Agitation and Restlessness
What is agitation?
Agitation often occurs after brain trauma, stroke, or when someone is delirious. It can be a common part of recovery from an illness or injury. About 33% of people become agitated after a head injury.
Agitation may include emotional changes such as anger or fear. It can also include physical aggression such as striking out. Someone who is agitated may say things you know they don’t mean. The patient is often very confused when this occurs. For instance, when the patient wakes up in a strange place and doesn’t know what happened to them, they may become scared and try to get away.
What causes agitation or makes it worse?
Agitation is common when there is a lot of activity. Someone with a brain injury or delirium can quickly become over-stimulated. The brain cannot process things fast enough to stay calm and relaxed. Sometimes, just thinking or hearing a conversation can overwhelm someone. Some things that can be over-stimulating are
- Bright lights.
- TV or radio on.
- Noise in room or hallway (For instance, alarms, nurse conversations, sudden noises).
- Too many guests.
- Items needed for the patient’s health care (IVs, feeding tubes, catheters, neck brace).
- Making the patient talk and answer questions.
What is restlessness?
Restlessness differs from agitation. This behavior often comes after a patient has gone through the agitation stage. This is also considered part of the recovery process. Someone who is restless will have trouble sitting still, will not be able to focus or concentrate, and may be impulsive. The patient may appear nervous and anxious. He may pace or fidget all the time.
What causes restlessness or makes it worse?
Restlessness most often is increased or due to too much stimulation to the brain (like agitation.) But this may also occur if a patient is very confused and not getting enough stimulation.
What can family members do to help?
- Talk to the patient in a calm, quiet voice.
- It is not helpful to yell or argue with the patient. Someone with a brain injury is not able to reason.
- If your loved one becomes aggressive (yelling, striking out) call for help. Ensure your safety first.
- Remove all things that may distract or stimulate the patient. For instance, keep the TV off.
- Limit guests and keep visits short. It is vital for the patient to rest.
- Provide frequent prompts about where your loved one is and their injuries. But be sure not to quiz the patient about what she remembers.
- Tell the hospital staff what helps the patient relax.
Feel free to talk with your loved one’s health care team about the above information and how family and staff can work as one to help the patient through this process.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/23/2011
Copyright © 08/23/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6703
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