BRAIN HEALTH AND RESTLESSNESS

Dementia-related restlessness, often manifesting as pacing, fidgeting, or agitation, is a common symptom stemming from cognitive decline, discomfort, or unmet needs. It frequently peaks in the late afternoon (sundowning). Effective management includes establishing routines, reducing caffeine, ensuring comfort, and using calm, empathetic communication.

Key Causes of Restlessness 

Physical Needs: Pain, infections (e.g., UTIs), constipation, hunger, or fatigue.

Environmental Factors: Overstimulation, noise, or unfamiliar surroundings.

Cognitive Decline: Confusion, fear, boredom, or frustration with tasks.

Medical Side Effects: Certain medications can increase agitation.

Management Strategies 

Create Routines: Maintain a consistent daily schedule to reduce anxiety.

Modify the Environment: Decrease noise, use calming music, and ensure proper lighting to reduce confusion.

Encourage Activity: Use physical activities like walking, or engagement through music and familiar hobbies.

Manage “Sundowning”: Limit daytime naps and caffeine to improve evening calmness.

Advice For Caregivers

Create a Calm Environment: Reduce clutter, noise, and the number of people in the room to minimize overstimulation.

Establish Routines: Keep daily routines (bathing, eating, waking) consistent.

Use Redirection: Distract the person with a snack, beverage, music, or a simple, enjoyable task (e.g., folding laundry).

Allow Pacing: If the person needs to move, create a safe space for them to walk around rather than forcing them to sit.

Validate Feelings: Instead of arguing, validate their emotions with a calm, soft voice and reassure them of their safety.

Limit Stimulants: Reduce sugar and caffeine intake, which can spike energy and increase restlessness.

Watch for Physical Needs: Restlessness often stems from unmet needs, such as pain, hunger, or the need to use the bathroom.

Safety Measures: Hide items that prompt leaving (e.g., keys, coats) and use child-proof locks if necessary.