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Navigating Challenging Behaviors with Dementia

As dementia escalates, your loved one’s behavior may start to become more erratic - they may start to show signs of sleep deprivation, delusions, or hallucinations. As a caregiver, sometimes these behaviors can feel overwhelming, exhausting, or even embarrassing at times. While many of these behaviors can be handled or curbed at home, it is often better to start with help from a professional. In this article, we’ll go through how to reduce or manage unwanted behavior in a loved one with dementia.

Identify the Cause

Sudden changes in behavior may be due to a physical change or health problem - especially if they’re showing signs of distress or agitation. If there has been a sudden or rapid change of behavior in your loved one, it’s worth seeking a professional opinion (to rule out issues like constipation or infection). They can also review any prescriptions your loved one is currently taking and evaluate for possible side effects.

Other causes of unwanted behavior beyond distress might be things like an unstimulating environment (boredom), a reaction to the behavior of others, or an uncomfortable environment, to name a few. To identify the cause of the behavior, it’s worth reviewing where the behavior happens, when it happens, the emotions they exhibit, and with whom. This may help to identify patterns (such as a crowded room of people, noisy room, or unfamiliar visitor, for example).

The behavior might be something related to:

  • A person

  • Their environment

  • A change

  • A memory

  • Something that causes them pain or fear.

Managing the Behavior

Here is a list of things you can do to help manage the unwanted behavior:

  • Talk to their primary care physician. Again, the first step to curbing unwanted behavior should be to get a professional opinion to rule out something serious that needs attending, or another issue (like worsening vision, hearing or toothache).

  • Don’t take it personally. Your loved one is reacting to something - they are not behaving this way on purpose (and may not even be aware of their behavior). They are responding to their reality, which may differ from your own and it isn’t personal. Try to instead understand on a deeper level what they’re trying to communicate to you.

  • Maintain calm. The loved one in your care will often react to your emotions and actions, so it’s important to remain calm or step away to gather your thoughts and emotions in private where possible. Acting aggressively, suddenly, or emotionally may escalate the situation.

  • Support their independence. Sometimes challenging behavior is caused by feeling unwanted or unneeded. It’s important to support your loved one’s independence with activities as long as it is safe to do so.

  • Move on. In some situations, the unwanted behavior is related to completing a task (like a meal or chore). At certain times, it may be worth considering whether that task can safely be completed at another, calmer, time. If so, consider moving on and coming back to it at a later time.

  • Find engaging activities. If you suspect boredom, find some new activities (or activities they used to enjoy) to engage your loved one and keep them mentally stimulated a bit more.

  • Take a break. As dementia escalates, you may find yourself more easily stressed or exhausted by unwanted behavior. It’s important to maintain your self-care and mental health as a caregiver, and ask for help when you need it. Talk to other family members or friends to see if they can help you for a few hours, take a day off, or hire respite caregivers to create breaks for yourself.

Closing Thoughts

Behavior changes are a hallmark symptom of dementia, and as a caregiver, they can make us feel lost, stressed, or overwhelmed. We hope you found this article helpful in providing a starting point - ways to identify and curb unwanted behavior.

No matter how difficult the caregiving journey may get, you’re never alone in it. For further reading and resources, we invite you to check out our library of information for family caregivers by clicking here. You are also welcome to give us a call at 800-543-8312 to find out more about how we can support you in your caregiving journey.


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