Managing Changed Behaviours in Dementia: A Practical Guide
Common dementia behaviours explained: why changes in behaviour happen, what triggers them, and practical, non-medication strategies for families and care teams.
Key points
- Behaviour is often a way of communicating an unmet need.
- Identifying triggers is the first step.
- Carer wellbeing is part of good dementia care.
Agitation, resistance to care, restlessness and repeated calling out are common in dementia and can be exhausting for families and staff. Understanding the reason behind the behaviour is the key to responding well.
Common dementia behaviours
Changes in behaviour are experienced by most people living with dementia at some stage. These are sometimes called behavioural and psychological symptoms of dementia (BPSD). Common examples include:
- Agitation, restlessness and pacing
- Wandering or exit seeking
- Resisting help with showering, dressing or medication
- Suspicion, accusations or false beliefs
- Verbal or physical aggression
- Withdrawal, apathy and loss of interest
- Sleep disturbance and increased confusion late in the day
- Disinhibited or impulsive behaviour
Why behaviour changes in dementia
Dementia affects the parts of the brain involved in memory, judgement, language and emotional control. As these abilities change, a person may misread situations, struggle to express needs or feel overwhelmed by things they once managed easily. The type of dementia also matters: frontotemporal dementia often affects behaviour and personality early, while Alzheimer's disease more commonly begins with memory changes.
Behaviour is communication
When someone can no longer easily put their needs into words, behaviour often becomes their way of telling us something is wrong.
Look for triggers
- Pain, constipation, infection or discomfort
- Hunger, thirst or tiredness
- Too much noise, people or activity
- Fear, confusion or feeling rushed
- Loss of control over everyday choices
A simple diary noting what happened before, during and after a behaviour (sometimes called ABC charting) can reveal patterns that are easy to miss day to day.
Communication strategies
- Approach calmly from the front and use their name
- Give one simple instruction at a time
- Acknowledge feelings rather than correcting facts
- Gently redirect to a familiar, enjoyable activity
- Allow extra time to respond
Adjust the environment
Predictable daily routines, good lighting in the late afternoon, reduced background noise and familiar objects can all reduce distress, particularly where symptoms worsen later in the day.
When to seek professional help
Consider professional support if behaviours are escalating, putting anyone at risk, causing significant distress, or making care difficult to sustain. A neuropsychological behaviour assessment looks at the person's cognitive profile, history and environment to understand why behaviours are occurring and to develop a practical, individualised support plan for families and care teams.
Look after the carer
Caring is demanding. Regular breaks, respite and support from others are essential, not a luxury. Dementia Australia's National Dementia Helpline (1800 100 500) offers free information and support.
This article provides general information only and is not a substitute for individual medical or legal advice.
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