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“My husband is getting restless in the evenings — pacing about, looking for nothing in particular. He is restless in bed through the night — yawning, sniffing, and moving around. I’m a light sleeper, so every movement wakes me,” shared one myALZteam member.
If your loved one with Alzheimer’s seems unable to settle down, they may be experiencing dementia-related agitation or restlessness — behavior changes that can have many causes, from physical discomfort and brain changes to medication side effects.
Here’s what Alzheimer’s agitation can look like, what may cause it, and how you can help manage it.
Restlessness is a common issue with Alzheimer’s disease. It may look different for everyone, but here are some possible signs and symptoms.
Sometimes, older adults living with Alzheimer’s may make small repetitive movements, such as fidgeting or tapping their fingers. One member asked, “Have any of you noticed repetitive movements and verbal sounds such as humming nonstop?”
Another said, “My mother is a smoker and will put out her cigarette just to light it back up. It’s like she is obsessed with the ‘hand-to-mouth’ and lighting up.”
Restlessness can show up as repeated walking or pacing, and some people with Alzheimer’s may try to leave the house. “Is nonstop walking and talking a normal phase?” one myALZteam member asked.
Some caregivers notice that their loved ones with Alzheimer’s tend to miss sleep. “My husband has been up since yesterday. He has been very restless lately,” one member shared.
Nighttime pacing and disrupted sleep can also leave caregivers exhausted.
Another said, “Does anyone else notice a lot of twitching and jumping when their loved one with dementia is sleeping during the day?”
Sleep disturbances can occur in Alzheimer’s and other dementias. Sleep patterns may change with age, but adults 65 and older generally still need 7 to 9 hours of sleep each night.
Restlessness may occur along with other behavioral changes, such as irritability, anger, verbal outbursts, uncharacteristic accusations, or aggressive behavior.
One member said, “I think what hurts the most is the nasty things he accused me of doing. I know it’s the disease, not him, because he was never like that. I really hate this rotten Alzheimer’s disease.”
When confusion, anxiety, agitation, or restlessness repeatedly appears in the late afternoon or early evening, it may be called “sundowning.”
As many as 66 percent of people living with Alzheimer’s or other dementias may experience late-day confusion. Sundowning usually peaks in the middle stages and lessens as the disease progresses.
For family members and caregivers, managing a loved one’s restlessness and agitation can be extremely difficult. Looking for possible causes can help you figure out how to respond.
Several factors can trigger agitation in people living with Alzheimer’s disease:
The Alzheimer’s Association recommends scheduling doctor appointments, trips, and bathing in the morning and early afternoon when your loved one may be more alert.
It may take time to identify what tends to trigger your loved one’s restlessness. Once you spot a likely trigger, you may be able to reduce or better manage future episodes.
Your loved one’s bouts of agitation can be frustrating or upsetting. Although it’s tough, practicing patience and understanding can help keep the environment calm and safe.
Here are some strategies that may help prevent or ease restlessness and agitation for your loved one and make caregiving a little easier.
Pay attention to the circumstances and events that seem to trigger agitation in the person you care for. This may help you anticipate situations that tend to lead to restlessness or agitation.
Keep a written log of suspected triggers so you can look for patterns. Share what you learn with family members and other caregivers who may provide respite care.
Keep the person’s surroundings calm, uncluttered, and well lit. Too much stimulation or poor lighting can increase confusion or agitation.
Maintain a consistent routine to provide a sense of familiarity and security. Set a schedule for daily activities, including mealtimes, bathing, and bedtime, to provide structure and reduce uncertainty.
“Our routine is breakfast, his pills, and a shower. We do it every day the same. I feel it works for him, but it helps me too,” shared a member who cares for a parent.
Speak calmly, lower your voice, and provide reassurance. Gentle touch, such as holding your loved one’s hand, may also help them feel calmer.
One myALZteam member recommended the following to another member whose mother was upset: “Take a few deep breaths. Take her dominant hand between your hands. Speak calmly and lower your tone.
“Say something soothing. Repeat this over and over. I hope this sequence will keep you calm and soothe her.
“I also used a stress-relieving lotion or oil to massage my late mom’s hands, neck, and shoulders to calm her.”
Encourage activities that promote relaxation, such as listening to familiar, calming music, engaging in gentle exercise, or doing hobbies the person enjoys. “My mom enjoys gospel and oldies to help her sleep and feel comfort,” one member commented.
Limit noise, visitors, and activities that may overwhelm your loved one. Monitor their reactions and adjust the environment as needed. If noisy crowds or loud venues seem to trigger agitation, consider choosing quieter settings.
A change of scenery may also help. “We went out to dinner yesterday for our 43rd anniversary,” a myALZteam member wrote.
“The first place we went to, Hubby got real nervous due to the noise level while waiting to be seated. We left and went to one of his favorite places instead, much quieter. This is something new, not liking crowded noisy places.”
Regularly check for any physical discomfort, such as hunger, thirst, pain, or the need to use the bathroom.
One member said, “Part of the problem is dehydration. Try to keep your loved one hydrated. It will help a bit.”
Addressing these needs promptly may help prevent agitation from getting worse.
When you’re concerned about your loved one’s symptoms, including restlessness and agitation, speak to their healthcare provider. They can look for possible causes and discuss treatment options.
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I just found out about a sensory quilt or what some term a fidget blanket....it gives the person something to occupy their hands and mind. You could Google it and see if it might work for your mom.
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