Dementia support: understanding and responding to changing behaviour

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  feel. They may show their feelings through their behaviour.

Common signs of changing behaviour include:

• repeating questions
• doing the same activity over and over again
• pacing back and forth
• sleep problems
• mood swings
• distress and shouting
• becoming suspicious of other people

• How dementia changes a person's behaviour

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

Some tips to help if the person you care for is repeating certain behaviour are below.

Try to be patient with the person. They may not realise they are repeating themselves and being patient can help them feel secure and supported.

Try to spot a link between different repetitive behaviours, for example, if they are repeatedly trying to remove their clothes, they may be too warm or may need to use the bathroom.

If the person is asking repeatedly what day or time it is, perhaps getting  a large calendar or 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 include:

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

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

If you notice them leaving, you might want to accompany them to guide them and make sure they don’t end up being distressed.

Make sure they have personal identification with them and are suitably dressed for the weather.

Speak to local shopkeepers and neighbours you trust to let them know about the person’s dementia and give them a contact number to call if they’re concerned about the person’s behaviour.

Use 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.

Make sure they have plenty to do and are 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.

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 belongings.

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.

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

Medicine 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 

Over time, dementia 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 say 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.

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.

Remember, you are not alone. Help and support is 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.

• Coping with dementia behaviour changes

You can find further information on dementia and support services available at the link below:

• Help and support for people living with a dementia