Every caregiver, especially those working in long-term resident care, encounters situations that words cannot do justice to. Perhaps Miss Thompson is too tough to be persuaded to take a bath, as she insists on leaving for Paris.
On the other hand, Mr. Garcia refuses to take his medication as he feels like he's on a secret mission. These are emotionally packed situations, but not uncommon at all. In 2025, about 1.24 million people were living in certified nursing facilities across the US.
Each must have had their own unique history, preferences, and emotional responses. In long-term care, fear and confusion often come disguised as obstinacy and defiance. Caregivers need to know relevant de-escalation techniques before a situation spirals out of hand.
This article will share four such effective techniques that can make caregiving less stressful for everyone involved.
Validate Feelings Before Addressing the Task
When a resident acts out or becomes resistant, a caregiver’s instincts may tempt them to correct or hurry the task along. The truth often is that such agitation reveals underlying emotions, such as fear, confusion, or a loss of control.
If such feelings are ignored, the situation can escalate quickly. It's important to validate the resident's feelings by acknowledging what they are experiencing without debating the facts. Empathy must triumph over the need to be right during these moments.
This approach is grounded in principles from behavioral and emotional science. For instance, professionals who complete a master degree in counseling psychology study how emotions influence behavior. The importance of a Master's degree lies in the depth of its training.
Evidence-based methods are taught to interpret behavior as communication. This is why empathy and fostering trust are seen as vital. As Felician University shares, caregivers and clinicians must weigh both the potential benefits and risks of assigning diagnostic labels to people.
While caregivers are not expected to hold this advanced degree, understanding the principles of empathy, active listening, and validation is still important. In practice, these would look like:
- Reflecting on what's being said rather than drawing hasty conclusions
- Acknowledging fear or confusion calmly
- Providing reassurance, even if the resident needs it multiple times a day
Lower Sensory and Environmental Stress
In many cases of behavioral escalations, the caregiving task in itself has no role to play. They're often rooted in overwhelming sensory and environmental input.
As per recent research, up to 60% of those living with dementia in long-term care experience symptoms of agitation or aggression. Such behaviors are often related to unmet needs and environmental triggers such as loud noises or bright lights.
Residents with cognitive impairment or sensory processing disorder struggle to filter simultaneous stimuli. As a result, a busy hallway, overlapping conversations, and harsh lighting can be too overwhelming for them.
The minute sensory inputs become too heavy for one’s body and mind to process, anxiety rises, and so does aggression. Caregivers can reduce this overload by making the following practical adjustments:
- Turn off or lower the background noise before care.
- Dim harsh lights or use softer ambient lighting.
- Close doors or draw curtains to reduce visual clutter.
- Limit the number of caregivers in the room at once.
- Pause briefly after speaking to allow the resident time to process what's been said.
These changes may appear small, but they can make a massive difference. You will be able to create an atmosphere that residents find to be safe and relaxing.
Offer Simple Choices That Restore a Sense of Control
If there is one aspect of aging in general that is most challenging, it has to do with a loss of independence. A 2024 dementia-related survey found that 47% of older adults with memory loss live with anxiety related to concerns like losing independence.
It only shows how critical autonomy is to emotional well-being. When residents must depend on external help for daily activities, it can all feel like a threat to their dignity. That's when offering simple choices becomes important.
They can restore a sense of agency and reduce the emotional strain that often fuels resistance. Instead of constant directions, give residents choices that give them a sense of control. You can ask the following:
- Would you like to shower before or after breakfast?
- Do you prefer the blue sweater or the grey one today?
- Should we start with your face or your hands?
- Would you like to walk now or in 10 minutes?
Keep the choices limited; two clear options are easier to understand and act upon. They will remove power struggles and restore a sense of self as the individual won't feel like just another care recipient.
Let Your Tone and Body Language Be Calm
Communication has to do with more than the words we speak, especially in caregiving. A resident’s response is shaped not only by what you say, but also by how you say it. That would factor in your tone, facial expressions, gestures, and even the distance you maintain while standing.
In a 2025 review, non-verbal communication elements were found to significantly improve a dementia patient’s subjective sense of security and quality of life. These elements included eye contact, touch, spatial distance, and tone of voice.
All of these together can help regulate emotions and stabilize behavior in ways that words alone cannot. On that note, caregivers can use the strategies listed below:
- Slow, calm speech with gentle inflection
- Approaching from the front instead of entering personal space suddenly
- Relaxed posture (which affects mood) and open gestures rather than stiff or rushed movements
- Soft eye contact that feels reassuring, not intense
- Appropriate touch (with consent) that communicates presence and safety
With these, residents are less likely to feel threatened or misunderstood. It further fosters a more comfortable care environment.
With the progression of time, de-escalation itself has become more about understanding people rather than stopping certain behaviors. Using person-centered communication and non-verbal attunement, caregivers are learning new ways to stay calm and composed even under immense pressure.
Even real-time staff feedback has become common to prevent stressful moments before they escalate. With the techniques discussed in this article, you can build trust and reduce conflicts. What's more is that the environment you create for your residents will be such that they feel understood and valued.
