Dementia doesn’t just affect memory - it can also cause major changes in mood, personality, and behavior. For family caregivers, these changes are often the most challenging part of the condition.
One day your loved one may seem calm and cheerful. The next, they might become suspicious, agitated, or even aggressive. These shifts can be hurtful, confusing, and exhausting -but they’re not your loved one’s fault. And they’re not your fault either.
Understanding why these behaviors happen - and how to respond - can make life a little easier for both of you.
Why Dementia Causes Behavior Changes
As dementia progresses, the brain struggles to make sense of the world. Changes in memory, reasoning, and perception can leave people feeling frightened, disoriented, or frustrated. This often leads to behaviors such as:
- Repeating questions or stories
- Pacing or wandering
- Shouting or swearing
- Paranoia or hallucinations
- Aggression or resistance to care
- Withdrawal or apathy
These behaviors are often expressions of unmet needs, not intentional defiance. They may be triggered by:
- Pain or discomfort
- Fatigue or hunger
- Confusion in unfamiliar environments
- Overstimulation (noise, clutter, busy spaces)
- Feeling rushed or misunderstood
Step 1: Look for the Underlying Cause
Before reacting to a behavior, pause and ask: What might be causing this?
Common root causes include:
- Needing the toilet
- Hunger or thirst
- Pain (especially undiagnosed infections or chronic pain)
- Medication side effects
- Feeling too hot, cold, or uncomfortable
- Boredom or lack of stimulation
Sometimes, just identifying the need behind the behavior can prevent it from escalating.
Step 2: Stay Calm and Reassuring
Easier said than done, we know. But how you respond can often determine whether a behavior escalates or eases.
Here are some tips:
- Speak gently and slowly
- Avoid arguing or correcting
- Use calm, simple language
- Offer reassurance with touch, eye contact, or a familiar object
- Redirect attention to a new activity or topic
The Alzheimer’s Society UK notes that reasoning with someone who doesn’t understand what’s happening rarely helps. Instead, meet them where they are emotionally.
👉 More from Alzheimer’s Society on managing behavior
Step 3: Modify the Environment
Sometimes the solution isn’t in words - but in surroundings.
Reduce stressors by:
- Removing loud or repetitive noises
- Ensuring good lighting to reduce shadows or confusion
- Keeping daily routines consistent
- Using memory cues (photos, signs, labels)
- Avoiding clutter that can cause visual overload or tripping hazards
Creating a calm, predictable environment can prevent behaviors before they start.
Step 4: Learn to Redirect, Not Confront
If your loved one is fixated on something untrue (“You stole my money”), avoid confrontation. Instead, validate their emotion (“That must feel frustrating”) and then gently redirect.
Try:
- Playing their favorite music
- Offering a snack or drink
- Going for a short walk together
- Engaging them in a simple task like folding laundry or sorting objects
This helps shift their focus and calms emotional energy without escalating conflict.
👉 HelpGuide has excellent redirecting strategies
Know When to Step Away
If things escalate or become unsafe, it’s okay to take a break. Step into another room, breathe, and return when you're calm. Safety comes first - for both of you.
Aggressive behaviors may signal pain or a medical issue. If episodes are frequent, speak with a healthcare provider about underlying causes or possible adjustments to medication.
Using Technology to Help
Apps like Elli Cares can support caregivers by:
- Scheduling video reminders to reduce agitation and repetition
- Tracking mood and symptoms to spot patterns
- Setting up Safe Zones for loved ones prone to wandering
- Alerting family members if something seems off
While tech can’t replace emotional presence, it can relieve some pressure - and help prevent challenging behaviors caused by missed routines or unspoken needs.
👉 Learn more at www.elliapp.co
You’re Doing Better Than You Think
Managing difficult behaviors in dementia is one of the most emotionally draining parts of caregiving. But your efforts, patience, and love make a difference - even when it doesn’t feel like it.
There is no perfect way to respond. There’s only progress, learning, and grace - for your loved one, and for yourself.
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