Dementia guide

Coping with dementia behaviour changes

Dementia can have a big impact on a person’s behaviour. It can make them feel anxious, lost, confused and frustrated. Although each person with dementia handles these feelings in their own way, certain behaviour is common in people with the disease. This includes:

  • repeating questions or carrying out an activity over and over again
  • walking and pacing up and down
  • aggression, shouting and screaming
  • becoming suspicious of other people

If you are experiencing these behaviours, or are looking after someone who behaves in this way, it's important to remember that this is an attempt to communicate how they're feeling and that they are not being deliberately difficult. If you stay calm and work out why they're expressing themselves in this way, you may be able to calm them down.

If you recognise early warning signs, you may be able to prevent behavioural outbursts. For example, if the person with dementia becomes anxious or agitated in large groups, you could arrange for them to be in a smaller group or have one-to-one support. Some people find that a distraction can focus a person’s energies elsewhere and prevent them from displaying challenging behaviour.

Your doctor may recommend behavioural therapies to help the person you care for. These therapies can be straightforward. For example, the person you care for may behave in a particular way because they're bored and have built up too much energy. A routine involving regular exercise could help solve both of these issues. Find out more about living well with dementia and things you can do to stay active.

Repetitive behaviour in dementia

People with dementia often repeat questions or carry out certain actions over and over again. This may be due to:

  • memory loss
  • boredom
  • anxiety
  • side effects of medication

If you think they're bored, try engaging them in an activity they enjoy, such as listening to music. Most people with dementia feel anxious at some point and will need to be reassured of your love and support. If you're concerned about the medication the person you care for is taking, contact their GP for advice.

Walking or pacing is a common behaviour in people with dementia. It is very common for people at certain stages of dementia to pace up and down or leave their homes for long walks. This is usually a phase and doesn’t normally continue for a prolonged period.

There can be a number of reasons why they walk. They may leave the house intending to go to the shops or visit a friend and then simply forget where they're going. They may be bored or uncomfortable sitting at home and want to use up some energy, or they may be confused about what they should be doing and where they should be.

One of the main concerns for carers of people with dementia is that the person they look after will be unable to find their way home if they leave the house and get lost. You can minimise the risk of this happening by letting trusted local shopkeepers and neighbours know about the person's condition. Give them a contact number to call if they're concerned about the person’s behaviour.

Some types of assisted technology devices may be of use to you and the person you care for. These include tracking devices and alarm systems, such as Telecare. Find out more about equipment and alarms in Carers Direct. Alternatively, you could accompany them on their walk and gently encourage them to return home.

People with dementia may exhibit aggression

Aggressive behaviour by the person you care for can be scary and upsetting. It can be distressing to see such a change in someone’s personality and is generally considered to be a far more upsetting effect of dementia than loss of brain functions, for example.

There are many causes of aggressive behaviour in dementia, including:

  • fear or humiliation
  • frustration with a situation
  • depression
  • no other way to express themselves
  • loss of judgement
  • loss of inhibitions and self-control

You may want to keep a note of anything that could trigger aggressive behaviour in the person you care for. This may take some trial and error, but if you can identify these triggers, you can avoid them. The most common form of aggressive behaviour is shouting, screaming or using offensive language. This can include continually calling out for someone, shouting the same word or screaming over and over again.

If the person you care for shouts out at night, a night light in their room will make them feel less anxious. If they're calling for someone from their past, try talking to them about this period in their life.

During an episode of aggression, it's important not to make the situation worse by arguing with them or adopting an aggressive pose as this may make them lash out. It may help to count to ten or remove yourself from the situation by leaving the room. One way to stay calm is to remember that even if the aggression seems personal or intentional, it is the result of the illness.

When the person has calmed down, act normally towards them. The person you care for may forget the incident quickly, or may feel awkward about it. Acting normally can help you both move forward. If you think they are in pain or ill, contact their GP.

People with dementia may become suspicious of others

Dementia can make some people become very suspicious. This can be due to memory loss, lack of recognition of familiar faces and general confusion caused by the effects of the disease on the brain.

The person you care for may accuse you or their friends and neighbours of taking their possessions. They may believe that everyone is out to get them. If they lose items, they may panic and convince themselves that they have been burgled. Their behaviour may seem delusional and paranoid, but as their carer, try to remember that the way they feel is very real.

Listen to their worries, calm them down and, if you're sure that their suspicions are unfounded, try to change the subject.

Drug treatment for dementia-related behaviour

In extreme circumstances, such as if the person’s behaviour is harmful to themselves or others, and all methods of calming them have been tried, a doctor may prescribe medication. If you want information about drugs to help manage behavioural symptoms of dementia or if you're concerned about the side effects of medication, speak to the person’s GP.

If you are looking after someone with dementia

It may help to talk to someone about how you're feeling. If you want to speak to other carers in similar situations, contact a local carers' support group or a specialist dementia organisation. To find out what's available in your area, contact Carers Direct on freephone 0808 802 0202. Lines are open 9am–8pm Monday to Friday and 11am–4pm on weekends, closed bank holidays.

Read more about caring for someone with dementia.

Last reviewed: 13/06/2012

Next review due: 13/06/2014


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