Dementia and behavioural changes
For some people, having dementia can change their behaviour. Knowing what to expect can help you prepare yourself and deal with problems more effectively, but bear in mind that everyone is different and your loved one might behave very differently.
Types of unusual behaviour
- Repetitive behaviour: for example, carrying out the same gesture or activity or asking the same question repeatedly.
- Restlessness: such as pacing up and down or fidgeting. This might be a sign that they are hungry, thirsty, in pain, stressed, upset, angry or in need of the toilet.
- Lack of inhibition: can be a problem with some types of dementia. Confusion might cause some people with dementia to behave in a way that others find embarrassing, such as undressing in public, swearing, making inappropriate comments or exhibiting sexual behaviour. Having the support of your local mental health team is important when behaviour becomes distressing to the person and their family and friends.
- Night-time waking: dementia can cause people to become restless at night and find it difficult to sleep. It can affect people’s body clocks so that they may get up in the night, get dressed or even go outside. Getting advice and support from your GP or local mental health team is important, to ensure safety and help you with managing your own need for rest and sleep.
- Trailing and checking: dementia can make people insecure and anxious, so they may follow carers or loved ones to check where they are.
- Hiding and losing things: people with dementia sometimes hide things and then forget where they are – or forget that they have hidden them at all.
- Paranoia: some people with dementia can become suspicious and paranoid. For example, if they have mislaid an object they may accuse someone of stealing it, or they might imagine that a close friend or family member is out to get them.
Coping with unusual behaviour
- Talk to your GP: or other health professional involved in your loved one’s care; this can really help you deal with the changes. Everyone is different and the response and support that is needed will be, too.
- Try to see things differently: remember that dementia affects a person’s ability to use logic and reason, so don’t expect your family member to think or behave in the same way that they did before the illness.
- Blame the condition: try to remember that it’s not them, but their condition that is making them behave in this way.
- Think about what is necessary: if your loved one appears agitated or acts unusually when you try to do a particular activity – such as washing, dressing or going out – ask yourself if it needs to be done, if you can do things differently, or if you can postpone the action for a while until they have calmed down.
- Communicate differently: remember that all behaviour, however unusual, can be a means of communication. Try to work out what they might be trying to communicate. For example: trying to undress could mean that they’re hot or need to go to the toilet; pacing up and down may mean that they need more exercise; and becoming agitated may mean that they’re uncomfortable in an unfamiliar, loud or busy environment.
- Step back and think: sometimes carers can make the situation worse by misunderstanding what the person with dementia is trying to communicate. Try stepping away from the situation, look at their body language and take time to try to understand what they might be feeling.
- Calming techniques: if your loved one becomes agitated, try to give them reassurance and calm them down. Being in an unfamiliar setting or doing new things might make them more agitated. Soothing activities, such as speaking in a gentle voice, watching a favourite TV programme, having a gentle massage or listening to their favourite music might help them to feel better.
- Take a break: unusual behaviours, particularly a repetitive behaviour, can be very irritating. If you find the person’s behaviour difficult to deal with, step out of the room for a while or explore alternative care options that will allow you to take a break, such as respite care, day care centres or specific clubs for people with dementia.
- Do your research: Use our care services directory to find local support groups for people living with dementia.
- Get support: looking after someone with dementia can be very tiring. Don’t be afraid to ask for help and advice if you need it. The following charities offer support in various ways.
A national membership charity that champions carers’ rights, connecting and supporting carers online and in local communities.
A charity aimed at improving the lives of people living with dementia.
Specialist dementia support for families through the Admiral Nurse service. This isn't available right across the country, so check what provision there is where you live.
Dealing with aggressive behaviour
Sometimes a person with dementia can become aggressive – verbally or physically – to those around them. Unfortunately, loved ones and carers are the ones that most often have to deal with this. Seek advice and support from the specialists involved in care or ask your GP if they think a referral to your local Community Mental Health Team might be needed.
After the incident
- Carry on as normal: draw a line under what happened and try not to bring it up again. They may have forgotten what happened and could become upset or distressed if you mention it later. Focus on your loved one, not the behaviour that they displayed.
- Don’t bottle things up: if you’re hurt, angry or upset, it might help to talk through your feelings with others – for example a health professional, family member, counsellor or dementia support worker.
- Don’t take it personally: try to remember that the person is probably trying to communicate a need and doesn’t intend to hurt you.
- Look for the cause: think about what may have triggered the behaviour. Remember that the condition is likely to make them think irrationally, so try to put yourself in their shoes. What might have made them feel threatened or upset? You might need to make changes to how you approach the situation.
- Take a breather: before you react, take a deep breath, step back to give the person space and take some time. If things aren’t going well, you may need to leave the room until you have both calmed down, then try again.
- Try to stay calm and avoid confrontation: shouting or losing your temper could make the situation worse. Try not to show any fear or anxiety, as this may increase the person’s agitation.
- Don’t attempt physical contact: if someone with dementia is being angry or aggressive, this usually isn’t the best time to initiate any physical contact. Even a friendly gesture (such as a hug) at this point could be misinterpreted as threatening behaviour. Unless it’s absolutely necessary, avoid closing in or trying to restrain someone, as this can make things worse.
- Listen: reassure your loved one that you’re listening and are trying your best to understand how they feel and what they want to communicate.
- Speak gently: try to explain calmly why you’re there and that you’re trying to help.
- Distract: if your loved one still seems angry, try to distract their attention to diffuse the situation.
Depression and dementia
It’s quite common for people with dementia to experience low moods, anger, frustration and even depression. This can be a symptom of the condition and the changes it’s making to their brain, or simply a natural consequence of being diagnosed.
It can help for your loved one to talk to someone – a family member, friend or a support group. If you suspect that they’re experiencing severe or clinical depression, ask them to speak to their GP who may refer them to a trained counsellor or prescribe medication.
The NHS website Moodzone contains practical information and advice on how to deal with mood-related problems.