By Lauren Mahakian Contributing writer. Originally published in PV News on 4/7/2021


Anxiety. Even the word starts to make me feel a little anxious.

Nervousness. Sweaty palms. Uneasiness. Fear of what’s coming, often something we can’t control.

Anxiety is a part of life, it seems, and there’s no escaping it. Brought on by many triggers, it thrives amid uncertainty and fears of the unknown.

Those of us caring for loved ones with Alzheimer’s Disease, or any other dementia for that matter, know anxiety all too well. The situation is fraught with uncertainty and unanswered questions.

How do I address the legal and financial challenges for my loved one who can no longer make sound decisions? Will I know when they reach this point? Who can I call for help and, for that matter, who can I trust?

With rare exceptions, most people care for aging loved ones with memory issues once or twice in their lifetimes.

With no prior experience and our loved ones’ well-being in the balance, many people seek my help as a care manager to navigate the many dimensions of dementia. I often measure my success by how much anxiety I can take away from my clients, resulting in better sleep, better self-care, and more confidence in making hard decisions.

However, those in our care live with their dementia with no real hope of relief. Alzheimer’s Disease and other dementias can rob people of their dignity and quality of life.

The cruel part is those who have dementia are often aware of their condition, and they don’t like it. Often, they fight with us about their care partly because they don’t want to be a burden. They may be angry about their situation, or they’re living in denial about the care they need.

Dementia patients may also simply be confused because their memory just doesn’t work the way it once did.

They’re not only concerned with not being able to recall recent events, per se, but also the tremendous confusion that accompanies not remembering moments before, understanding the present circumstances and how they’re dependent on others for their care needs, and uncertain about their future.

We shouldn’t be too surprised, then, that WebMD reports that three out of four people with Alzheimer’s Disease suffer from some level of anxiety. This anxiety, especially if we don’t recognize it, can lead to other challenging behaviors I see all the time, like rapid emotional swings, aggressive behaviors, wandering, and more.

In some cases, our loved ones may be so deeply worried they’re acting with absolutely no thought about what they want to change. The adrenaline that accompanies anxiety is very real and can lead to adverse outcomes.

Because our loved ones are unaware of their anxiety and can’t rationalize the source of their feelings, our challenge is to recognize it quickly.

A few more common signs include poor sleep or unexplained muscle tension. Our loved one may appear restless, unable to sit for any length of time or pacing. Repetitive behaviors, including repeating speech, may also be a sign of restlessness.

Other signs of anxiety include irritability and agitation. Often, agitation and aggressive behaviors are rooted in fear, among other causes.

One of the more common signs of anxiety that I see is a growing resistance to joining social gatherings.

Our loved one may have enjoyed family gatherings in the past but then begins to make excuses for not wanting to join. It’s too far away, too many people, too much of an inconvenience. They may be telling us they’re anxious about an upcoming event but don’t recognize their feelings as anxiety.

Recognizing underlying causes of anxiety is just the first step. We still need to address them. WebMD makes several worthwhile suggestions for some common emotional triggers. These include being too hot or too cold or being hungry or thirsty. It’s easy to address these causes, but people with dementia have increasing difficulty recognizing them or expressing their needs as their impairment progresses.

Other recommendations include assessing activities and making sure that loved ones have appropriate stimulation levels. Too much stimulation can be overwhelming. Too little leads to boredom and opens doors to depression.

In the end, we need to be vigilant as we provide care. Most negative behaviors are rooted in some underlying cause, with anxiety among the more common. When we identify and address these triggers, we can help assure a better quality of life for our loved ones and lower our anxiety levels.


Lauren Mahakian is a certified care manager. Check out her free podcast, Unlocking the Doors of Dementia™ with Lauren and Free Support Groups on Zoom.

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