The Key to Understanding Challenging Common Behaviors of Dementia

• Anger and aggression
  • Treatment:
    • Use calm, reassuring communication.
    • Identify triggers to avoid future incidents.
    • Consider medication if necessary, as advised by a health care provider.
• Apathy or disinterest
  • Treatment:
    • Engage in activities the person previously enjoyed.
    • Encourage social interactions.
    • Consult a doctor for potential depression.
• Changes in personality
  • Treatment:
    • Stay patient and understanding.
    • Maintain a routine to provide a sense of stability.
    • Seek professional advice for behavioral management strategies.
• Communication problems
  • Treatment:
    • Use simple, direct sentences.
    • Employ nonverbal communication like gestures.
    • Create a quiet, distraction-free environment for conversations.
• Shadowing (following around)
  • Treatment:
    • Provide reassurance and attention.
    • Distract with a task or activity.
    • Ensure personal time for the caregiver to prevent burnout.
• Mood swings
  • Treatment:
    • Create a calm environment.
    • Avoid confrontation; acknowledge feelings instead.
    • Consult a doctor for possible mood-stabilizing medications.
• Nighttime waking
  • Treatment:
    • Establish a regular sleep routine.
    • Limit caffeine and naps during the day.
    • Make the sleeping area comfortable and secure.
• Pacing or wandering
  • Treatment:
    • Ensure a safe environment.
    • Use door alarms or locks for added safety.
    • Provide regular physical activity to reduce restlessness.
• Violent behavior
  • Treatment:
    • Stay calm and avoid escalation.
    • Remove potential triggers from the environment.
    • Seek immediate medical advice for risk assessment and management.
• Restlessness
  • Treatment:
    • Engage in physical activities or walks.
    • Provide sensory stimulation, like music or tactile objects.
    • Maintain a structured daily schedule.
• Verbal abuse
  • Treatment:
    • Do not take words personally; stay calm and composed.
    • Redirect attention to a different, positive activity.
    • Discuss with a health care professional for coping strategies.

1. Ask for help. Getting input and support from experts and fellow caregivers can help you find a new solution, take a new course of action, or better understand dementia behaviors.
2. Look for underlying causes. Sometimes, physical and/or mental issues can result in discomfort, frustration, and ultimately unwanted behaviors. Always report behavioral symptoms to a health care provider.
3. Be flexible. What works today may not work tomorrow. Especially when it comes to dementia and inappropriate behavior, you must always be prepared to shift strategies or solutions if something isn’t working for your loved one in the moment.
4. Change your perspective. Changing how you see and react to a situation will help your loved one with dementia to exhibit different behavior. Lean into curiosity to better understand where your parent is coming from.
5. Develop coping strategies in advance. There are good days and bad days in dementia care. It’s best to be prepared.
6. Disrupt patterns that lead to negative behavior. For example, if your parent needs to eat something, don’t immediately resort to commands. Instead, ask a question, such as “I’m hungry, aren’t you? Let’s eat something.”
7. Remain compassionate. Keep in mind that although you cannot change your loved one’s behavior, you can always change your own.
8. Be patient. Remember that most dementia behaviors are motivated by something your loved one is unable to vocalize. Although it may not seem like it, your parent is likely trying to make a statement, even when performing inappropriate actions. Stay patient and calm, and talk with them to determine the underlying cause.
9. Anticipate underlying needs. You can redirect many negative behaviors by being aware of your loved one’s needs. For example, if your parent is bored, redirect them to help with simple household chores or other activities.

Agitation and anxiety

• Addressing any chaos in the environment by reducing noise levels and the number of other people nearby
• Avoiding moving household objects whenever possible (familiar objects located in the same places can provide a sense of security)
• Changing the immediate environment when the person with dementia becomes agitated
• Playing soothing music
• Safety-proofing the environment to allow for as much autonomy as possible

Difficulty communicating

• Providing consistent reassurance
• Limiting outside distractions when attempting to communicate (turn off the radio and television)
• Listening for the meaning of the feelings behind their words
• Speaking clearly and loudly enough to be heard
• Using nonverbal means of communication (such as body language, facial expressions, and touch)

Delusions, hallucinations, and paranoia

• Avoiding arguing or trying to impose a sense of truth or reality onto your loved one
• Consulting with a health care provider to find out whether medication may be needed
• Providing reassurance by saying things like, “I’m sorry you are getting upset by this”
• Redirecting your parent’s attention to something more appropriate, such as housework

Sleeplessness and sundowning

• Not giving your loved one alcohol, caffeine, or sugar
• Hiring help at night so you can get enough sleep without having to leave your loved one unattended
• Discouraging long naps during the day
• Talking to a health care provider about natural sleep-inducing medication, such as melatonin

Wandering

• Adding “child-safe” plastic covers to doorknobs
• Purchasing a GPS tracking device
• Keeping a current photo on file, just in case your loved one goes missing
• Installing a senior home monitoring system and setting it to alert you or another family member if your loved one leaves the house
• Installing locks that require a key