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Transportation Solutions for Caregivers: A Starting Point

Dealing with Agitation

| Introduction | Communication | Sensitivity | Preventing Agitation | Dealing with Agitation | Transportation Review | Providing Physical Assistance | Resources for Caregivers

Agitation or the attempt to leave the vehicle may be the result of a desire to meet former obligations that no longer exist, lack of awareness of current surroundings while desiring to perform another task, or an inability to communicate basic needs. If your loved one becomes agitated, resistive or argumentative because of a belief that he should be going somewhere other than your destination, it is often helpful to agree and act as if you are going along with his plan -- even use it as a discussion topic -- while you actually are proceeding with your original plan and destination.

This approach, as opposed to arguing, disagreeing or re-orienting, is called “validation.” In other words, you are validating your loved one’s beliefs, leading to more cooperation. For example, ask your loved one why he does not want to get in. If he can tell you what he believes is happening, “validate” his belief by going along with the story and incorporating the need for the car ride into the story. This is usually more effective than arguing with someone with dementia, as he may not have the ability to understand the reality of the situation even after many attempts on your part.

If your family member becomes agitated or resistive while attempting to enter the car or during the ride, try to determine the cause of agitation -- especially if it might stem from a situation that happened prior to getting in the vehicle. Next time, you could try going for a brief walk together before entering the car, allowing time for him to calm down. Sometimes agitation can stem from forgetting how to enter the car. Patience and simple directions may be enough to diffuse the situation.

Seat your loved one in the rear passenger side seat so that the steering wheel is out of reach and he is not directly behind you. This way you can avoid being startled from behind when you are driving.

If your car has child safety locks, it’s always a good idea to have them on -- allowing the rear door to be opened only from the outside. This will ensure that the door cannot be opened by your loved one while the car is moving. Using a seat belt buckle cover can discourage unbuckling the seat belt during your ride.

If agitation persists during the ride, try playing relaxing or favorite music. Also, it may be helpful to offer an activity such as a photo album of family (e.g., good conversation starter), a book, candy, or a magazine to decrease agitation or distracting behaviors.

The National Center on Senior Transportation is funded through a cooperative agreement with the U.S. Department of Transportation, Federal Transit Administration and with guidance from the U.S. Administration on Aging. NCST is administered by Easter Seals Inc. in partnership with the National Association of Area Agencies on Aging (n4a).