1. Agitation: It's Not Just an Angry Outburst
Identify outbursts of anger and repetitive behavior patterns as agitation. Get a clinical assessment to be certain. Learn the signs and symptoms of agitation so you know when to expect them and how to handle them. Acute agitation is more complicated than an isolated incident of road rage. According to Bogner and Corrigan, agitation is characterized by an "excess of one or more behaviors that occurs during an altered state of consciousness." Agitation is generally associated with other underlying conditions such as Alzheimer's disease, bipolar disorder, dementia, alcohol or drug abuse, schizophrenia and obsessive-compulsive disorder.
2. Create a Calm and Safe Living Space
Assess the type and severity of the agitation to determine a course of treatment. Mild agitation may be treated by talking to the patient in a soothing tone and creating a serene living space. Simple things like soft lighting and music can help to keep a patient calm. Not pressuring the patient to perform or remember the past is also very important to maintaining the peace. Acute agitation that includes scratching, hitting, pacing and screaming may require pharmacological treatment, which you should discuss with a doctor.
Notice the time of day symptoms occur. Many older patients experience agitation in the early evening as they get tired. Patients often feel frustrated when they can't complete a task or communicate a simple need. Try to identify the need as quickly as possible by speaking gently with the patient and using gentle touch or simple gestures toward objects. Look for common triggers, and try to remove them completely from the patient's life. Remove any objects that may allow the patient to harm himself during an episode, especially if the patient tends to flail or pace out of control during an incident. Lock doors at night if you suspect the patient is wandering.
3. Discuss Medications With Your Doctor
Talk with your doctor about managing agitation with medication. Your doctor will discuss underlying medical conditions and should prescribe a drug that addresses the dominant behavior exhibited during agitated states. Ask for a medication with a fast delivery time, especially if you're dealing with a patient who tends to get violent or harm herself during outbursts. Common medications may include atypical anti-psychotic drugs, haloperidol, benzodiazepines and lorazepam, an anti-anxiety drug. Most drugs come in pill or liquid form, but some patients experience fast relief from intramuscular injections.
