Redirection technique for agitation
Key points
- Agitation is a form of communication—always check for pain, hunger, thirst, or bathroom needs first.
- Stay calm yourself; your anxiety can escalate their agitation. Use deep breathing before you act.
- Validate their feelings before redirecting. Never argue or use logic—it will not work.
- Use sensory calming tools: soft music, hand massage, familiar objects, and a quiet environment.
- Tailor your approach to the type of dementia (e.g., avoid antipsychotics in LBD; use simple commands in FTD).
- Non-drug strategies are effective and safe, but they require practice and patience. You are not alone—seek support from online communities like ALZConnected.
General caregiving information, not medical advice. Check medications and major care changes with your clinician.
Step-by-step
Pause and take three slow, deep breaths before responding; say softly to yourself: 'I am safe. We can handle this.'
Check for physical causes: pain, hunger, thirst, or need to use the bathroom. Ask gently and watch for non-verbal cues (e.g., wincing, grabbing stomach). If they cannot communicate, assume pain may be present and discuss with their doctor.
Reduce environmental triggers: turn off TV, dim bright lights, close curtains to cut glare, move to a quieter room.
Validate their feelings and join their reality: never argue or try to reason. Acknowledge the emotion, then gently redirect to a shared activity (e.g., 'I see you are upset. Let's get our coats and go for a walk.').
Use a gentle, slow voice and short, concrete sentences. Avoid 'why' questions. Offer a gentle touch on the arm if they are comfortable with it.
What not to do
Do not argue, correct, or try to reason with their reality.
Do not ask 'why' questions.
Do not ignore possible physical pain or discomfort.
Practical tools
Deep breathing
Take three slow, deep breaths before responding to activate calm and prevent reactive replies.
Environmental adjustment
Reduce background noise, dim lights, close curtains, move to a quieter space.
Validating redirection
Acknowledge the emotion first, then offer a concrete, shared activity instead of arguing.
Sensory comfort
Offer a familiar object like a soft blanket or a gentle touch on the arm to provide comfort.
Discuss with your clinician
If agitation appears suddenly, rule out delirium (caused by infection, medication side effects, or dehydration). Sudden onset requires immediate medical evaluation.
If you suspect pain but your loved one cannot communicate, ask the doctor about a trial of acetaminophen or other pain medication to see if agitation improves.
If non-drug strategies are not working after several weeks, discuss the risks and benefits of medications like antipsychotics (e.g., risperidone) with the doctor. Be aware of the black box warning for increased risk of death in older adults with dementia.
If your loved one has Lewy body dementia, ask the doctor about the extreme sensitivity to antipsychotics and explore alternative medications or non-drug approaches first.
If your loved one is on multiple medications, ask the doctor to review them for side effects that could cause agitation (e.g., anticholinergics, corticosteroids, narcotics).
If you are considering using aromatherapy or supplements, discuss with the doctor first to ensure they do not interact with other medications or cause adverse effects.
Related guides
- responding to shadowing
- Sensory communication strategies for dementia
- De-escalating anger and distress in the moment
- Using familiar songs to engage a person with dementia
- Using Validation Therapy to Reduce Conflict with Your Loved One
- hand-under-hand for mouth and oral care
- Sudden Confusion: Is It Delirium?
- Finding Your People: A Caregiver's Guide to Dementia Support Groups
- Using Aromatherapy to Calm Both Caregiver and Loved One
- Responding to Delusions and Hallucinations in Lewy Body Dementia