Agitation and Aggression

WEEKLY COMMUNICATOR (300 x 100 px) (200 × 100 px) (1)

DEFINITIONS

  • Agitation – Restlessness and irritability exhibited by pacing, worried expression, inability to sit still, and/or verbal repetition of a disturbing thought
  • Aggression – Verbal or physical assault of another individual

CAUSES

Physical discomfort

  • The person may be unable to verbally express hunger, thirst, pain, nausea, or other discomforts associated with a physical change such as a urinary tract infection, soiled garments, or a sunburn.

Loss of control

  • Giving up driving, paying bills, and other activities instrumental to day-to-day living may lead to agitation and anger, especially when the person does not feel they need to do so.

Fatigue

  • A day with more activities may be tiring and lead to agitation or aggression later in the day. Loneliness or boredom • Having nothing to do may lead to restlessness and agitation.

Confusion

  • Unfamiliar surroundings, being around new people, losing train of thought, and an inability to find words are some of the confusing situations that may lead to agitation or aggression.

Overstimulation

  • A noisy or cluttered environment may be too much to process.

Over-communicating

  • Too many instructions at once or instructions that are too difficult to understand create challenges that lead to irritable behaviors. Reduced processing speed and inability to sequence steps may also contribute.

Medication

  • Agitation may be a side effect of medication.

Irritability or stress from others nearby

  • The inability to filter incoming information is exaggerated in a stressful environment. The body language and tone of voice of others cue that something is not right, which leads to agitation.

STRATEGIES

  • Identify triggers. Knowing the source of agitation or aggression will guide the strategies to use. Be especially alert to what immediately preceded an outburst.
  • If a urinary tract infection or other medical issue is suspected, call the provider.
  • Resist the instinct to fight back. Use a soft voice and a reassuring tone.
  • Do not try to talk the person out of whatever has upset them. Acknowledge their feelings and calmly suggest ways to help.
  • Try a relaxing or distracting activity such as music, exercise, or a change in scenery.
  • If it is safe to do so, separate from the person and go to another room, allowing each person to calm down.
  • Avoid physical contact because even a light pat on the arm can be interpreted as aggression.
  • Never use force unless safety of another person is significantly at risk.
  • If safety is at risk, call 9-1-1 for assistance, providing details of the concern, including the diagnosis. First responders are trained in these situations. They may decide to take the person to the emergency room for evaluation.
  • Report the behaviors to the provider who may prescribe a medication to lessen the agitation.

PREVENTION

  • Identify common triggers and avoid them.
  • Maintain a routine schedule which includes adequate sleep.
  • Limit the frequency and intensity of activities, providing rest periods during the day.
  • Keep special objects and family photos around the house to enhance familiarity with the environment.
  • Play music, take walks, and read together.
  • Read the website document Engagement Activities for more ideas.
  • Limit caffeine, sugar, and alcohol.

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