How to calm agitation in dementia: Non-drug strategies for memory care teams

Published January 20, 2026 · Updated October 16, 2026

It’s late afternoon in memory care. One resident is pacing the hallway, another keeps calling out for her mother, and a third pushes away every offer of help. Dinner is in an hour, and the rest of the unit still needs you.

Most care teams know this moment, and know it will come back tomorrow. It wears on residents and staff alike, and medication is rarely the first answer anyone wants to reach for.

Much of this distress can be calmed without medication once the trigger is clear, and a lot of it can be prevented by how the day is organized. Below, we cover what causes agitation, what to do in the moment, and which daily activities keep it from building up.

What is agitation in dementia?

In dementia, agitation is emotional distress that shows as restlessness, verbal outbursts or physical aggression. It happens because the condition changes how the brain works: the person finds it harder to make sense of their surroundings, to say what they need and to calm themselves down.

Restlessness and agitation can also occur with other conditions, such as delirium or a psychiatric illness. What sets agitation in dementia apart is that it grows out of the cognitive changes themselves. The International Psychogeriatric Association uses this as its definition of agitation in people with cognitive impairment or dementia (Cummings et al., 2015). A sudden change in behavior can also signal delirium, which needs medical attention.

Although agitation expressions may appear to be personal and done on purpose, the reality is that they are not. Agitated behaviors are signs of stress, fear, confusion and overwhelm that the person with dementia does not have control over. Therefore, it’s important to always try to see things from their perspective and to not blame them for their behavior.

What causes agitation in people living with dementia?

Agitation is usually a response to something the person needs or cannot cope with. For people living with dementia, this could be pain, hunger or thirst, a full bladder, too much noise, too little to do, or a change in routine.

Because dementia makes these needs harder to name, the behavior becomes the message. Looking for the trigger is often the fastest way to calm it.

Physical discomfort

Pain is a frequent cause, and an easy one to miss. Someone who can no longer say “my hip hurts” may pace, pull at their clothing or push away help instead. Check the basics first: pain, thirst, hunger, the bathroom, and whether they are too warm or too cold.

Too much or too little stimulation

A loud dayroom, a television nobody is watching or a crowded hallway can overwhelm someone who struggles to filter what they see and hear. Too little stimulation causes problems too: long hours with nothing to do leave restless energy with nowhere to go.

Time of day and sundowning

Many care teams see agitation rise in the late afternoon and early evening, often called sundowning. Fading light, tiredness and the bustle of a shift change can all add to it. A calm, predictable routine at that time of day helps.

How do you calm someone with dementia who is agitated?

Stay calm yourself, look for the trigger, and lower the stimulation before you try to redirect attention. That is easier said than done on a busy shift, and no approach works every time. These four steps help most:

• Check for a physical cause first. Pain, hunger, a full bladder or feeling cold are common and easy to miss.
• Slow down and lower the noise. Approach from the front, get to eye level, speak slowly, and move to a quieter spot if you can.
• Acknowledge the feeling. “You look worried” helps more than correcting what the person says.
• Redirect to something familiar. A favorite song, a short walk or looking at photos, once the person is a little calmer.

If a moment does not settle, step back, keep the person safe and ask a colleague to take over for a few minutes.

Why can agitation be difficult for caregivers looking after people with dementia?

Caregivers will likely encounter agitation on a regular basis, but frequency does not necessarily make it easier to handle. Responding to agitated behavior in people with Alzheimer’s disease or other forms of dementia can be challenging, both practically and emotionally.

Agitation can appear suddenly and without a clear cause, while communication difficulties make it hard for individuals to explain what they are feeling or what they need. Repeated exposure to agitation can lead to stress, frustration, and feelings of helplessness, especially when caregivers feel they have few effective tools at hand.

Without adequate support, this strain can build up, affecting mental well-being and increasing the risk of burnout.

What treatments are available for agitation in dementia?

There is no single solution to treat agitation in dementia care. Agitation can look very different from one person to another, so effective care involves a combination of approaches specifically tailored to the individual.

In some situations medication can be used, especially when agitation is severe or persistent. Pharmacological treatments can help reduce acute symptoms, but they do not address the underlying causes of agitation and may bring side effects such as drowsiness or increased risk of pneumonia, stroke and kidney injury.

Studies and experts suggest that the best approach to reduce agitation is to always try non-drug approaches first. These focus on understanding the root cause of agitation and responding to those needs in a person-centered way.

Non-drug strategies that reduce agitation in dementia care

Non-pharmacological interventions can lead to calmer moments, stronger relationships between caregivers and residents, and a more positive overall care environment. They aim to:

• Prevent agitation before it occurs
• Reduce the severity and duration of agitated behaviors
• Lower caregiver distress
• Bring reassurance to family members

Below, we explore some of the non-drug approaches that help reduce agitated behaviors in dementia care environments.

Regular activity and involvement

Staying constantly active can play an important role in reducing agitation. When seniors with dementia are engaged in activity, they are less likely to feel restless or disconnected. Making sure they have enough opportunities for movement, interaction, and play can help release built-up tension and prevent agitated behaviors and drastic mood changes.

Make sure to offer activities that are accessible and adapted to the individual’s abilities. Group activities that invite light movement and social interaction can gently encourage participation without pressure.

Musical interventions

Music has a powerful effect on mood and emotion. Studies show that music can reduce agitated behaviors: a meta-analysis of 12 studies found a medium effect of music on agitation in people with dementia (Pedersen et al., 2017). A familiar song or sound can evoke feelings of comfort, familiarity, and calm.

Music-based activities like listening to favorite tunes, singing along, or gentle movement to music are ideal to mitigate agitation. Some interactive games for people with dementia incorporate sound and rhythm in a way that naturally invites engagement without being overstimulating.

Sensory-based therapy and stimulation

Agitation often results from sensory overload or too little stimulation. Stimulating the senses in a balanced and meaningful way can help regulate emotions and behaviors in a person living with dementia.

Sensory-based support may involve gentle visual input, soothing sounds, or touch- and movement-based activities. They can help anchor attention to the present moment, creating a sense of safety and focus that calms and soothes.

How the Tovertafel supports multiple non-pharmacological approaches to reduce agitation

What makes non-pharmacological approaches effective is not one single intervention, but the right combination of different approaches working together. Tover calls this purposeful play: play that is designed with a clear purpose for the person taking part. The Tovertafel, with interactive light projection games designed for people living with dementia, brings these approaches together in one accessible, easy-to-use tool.

The Tovertafel games are co-designed with care professionals and built on more than a decade of research. They encourage gentle movement, incorporate music and sounds to support emotional regulation, and provide visual and sensory stimulation that adapts to each person’s responses.

The Tovertafel helps care teams respond proactively to agitation, strengthens relationships between caregivers and residents, and contributes to a calmer, more positive atmosphere across care settings. That is what we mean when we say we are serious about play.

Curious to see how the Tovertafel can reduce agitation in your nursing home or memory care community? Learn more about our solution or get in touch with us to explore what this could look like for your care setting.