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Appendix C: Non-Pharmacological Management of Agitation
Problem Cause Approach to Management
Patient does
not sleep,
wanders at
night
• Patient may need to void
• Patient is awakened at
night by noise, bright lights
outside window, or by staff
coming into his/her room
• Patient may be napping or
sedentary during the day
• Schedule toileting
• Indirect light
• Provide window shade
• Reduce nighttime noise
• Review sleep routine; sleep log
• Educate staff to change their care
routines and approach to patients
at nighttime
• Increased daytime activity/exercise
Patient is
combative
when being
bathed
• Patient is anxious because
he or she misinterprets the
event or because he or she is
cold or hot.
• Concern over modesty and/
or privacy
• Pain from moving joints
• Staff reassurance
• More flexibility in bathing
methods and schedule (consider
towel bath)
• Staff training in how to approach
and calm anxious patient
• Consider caregiver or specific
gender
• For pain, consider pretreatment
with analgesic
• Aromatherapy, low intensity
lighting, calm music
Patient is
exhibiting
agitated
behavior
throughout
the day
• Patient is in pain or is
depressed
• Patient is experiencing
environmental over-
stimulation
• Patient is reacting to an
unsuitable or inappropriate
action by a caregiver or
family member
• Pain management
• Depression screening
• Staff training in observing signs
and symptoms in patients with
dementia
• Determine relationship to
environmental setting
Patient makes
inappropriate
sexual
advances
toward other
residents and
staff members
• May represent an
exaggeration of previous
personality trait, loss of
social inhibitions
• Patient has a basic drive for
intimacy and love
• Steer aggressive patient away from
other residents her or she has
targeted during social gatherings
• Assign care of aggressive patient to
a staff member who is not likely to
be target of advances
• Educate staff on issues related to
geriatric sexuality
• Educate family members about the
sexual needs of geriatric patients
and encourage them to show
physical affection (i.e. caressing,
hugging ) during visits
