Dementia support: understanding and responding to changing behaviour

Dementia is a progressive condition that, over time, can affect a person's behaviour. On this page, you can find information about understanding and supporting a person living with a dementia who may be displaying changing behaviour.

Commons signs of changing behaviour and dementia 

As a dementia progresses, it can lead to a person feeling anxious, confused and frustrated. A person living with a dementia may be less able to tell what they need or what they are feeling. So they will try to tell what they are feeling through their behaviour.

Common signs of changing behaviour include:

  • repeating questions or carrying out an activity over and over again
  • walking or pacing up and down
  • sleep problems
  • mood swings
  • distress and shouting
  • becoming suspicious of other people

 

Repetitive behaviour and dementia 

People with a 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

Tips for carers 

Some tips that you may find helpful if someone, you are caring for, is repeating certain behaviour include:

  • although it can be difficult, trying to be patient with the person - they may not realise they are repeating themselves and being patient can help someone to feel secure and supported
  • trying to spot a link between different repetitive behaviours, for example, if they are repeatedly trying to remove their clothes, are they too warm or do they have to use the bathroom?
  • if the person is  asking repeatedly what day or time it is, perhaps getting  a large calendar/clock that they can easily see might help
  • if you think they're bored, try engaging them in an activity they enjoy, such as listening to music

Walking or pacing

It’s very common for people at certain stages of dementia to pace up and down or leave their home for long walks. The reasons why someone with a dementia walks or paces may not be obvious.

Reasons may include:

  • intending to go to the shops or visit a friend and then simply forgetting where they’re going
  • the person may be bored or uncomfortable sitting at home and want to use up some energy
  • the person may simply be confused about what they should be doing and where they should be
  • the feeling they have somewhere to be

Tips for carers 

Some tips you may find helpful if someone, you are caring for, is walking or pacing include:

  • if you notice them leaving, you might want to accompany them to guide them and make sure they don’t end up being distressed
  • making sure the person has some form of personal identification with them and are dressed appropriately for the weather
  • talking to local shopkeepers and neighbours you trust to let them know about the person’s dementia - give them a contact number to call if they’re concerned about the person’s behaviour
  • tracking devices and alarm systems (telecare) – they won’t solve all your worries about someone with a dementia, but may give you some peace of mind
  • making sure the person has plenty to do and is getting mental and physical stimulation during the day

Sleep problems 

People with a dementia often experience disturbed sleep. They may wake up during the night or be restless. These problems may get worse as the illness progresses. People with a dementia may also have painful illnesses, such as arthritis, which cause or contribute to sleep problems.

Some medication can cause sleepiness during the day and interfere with sleep at night. Sleeping pills can be used with care in people with a dementia (speak to their GP for advice). However, ‘sleep hygiene’ measures are best.

These measures include:

  • having no naps during the day
  • keeping regular bedtimes
  • avoiding alcohol or caffeine at night

Mood swings 

People with a dementia can experience mood swings as they cope with the daily challenges of living with their condition. This can lead to a person feeling sad or angry at times, or scared and frustrated as the disease progresses.

It is important to remember that if you are living with a dementia you are not alone. Help and support are available (see links below).

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
  • general confusion caused by the effects of the condition on the brain

The person you care for may accuse you or their friends and neighbours of taking their possessions. If they lose items, they may panic and convince themselves that they have been burgled.

Their behaviour may seem delusional and paranoid. However, as their carer, try to remember the way they feel is very real.

Tips for carers 

Some tips that you may find helpful if someone, you are caring for, is becoming suspicious include:

  • listening to their worries
  • trying to change the subject, if you're sure their suspicions are unfounded
  • not taking the false accusations personally
  • trying not to argue with or correct them
  • trying to find out if there is a reason behind their behaviour, for example, have they forgotten where they left something

Drug treatment for dementia-related behaviour 

In extreme circumstances – for example, 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.

Encouraging someone with a dementia to communicate 

Dementia is a progressive condition. Over time, it will affect a person's ability to remember and understand basic everyday facts, such as names, dates and places. 

All behaviour is a form of communication. A person living with a dementia may be less able to tell what they need or what they are feeling so they try to tell this through their behaviour.

By communicating well with a person living with a dementia, you can help increase their understanding and wellbeing.

Where to find help and support 

If you have a dementia, you may feel sad or angry at times, or scared and frustrated as the disease progresses.

As a carer, seeing a loved one's behaviour change can also be difficult and distressing.

It is important to remember that you are not alone. Help and support are available. It can help to talk to someone about your worries.

This could be a family member or friend, a member of your local dementia support group or your GP, who can refer you to a counsellor in your area .

You can find more information and support services from the following organisations, see also ‘more useful links section’:

The Public Health Agency has also produced a range of information to help support people with a dementia, their families and friends.

This information includes the following publications:

Dementia apps library

The ‘Apps4Dementia’ library is a digital service which groups together safe, trusted apps to provide information and guidance on the condition.

There a number of apps that offer support, self-care of symptoms and enable users to carry on with their day-to-day activities for as long as possible.

More useful links 

The information on this page has been adapted from original content from the NHS website.

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