Agitation takes on many forms in those with dementia, and it's important for caregivers to recognize symptoms and possible causes to find solutions that benefit both the patient and their families.
At a recent Town Hall Forum co-sponsored by The Glenner Alzheimer's Family Centers, Dr. Alan Berkowitz explained that the vast majority of dementia patients experience some type of behavioral change when their routines or settings are disrupted. "Transitioning from home to whereever it may be is a huge step," said Dr. Berkowitz, a geriatric psychiatrist with Sharp Healthcare. He discussed how best to manage acutely agitated long-term care patients.
"Early identification is important," he said, noting a Newsweek article a couple of years ago that spoke of "pleasant dementia." "Most people with dementia don't have 'pleasant dementia.'"
"Agitation" is any inappropriate verbal, vocal or motor activity that is not an obvious expression of need. Physical, non-agressive signs of agitation include:
--Pacing
--Inappropriate dressing or underdressing
--Inappropriate handling of objects
--Complaining
Physical, aggressive signs of agitation include:
--Hitting
--Kicking
--Biting
--Scratching
--Threatening
Some common reasons for agitation are:
--Caregiver-related
--Environment-related
--Confusion
--Psychiatric
--Manifestation of a medical disorder
--Medication side effects
--Urinary tract infection
UTIs, in fact, are the biggest cause of agitation in long-term care facilities, Dr. Berkowitz said. Once the cause can be found, modifications may bring an end to the behaviors or at least mitigate them.
