Dementia care – dealing with behavioural changes

Understanding behavioural problems caused by dementia

As dementia progresses, it can make people feel lost, confused, anxious and frustrated, which can sometimes result in physical manifestations of these feelings, as well as angry outbursts and suspicious behaviour.

Learning and understanding strategies to deal effectively with dementia behaviour is essential if you are a caregiver or provide live-in care. Dementia care staff will be trained to deal with these behavioural problems, but learning how you can manage better when faced with a loved one’s aggressive, oppositional or sometimes violent actions or speech will help you both. The way you communicate with them can make a significant difference.

While each person with the disease will handle their feelings in their own way, certain behaviours are common among people with dementia. These include:

• Suspicion of others
• Aggression, including screaming and shouting
• Pacing back and forth
• Repetitively carrying out an action or repeating questions over and over again

These actions are an attempt to communicate, and it is important to remember that your loved one is not choosing to be difficult. Try and stay calm and establish why they’re expressing themselves in this way. By trying to understand, you are closer to being able to calm them down. If you spot early warning signs that your loved one is about to have an outburst, you may be able to prevent it. Distraction techniques can be effective in refocusing a person’s energy elsewhere, preventing the challenging behaviour from being displayed.

Becoming suspicious of others

A common problem for people with dementia is that they become suspicious of others. This can be caused by memory loss, general confusion and lack of recognition of friendly faces.

You may find they accuse you or their live-in carer of taking their possessions. If they lose something, they may panic and think they’ve been burgled. They may believe that everyone is watching them or planning something against them. This behaviour may appear paranoid and delusional, but you must remember that these feelings are very real for your loved one. Listen to their concerns, do your best to calm them down, and change the subject as best you can. 

Aggressive behaviour

This is a common symptom of dementia and can be especially upsetting and scary when it is totally out of character. Witnessing your loved one’s personality changing can be distressing, and is often the hardest part for a carer or family member to deal with.

Aggression caused by dementia most commonly manifests itself in using offensive language, shouting, repetitively yelling the same thing, or prolonged screaming. The causes for this behaviour include depression, frustration with a situation, humiliation or fear, loss of judgement, loss of self-control and inhibitions and no other way to express feelings.

Try and identify any triggers that set off this behaviour to avoid them in future. Don’t argue or become aggressive yourself, as your loved one may become violent. If you find this hard, remove yourself from the room. Always remember, even if it seems very personal, it is the condition causing the behaviour. When your loved one has calmed down, act normal once again to move forward.