How do I treat my extreme restlessness

From: Alzheimer Info 2/14

Medicines against restlessness - is that necessary?

“My mother has been living in the nursing home for a few weeks,” reports a worried daughter on the Alzheimer's phone. “She has been very restless since then, walks around all day, goes into strange rooms - even at night - and disturbs the other residents. She has already fallen several times. On my last visit, I found my mother very sleepy and sitting in a wheelchair. I wanted to take her for a walk as usual, but she could barely stand on her feet. She seemed very apathetic to me. I wonder if her illness got worse so quickly or if she was given medication to calm her down. "

Together we try to find an answer to this question: I give the caller the following explanation: “Restlessness, nervousness and fears are normal physical and emotional states that people experience when they develop dementia. In nursing homes, people with dementia often experience these conditions more intensely because they cannot find their way around the new environment and the daily routine is completely different from that at home. After a period of acclimatization - which can take three months or more - the uncertainty can also decrease again.

“Your mother's sleepy and apathetic condition could also be an indication of an acute illness. You should therefore speak to the staff in the home about this, tell them your concern and, if necessary, ask directly what medication your mother is currently receiving. As a daughter, you have - at least if you have a power of attorney or are a court-appointed carer for your mother - the right to inspect the care documentation and to have a say in medical treatment.

When restlessness and anxiety occur in people with dementia, relatives and caregivers often have great hopes for drug treatment. Although drugs can actually relieve anxiety and anxiety in some cases, they often have undesirable side effects. They can impair comprehension, concentration, speech comprehension and expressiveness in people with dementia and can also trigger muscle stiffness, muscle weakness, listlessness and drowsiness. This is often associated with an increased risk of falling. Often these drugs have no or the opposite effect in people with dementia.

On the Alzheimer's phone, relatives are informed about the possible side effects of calming drugs, but especially about non-drug alternatives. It is important that relatives and caregivers come together at the same table in the home in order to look for good solutions for everyone involved without mutual reproach. Case discussions with relatives, caregivers, caregivers and possibly occupational or physiotherapists can be very helpful.

The following aspects should be discussed:

  • What do the nursing staff in the home describe as problematic when dealing with residents with dementia?
  • How have the home / nursing staff reacted to this so far? Which behaviors, which changes have proven to be positive?
  • What preferences and favorite activities did / does the resident have? Can these be implemented (modified) in the home?
  • Is there a need for more orientation and employment for the sick in the nursing home? Can processes, activities and employment offers be more individually adapted to the patient?
  • Is more outside help needed, for example more frequent visits from relatives, visiting services, physiotherapy, occupational therapy, speech therapy, etc.?
  • Have other anti-anxiety and calming alternatives been tried? (Music for falling asleep, night light, herbal sedatives such as cocoa, lemon balm, hops, essential oils in fragrance lamps or for rubbing, cuddly toys, sporting activities, etc.)?

The knowledge gained over many years on the Alzheimer's phone and the experience of many relatives prove what the experts now regard as proven: restlessness and anxiety in dementia patients can usually not be relieved with sedating drugs. On the contrary: These often promote the risk of falling, restrict mobility and hinder the extraction of the remaining resources of people with dementia. The creative use of non-drug alternatives is worthwhile for everyone involved!

Ellen Nickel
Alzheimer's phone