Why Can't They Sit Still? Restlessness in Dementia, and What Helps

A quick note before you read on: if you're reading this at the end of a long day of someone never settling, that tiredness is real. You're not failing, and there are things that can make this easier.

Is it normal that they can’t sit still?

Yes. Restlessness and agitation are among the most commonly reported symptoms of dementia. It can look like:

• Fidgeting, tapping, picking at clothes or rubbing hands
• Getting up and sitting down again, over and over
• Pacing, walking from room to room, or following you around
• Rummaging, moving things, “busy” tidying or washing
• Never quite settling to the TV, a meal or a conversation

Some of it comes from the changes dementia makes in the brain itself. It’s more common in some types, such as dementia with Lewy bodies. But restlessness very often has a cause you can do something about.

What’s often behind it

• Discomfort — pain, needing the toilet, constipation, feeling too hot or cold, tight clothes or uncomfortable shoes
• Boredom or no sense of purpose — a busy person who suddenly has nothing to do
• Anxiety — feeling unsafe or unsure where they are, or looking for someone
• Too much going on — noise, visitors, a busy room. See Noise and overstimulation →
• Tiredness — restlessness often builds in the late afternoon and evening. See Sleep and dementia →
• Hunger or thirst — someone who won’t sit for a meal may still need food. Finger food and snacks they can eat on the move can help
• Medication — some medicines can cause restlessness as a side effect, especially after a new one is started or a dose changes. Ask the GP or pharmacist for a medication review. See Medications and confusion →

If it’s new, or suddenly much worse

A sudden change is worth checking rather than putting down to the dementia. Infection, pain, constipation and dehydration can all make someone suddenly unsettled. Run through the PINCH-ME checklist →, or use our free Sudden Change Checker → to think through what to mention to a GP, pharmacist or 111.

What tends to help

Check comfort first. Toilet, pain, temperature, clothes, shoes, hunger, thirst. It sounds simple, but it’s the thing most often missed.

Give their hands something to do.

• A fiddle blanket or twiddle muff, with buttons, zips and textures
• A basket of things to sort, towels to fold, or socks to pair
• A small version of a job they used to do, like sorting nuts and bolts, polishing, or laying the table

Let them move, safely. Trying to keep someone still usually makes it worse. A regular walk, a clear route around the house, good shoes and fewer trip hazards often help more. If walking about turns into trying to leave, see Wandering and getting lost →

Keep the day predictable. A similar routine each day, activity earlier on, and a calmer, quieter late afternoon.

Try music. Familiar songs from their younger years can settle someone when words don’t.

Stay calm yourself, where you can. Restlessness can be catching. A slow voice and fewer questions usually land better than trying to reason it out.

“They keep washing”

Repeated washing, of hands, face, or the kitchen, can be the same restlessness: a familiar, purposeful task the hands go back to. Gently offering a different task often helps more than stopping them. Keep an eye on their skin, as frequent washing can make it dry and sore. If it’s the other way round, and you keep having to wash them because of accidents, that’s worth raising with the GP, who can refer you to the local continence service. See Commodes and toileting equipment →

When it’s wearing you out

Living with someone who never settles means never settling yourself. Constant watching, broken sleep and never finishing a cup of tea add up. Feeling exhausted, snappy, tearful or unable to switch off are common signs of carer strain, sometimes called carer burnout. It’s a sign of how much you’re carrying, not a sign you’re doing it wrong.

• Ask for a Carer’s Assessment from your council. It’s free, and it’s about what you need. See Carer’s Assessments explained →
• Look at a break, even a few hours a week. See Respite care explained →
• Talk to a specialist dementia nurse. The Admiral Nurse Dementia Helpline is free on 0800 888 6678 (Monday to Friday 9am–9pm, weekends 9am–5pm).
• Tell your own GP how you’re doing. Your health matters too, and they can note that you’re a carer.

When to get help quickly

If restlessness comes on suddenly with confusion, a high temperature, a fall, or they seem very unwell, contact the GP or call 111. In an emergency, call 999. If you’re struggling to cope yourself, Samaritans are free on 116 123, any time.

If things keep going missing, or you’re being accused of taking them, see Hiding, hoarding and losing things →

A word from The Care Compass

You don’t need to stop the restlessness completely. Easing it a little, and getting some rest for yourself, is a real win.