A resident with dementia becomes agitated and tries to strike nearby staff. What is an appropriate de-escalation approach?

• A. Speak calmly in a low voice, identify yourself, use simple directions, redirect to a calming activity, and keep yourself safe; avoid arguing.
• B. Shout loudly to dominate the situation.
• C. Argue to prove your point.
• D. Leave the room immediately.

Answer: (A)

When someone with dementia becomes agitated, the aim is to defuse the situation calmly while keeping everyone safe. Speaking in a calm, low voice, identifying yourself, giving simple directions, redirecting to a calming activity, and staying safe embodies an approach that reduces fear and confusion. A calm voice helps the person hear and feel safe; identifying yourself reduces uncertainty about who is addressing them; simple, one-step directions are easier to process when cognitive load is high; redirecting to a calming activity provides a focus away from the trigger and can restore composure. Keeping yourself safe means maintaining a respectful distance, using nonthreatening body language, and being prepared to step back or call for help if needed. Avoid arguing because it raises defensiveness and heightens agitation, making the situation harder to resolve. Shouting to dominate would likely scare the resident and worsen aggression, and leaving the room immediately can leave the person unsettled and may require others to intervene in a more chaotic way.