Is Agitation Ruining Your Caregiving? What You Need to Know
When a loved one with Alzheimer’s disease is pacing, yelling, resisting help, or seeming suddenly unlike themselves, everyday Caregiving can feel exhausting and isolating. Agitation is not a character flaw or a sign that a Family Caregiver has failed. It is a common, distressing group of Dementia Symptoms that deserves attention, patience, and a thoughtful plan.
In the GoToHealth conversation “Is Agitation Ruining Your Caregiving? What You Need to Know,” psychiatrist Brent Forester MD and caregiver advocate Karen Finocchio describe the very real impact of agitation on people living with dementia and the people who support them. Their central message is practical: protect safety first, look for possible causes, and bring concerns to a health professional before the situation becomes unmanageable.
WHAT AGITATION CAN LOOK LIKE
Agitation in Alzheimer’s disease can range from restlessness to behaviors that feel frightening or unsafe. A person may pace, wander, repeat a question or action, become irritable, cry, yell, curse, resist bathing or dressing, or lash out physically. The intensity may rise and fall, and the behavior may look different from one day to the next.
These changes can be especially confusing when a loved one also has Memory Loss. It can help to remember that the behavior is a form of communication, not a deliberate attempt to make life harder. Changes in the brain linked to alzheimer’s disease can affect emotional regulation, perception, and the ability to express discomfort. Other medical conditions, pain, fatigue, or an overwhelming environment can add to the strain.
Families sometimes search for “alzheimers” or “alzheimers disease” when they need urgent answers. The standard clinical name is Alzheimer’s disease, a condition within the broader group of neurological disorders known as dementia. Whatever words a family uses, a sudden or worsening behavior change deserves compassionate attention.
Families may use several search terms—including alzheimers, alzheimers disease, alzheimer’s disease, and alzheimer’s—when looking for reliable care guidance. The standard clinical name is Alzheimer’s disease, a condition within the broader group of Neurological Disorders known as dementia. Whatever words a family uses, a sudden or worsening behavior change deserves compassionate attention.
SUNDOWNING IS A PATTERN, NOT A PERSONAL FAILURE
Sundowning describes agitation or confusion that tends to emerge later in the day, often in the mid-to-late afternoon or evening. As daylight fades, fatigue, reduced stimulation, shadows, and changes to the body’s internal clock can make a difficult time of day even harder.
A predictable pattern can give you a useful starting point. Notice when the behavior happens, what came before it, who was present, and what seemed to help. A simple written log can reveal whether the person is hungry, tired, in pain, overstimulated, confused by a task, or reacting to a change in routine. This observation is a key part of effective Dementia Care and can help the care team make better recommendations.
CALMING TECHNIQUES THAT START WITH THE ENVIRONMENT
Calming Techniques do not mean trying to “win” an argument. They mean lowering stress and making the next moment easier. Begin with your own tone and body language. Speak slowly, use short sentences, offer one choice at a time, and give the person extra time to respond. Avoid correcting, quizzing, or insisting on facts when that approach makes distress worse.
Reduce noise, turn off a busy television, soften harsh lighting, and move to a quieter space if possible. Familiar music, a favorite drink, a brief walk, a simple activity, or a reassuring touch—when welcome—may help the person feel more secure. Keep daily routines as consistent as possible, especially around meals, personal care, and sleep.
If the person is becoming more upset, pause the task rather than forcing it. Step back, validate the emotion, and try again later if it is safe to do so. These practical Caregiving Tips can support Elder Care and Senior Care at home, but there is no single solution for every person or every episode.
LOOK FOR THE “WHY” BEFORE ASSUMING IT IS ONLY DEMENTIA
Dr. Forester emphasizes the importance of identifying possible drivers of agitation. A behavior change may be linked to a noisy setting, an unfamiliar caregiver, a disrupted routine, discomfort, constipation, dehydration, poor sleep, infection, a medication effect, or another health problem. It can also reflect the underlying changes of dementia itself.
Contact the person’s primary care clinician or dementia care team when agitation is new, more frequent, harder to manage, or affecting safety. Ask for an evaluation rather than making medication changes on your own. The clinician can help rule out reversible causes and discuss an individualized plan that may include behavioral approaches, treatment of an underlying problem, and, when appropriate, other options.
MAKE SAFETY THE FIRST PRIORITY
During an episode, create space and remove immediate hazards when you can. Do not block a doorway, corner the person, argue, or try to physically restrain them unless trained professionals have given you specific direction. If there is an immediate threat of injury, call emergency services.
For continuing concerns, tell the care team clearly what is happening: what the person does, when it happens, what may trigger it, how long it lasts, and what helps. This practical detail supports better decisions for the person with dementia and stronger Caregiver Support for the people around them.
CAREGIVER SUPPORT IS PART OF GOOD DEMENTIA CARE
The needs of a Family Caregiver matter. Agitation can disrupt sleep, strain relationships, and leave caregivers feeling anxious or guilty. Ask a trusted family member or friend for a specific task, explore respite options, or contact a local dementia support organization. If a loved one receives hospice care, notify the hospice nurse about new or escalating agitation. The hospice nurse can help assess comfort, safety, and changes in the care plan while keeping the person’s goals of care at the center.
Caring for an older adult also means caring for your own Brain Health. Regular rest, meals, movement, social connection, and breaks from caregiving are not luxuries; they help sustain the patience and resilience that caregiving requires.
WORLD ALZHEIMER’S DAY: SHARE KNOWLEDGE, REDUCE STIGMA
World Alzheimer’s Day, observed each September 21, is a time to raise awareness, challenge stigma, and stand with people living with Alzheimer’s and other dementia. Sharing accurate information about agitation can make it easier for families to ask for help early instead of facing difficult Dementia Symptoms alone.
On World Alzheimer’s Day, consider starting a conversation about Alzheimer’s disease, checking in with a caregiver, or sharing resources that support Elderly Health. Better understanding cannot erase every difficult moment, but it can help families respond with more confidence, dignity, and connection.
WHEN TO REACH OUT NOW
Seek prompt professional guidance when agitation is sudden, severe, escalating, associated with possible illness or pain, or making it impossible to provide safe care. Call emergency services if anyone is in immediate danger. For non-emergency support, start with the person’s primary care clinician, dementia specialist, or care team.
This page is for education and does not replace individualized medical advice, diagnosis, or treatment.
SOURCES
AlzGOALS: “What is Alzheimer’s disease agitation?”
https://www.alzgoals.com/
Alzheimer’s Association: “World Alzheimer’s Day is Sept. 21”
https://www.alz.org/about/awareness-initiatives/world-alzheimers-day
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