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Minimising Distress

When a person with dementia becomes distressed, it is often because they are trying to communicate something to you. You might see their behaviour change at these times: they may become agitated, and start to pace or ask to go home. Or they might become withdrawn and uncommunicative. This distressed behaviour can be because the person is disorientated, frightened or anxious. They might be trying to make sense of the world around them, and they might see things quite differently to the way that you do (for instance, they might not recognise the place they are in as their home). They also might be trying to communicate an unmet need, such as that they are in pain, hungry or thirsty, or experiencing discomfort, such as constipation or an infection.

Changes in routine can be distressing for a person with dementia. This can include going somewhere they do not usually go, such as for a hospital appointment, or attending a day centre, or going to a family gathering. Visitors to the person’s house can also be unsettling, due to the change in routine and the extra noise and activity it creates.

If possible, it’s important to identify the cause or source of the person’s distress, as then you can take steps to try and help them.

Techniques to avoid or lessen distress in advance

There are techniques that we can try to prevent a person with dementia from becoming distressed in the first place. You could:

  • try to maintain a daily routine
  • explain the situation to the people around you, so they know not to drop in at unexpected times or to take the person out unexpectedly
  • give the person with dementia information in easy to digest nuggets, and in a timely manner. This means giving them some advance notice but not too much: if you are going out, try to tell them on the day itself, and with a little bit of notice for them to absorb the information

You might need to adjust this to the person: being told in advance that they are going out can cause some people to feel anxious. But some people like to be given advance notice to get ready. Use your knowledge of the person to gauge what is right for them.

Techniques for promoting calm in the moment

If the person with dementia does start to become upset, there are some methods you can try to help them feel calmer. These are:

  • Try, yourself, to remain calm. A person with dementia might say something upsetting to you, often when they themselves are upset.
  • Take five or ten seconds; think about what you’re going to say, before you reply
  • Keep a calm and steady tone of voice
  • Try and maintain eye contact with that person

You know the person with dementia best. This means you are best placed to know what will give them reassurance. Not everything will work for everyone, but some things you can try include:

  • giving the person a hug
  • playing some music they love
  • sitting and holding their hand
  • offering them a cup of tea
  • changing the scenery and proposing you both go into a different room

Sometimes, none of these tips will work. And sometimes, it might seem like the more actively you try to calm the person down, the more upset they become. It can help to acknowledge that they are upset and then give them some space; perhaps go into a different room for five or ten minutes if it is appropriate to do so.