October 28, 2016

Managing Challenging Behaviors: Anxiety

In our last blog post on managing challenging dementia behaviors, we focused on aggression and highlighted a few strategies care providers might employ with their clients or patients to minimize its effects. Anxiety is another highly prevalent symptom that many people with Alzheimer’s disease and related dementias experience.

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According to the research, as many as 21% of people living with dementia are also living with an anxiety disorder, and up to 71% of dementia patients experience anxiety symptoms as their condition progresses. Anxiety is associated with diminished quality of life, difficult behaviors, limitations in performing activities of daily living, nighttime awakenings and poorer neuropsychological performance.

With dementia, anxiety may be caused by a number of different medical conditions, medication interactions or by any circumstances that impact a person’s ability to make sense of the world around them. Situations that may lead to anxiety include: moving to a new residence, changes to the existing environment or caregiver arrangements, or misperceived threats.

How we -as care providers- listen and respond to symptoms of anxiety is crucial. Try to understand what’s causing the anxiety, then reassure the person by using calming phrases such as: "You're safe here;" "I'm sorry that you are upset;" and "I will stay until you feel better." Let the person know you are there to help.

Once you’ve validated the person’s feelings and fears, create a calm environment by removing stressors (including decreasing noise and distractions) or relocate to a new place. Activities like art, music or exercise can be great ways to divert attention away from the anxiety and onto something more positive. Continue to monitor the personal comfort of the person (including hunger, thirst, full bladder and fatigue) and remain sensitive to fears, misperceived threats and frustration with expressing what is wanted.

This blog post is Part 2 of a 5-part series on managing challenging behaviors.