Agitation in Dementia: Communication Strategies (Processing Time, Perceived Threat, Preserving Dignity)

In Part 2 of Town Square University Parkway’s dementia caregiver education series, Catherine McDermott, PMHNP, delivers practical communication training for the exact moment agitation starts to build.

While many resources focus on triggers and causes, this session focuses on what caregivers can say and do in real time to reduce distress, lower perceived threat, and preserve dignity.

Catherine explains that many Alzheimer’s behaviors and dementia related agitation are protective reactions. When a person cannot understand what is happening or what is being asked, the brain may respond with refusal, yelling, withdrawal, or aggression as a way to stay safe. This is especially common during personal care tasks like showering, toileting, or changing clothes. In those moments, calm verbal cues, slower pacing, and clear, non-threatening body language can make the difference between cooperation and escalation.

Viewers learn repeatable dementia communication strategies to prevent escalation, including how to “buy time” and reduce anxiety by turning questions around and gently shifting focus. Catherine shares real-world examples for responding to repetitive or distressing questions, such as “Where’s my mom?” without correcting or confronting. Instead, she teaches a steady approach that starts with validation, follows with reassurance, and then pivots toward something comforting or engaging.

The session also clarifies the difference between redirection and reorientation. Redirection supports the person by joining their reality and guiding attention toward safety and calm. Reorientation focuses on bringing someone back to facts. Catherine explains why reorientation can sometimes increase anxiety, and when it is still necessary for safety, including situations involving driving or other risks.

In addition to specific language and scripts, the video covers how overstimulation can intensify agitation and how caregivers can make quick environmental adjustments, such as reducing background noise, simplifying the space, and leaning on predictable routines that help the brain feel more settled. This session is ideal for caregivers who want a clear, compassionate, and potentially non-pharmacological approach to dementia behavior management using communication, environment, routine, and supportive redirection first. The goal is to help families feel more confident, reduce conflict, and prevent caregiver burnout.

To find out more about dementia education or learn how Town Square University Parkway can be a good fit for your situation, please call us at 941-277-5048. Our true medical model adult day and senior center is here to help you and your loved one on this journey.