicines can include drowsiness, dry mouth, constipation, and anxiety.

Anti-anxiety medications, which include alprazolam (Xanax), buspirone (BuSpar), lorazepam (Ativan), and oxazepam (Serax), often cause drowsiness. (Paradoxically, they may also worsen confusion and agitation.)

The best way to help your loved one with agitation is to work with their doctor. They can recommend the right mix of medication and caregiving tips to keep them calm and make things easier for you, too.

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