Why Is My Loved One With Dementia Acting Out? What Their Behavior May Be Communicating

When a person living with dementia becomes agitated, repeatedly calls out, wanders, resists care or accuses someone of taking an item, the behavior can be upsetting for everyone involved. But what appears to be a “challenging behavior” may be the person’s way of communicating discomfort, fear, confusion or an unmet need.

Try to put yourself in their shoes. Imagine being absolutely certain that you are late for work, only to have someone insist that you are mistaken and do not need to leave. You might feel anxious, frustrated, dismissed or even trapped. For a person living with dementia, what they are experiencing feels real. Responding to the emotion behind the behavior, rather than arguing about the facts, can help reduce distress and build trust.

Look for Possible Unmet Needs

Someone living with dementia may not be able to express that they are hungry, in pain or need to use the bathroom. Rather than relying only on questions, caregivers can look for possible unmet needs and offer practical support, such as providing a snack, offering a drink or assisting the person to the restroom.

Pain, constipation, dehydration, infection and medication changes may also affect behavior. A new, sudden or significant change should be reported to the person’s nurse or healthcare provider so a medical cause can be considered or ruled out.

Consider the Environment

The environment may offer other clues. Bright glare, deep shadows, loud televisions, crowded spaces or several people giving directions can become overwhelming.

Reducing noise and activity and moving to a familiar, quiet setting may help the person feel more secure. Gentle sensory experiences may also provide comfort. Familiar music, calming nature scenes, a textured object, a weighted lap blanket or a lifelike pet or doll may help the person relax and focus on something reassuring.

Sensory support should be individualized. A song, scent or object that comforts one person may be unpleasant or confusing to another. Introduce one element at a time, observe the person’s response and consider their history, preferences and interests. The goal is to create a calm experience without adding more stimulation.

Respond With Calm and Patience

How you respond also matters. Approach from the front, speak calmly and avoid rushing into the person’s space. Use short sentences and simple choices.

If a task becomes frustrating, break it into smaller steps, pause or try again later. Arguing, scolding or insisting that the person accept your version of events can increase distress.

Validate the Emotion, Not the Details

As mentioned, try to consider the situation from the person’s point of view. If they believe they are late for work but are being told they cannot leave, they may understandably feel anxious, frustrated or trapped.

Rather than correcting them, acknowledge the emotion and offer reassurance. When appropriate, a therapeutic fib may help prevent unnecessary distress. You might say, “It sounds like getting to work on time is really important to you. Good news! your boss called and said you have the day off today. Why don’t we have some coffee and enjoy the morning?”

This approach addresses the person’s feelings without arguing or creating a confrontation. A snack, drink, familiar song, photograph, quiet walk, tactile object or purposeful activity may also provide comfort and redirection.

Understand What Wandering May Mean

Wandering can have meaning as well. A person may be searching for a spouse, trying to “go to work” or following a routine formed decades earlier.

The goal is to support safe movement while looking for the need, emotion or memory behind it.

Replace Judgment With Curiosity

Dementia changes how a person experiences and communicates with the world. When we replace judgment with curiosity, we are more likely to find a compassionate and effective response.

OAK PARK® Place memory care communities provide calm surroundings, structured support and individualized care centered on each resident’s life story.