What Are Considerations?
Understanding agitation seniors caregiver calming is important for seniors and their caregivers. agitation can come on suddenly or over time. It can last for a few minutes, for weeks, or even months. Pain, stress, and
fever
can all increase agitation.
Agitation by itself may not be a sign of a health problem. But if other symptoms occur, it can be a sign of disease.
Agitation with a change in alertness (altered consciousness) can be a sign of
delirium
. Delirium has a medical cause and should be checked by your health care provider right away.
What Are the Common Causes and Risk Factors?
There are many causes of agitation. Some of them are:
-
Alcohol intoxication or
withdrawal
- Allergic reaction
- Caffeine intoxication
- Certain forms of heart, lung, liver, or kidney disease
- Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiods)
- Hospitalization (older adults often have delirium while in the hospital)
-
Overactive thyroid gland (
hyperthyroidism
)
- Infection (especially in elderly people)
-
Nicotine withdrawal
- Poisoning (for example, carbon monoxide poisoning)
- Some medicines, including theophylline, amphetamines, and steroids
- Trauma
-
Vitamin B6
deficiency
Agitation can occur with brain and mental health disorders, such as:
- Anxiety
-
Dementia
(such as
Alzheimer disease
)
-
Depression
- Mania
-
Schizophrenia
Home Care
The most important way to deal with agitation is to find and treat the cause. Agitation may lead to an increased risk of
suicide
and other forms of violence.
After treating the cause, the following measures can reduce agitation:
- A calm environment
- Enough lighting during the day and darkness at night
- Medicines such as benzodiazepines, and in some cases, antipsychotics
- Plenty of sleep
Do not physically hold back an agitated person, if possible. This usually makes the problem worse. Use restraints only if the person is at risk of harming themselves or others, and there is no other way to control their behavior.
Preventing Agitation Episodes: Daily Care Tips
Caregivers can reduce the frequency of agitation episodes by building predictable routines and removing common triggers. Start by observing the times of day when agitation tends to appear; hunger, fatigue, pain, and overstimulation are frequent culprits. Keep meals, medication, and rest on a steady schedule, and offer calm reassurance in a low, even voice when tension builds. A quiet, familiar environment with soft lighting and minimal background noise helps older adults stay oriented, especially those living with dementia or delirium.
When an episode begins, avoid arguing or trying to reason at length. Instead, redirect attention to a soothing activity such as gentle music, a familiar photo album, or a short walk. Physical comfort matters too: check for pain, a full bladder, constipation, or discomfort from cold and heat, since unmet physical needs often surface as restlessness. If agitation becomes frequent, dangerous, or lasts for days, keep a simple log of episodes and share it with the doctor, because new or worsening agitation can signal a medical problem such as an infection, medication side effect, or pain that needs treatment.
When to Contact a Medical Professional?
Contact your provider for agitation that:
- Lasts a long time
- Is very severe
- Occurs with thoughts or actions of hurting yourself or others
- Occurs with other, unexplained symptoms
If you or someone you know is thinking about suicide, call or text 988 or chat
988lifeline.org
. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
What to Expect at Your Office Visit?
Your provider will take a medical history and do a physical exam. To better understand your agitation, your provider may ask you specific things about your agitation.
Tests may include:
-
Blood tests (such as a
complete blood count
, infection screening, thyroid tests, or vitamin levels)
-
Head CT
or
head MRI
scan
-
Lumbar puncture
(spinal tap)
- Urine tests (for infection screening, drug screening)
-
Vital signs
(temperature,
pulse
, breathing rate, blood pressure)
Treatment depends on the cause of your agitation.
Restlessness
American Psychiatric Association. Schizophrenia spectrum and other psychotic disorders.
Diagnostic and Statistical Manual of Mental Disorders
. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.
Donovan AL, Punko D, Bird SA, Ivkovic A, Prager LM. Emergency psychiatry. In: Stern TA, Wilens TE, Fava M, eds.
Massachusetts General Hospital Comprehensive Clinical Psychiatry
. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 83.
Inouye SK. Delirium and changes in mental status. In: Goldman L, Cooney KA, eds.
Goldman-Cecil Medicine
. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 361.
Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
