“I don't know what to do when he gets upset”: a little help for those who care for him every day
Reading time: 6 minutes
There is a moment that caregivers know well.
The one where the person you love, your father, your mother, your husband, he gets agitated, becomes stiff, starts saying things that don't add up, or looks at you as if you were a stranger. And you're there, still, with your heart in your throat, wondering: what do I do now?
No manual really teaches you this. Courses talk about "managing difficult behavior," but when you're in the kitchen at 8 PM and things are escalating, the course slides seem far away.
This article is for those moments.
First of all: don't try to figure everything out at the moment
The first instinct is to understand Why What's happening? Do you have a headache? Did you have a bad dream? Did you do something wrong?
At that moment, however, you may not be able to immediately find an answer. And while agitation is already high, persisting with questions, explanations, or attempts at reasoning can increase tension. Possible causes include pain, physical discomfort, fatigue, noise, changes in environment or routine., they should not be ignored: can be evaluated more carefully when the situation allows.
What you can do, instead, is take action on the environment and on yourself. Now.
The 3 things to do (even when your mind goes blank)
1. Lower your voice
Don't raise your voice to make yourself heard. Instead, try to speak calmly, slowly, using simple sentences and giving the person time to respond.
In times of turmoil, the way you communicate can make all the difference. A calm, non-threatening tone can help reduce tension, while speaking quickly, insisting, or trying to persuade the person can make communication even more difficult.
Before you answer, try slowing down for a few seconds. Lower your shoulders, take a breath, and then speak.
2. Reduce the stimuli around you
Television on, light too bright, several people talking, noises from the corridor: too many stimuli can increase discomfort and make it more difficult to orient yourself, especially for a person with dementia or cognitive impairment.
There's no need to make grand gestures. Turn off the TV if it's not necessary. Reduce noise, limit the number of people present for a few minutes, and try to create a quieter environment. Lighting can also make a difference: it's best to avoid conditions that are too intense, too low, or that create confusing shadows and reflections.
Reducing stimuli does not mean isolating the person: It means trying to make the environment simpler and less tiring to interpret in a moment of difficulty.
3. Don't contradict, accompany
This is perhaps the hardest thing. Because it goes against instinct.
If he says something that isn't true, if he complains about something you can't see, or if he feels he needs to go somewhere, the natural reflex is to correct him: “No, Dad, you don’t have to go anywhere.” “You’re wrong.” “That didn’t happen.”
But insisting on correcting, arguing or trying to convince the person can increase tension. In that moment, what she is experiencing may be very real to her, even if you know otherwise.
This doesn't mean agreeing with her on everything or confirming something that isn't true. Rather, it means listen to what he is trying to communicate and recognize the emotion behind it.
Sometimes a simple sentence like “I understand that this thing worries you.”, “I'm here with you” or “Let's see what we can do together” It may be more helpful than a long explanation.
The goal, at that moment, is not to prove who is right: it is to try to reduce the tension and make the person feel listened to and safe.
One thing that no one says enough
In those moments, Even the way you move and position yourself can influence the situation.
If you're tense, scared, or exhausted—and this can easily happen—you might speak faster, stiffen your posture, or move more abruptly without even realizing it. A person with dementia may have difficulty understanding words, but still grasp them. tone of voice, facial expressions, posture, and other nonverbal cues.
It's not about pretending to be fine or feeling responsible for their agitation. It's about, when possible, giving yourself a few seconds before reacting.
Slow down. Lower your shoulders. Take a breath. Avoid sudden movements and approach while respecting their space.
It's just a few seconds, but it can help you deal with what's happening more calmly.
After he calms down: take care of yourself
Once the situation stabilizes, there is a common trend: carry on as if nothing had happened. Put away, continue with dinner, reply to the message that was waiting.
But an episode of agitation can also be tiring for those who witness it. It can leave you feeling tense, tired, and perhaps even thinking: “I could have handled it better.”
When you can, take a few minutes to stop. It can also be helpful briefly note down what happened: what was happening before the episode, how the agitation manifested itself, and what seems to have helped reduce it. Over time, this information can help you recognize situations or possible recurring factors and they can also be helpful when you talk to your doctor or healthcare provider.
Talking about it with someone can help, especially when these episodes become frequent or particularly difficult to manage.
And above all, Don't turn every episode into a test of how good a caregiver you've been.. There is no perfect answer that works for every person and every situation.
When these episodes become frequent
If the shaking occurs often, becomes more intense or you notice a sudden change from usual behavior, it is important to talk about it with your doctor or specialist.
An increase in agitation or confusion it should not be automatically attributed to dementia. Sometimes there may be physical or environmental causes to identify: pain, infections, constipation, medication side effects, sleep disturbances, changes in routine, or other uncomfortable conditions.
For this reason it may be useful to also report When the episodes started, how long they last, what happens immediately before, and whether you've noticed any other changes in the person's behavior or condition.
If the change is sudden or particularly marked, it is best to report it promptly to your doctor or local health service.
Asking for help doesn't mean you haven't been able to handle the situation: it means trying to understand. if there is something behind that behavior that can be addressed or treated.
In summary
When you don't know what to do, try starting with a few simple things:
Speak calmly. Reduce surrounding stimuli. Avoid arguing or insisting on corrections.
Observe what is happening and, when the situation allows, try to understand if there could be a physical discomfort, a change in environment, routine, or some other factor which contributed to the unrest.
There is no one strategy that always works. Every person is different and even two episodes of the same person can have different causes and developments.
The goal is not to manage everything perfectly, but reduce tension, try to understand what the person is communicating and face a difficult moment in the most confident and calm way possible.
And remember that you are part of the situation too: Taking a few seconds to slow down isn't wasting time. It's giving yourself the ability to choose how to react, rather than reacting instinctively.
💛 A gift for you…
I've put together a simple checklist to keep handy to help you through difficult times.
Have you experienced a similar situation? Let us know in the comments how you handled it.. Your experience can be invaluable to anyone reading this today.