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Understanding Behaviors

Why is he acting like this?

Challenging behaviors are common in persons with dementia as they may be the only means of communication. As the disease progresses, day-to-day living becomes challenging and frustrating. An independent person now needs total assistance from a caregiver.

Increasing confusion may cause your loved one to react verbally or physically as a self-protective response. Think about possible triggers. Challenging behaviors can often be prevented when caregivers anticipate and meet basic physical needs and use a soft, slow approach. You might also try pleasant distraction—singing a favorite song, reciting a familiar prayer, offering a soft stuffed animal to hold, or other comforting measures.


Unmet needs that may cause distress:

  • Hunger/thirst
  • Need for toilet/brief change
  • Desire to change body positioning
  • Pain
  • Wrong room temperature
  • Loud noise level

Other triggers that may aggravate:

Excess fatigue often results in “sundowning” in the late afternoon or evening. The demands of the day, along with memory difficulties and inability to recognize or communicate basic needs, often causes increased physical and/or verbal agitation. A common theme is the person wanting to "go home."

Boredom may lead to disruptive behaviors as the person searches for something meaningful to do.

Overstimulation may cause behaviors. Avoid exposure to large groups of people, overwhelming or complex tasks, or noisy environments (television and radio) and make sure the person gets enough rest during the day.

Change can be stressful and disruptive. A move from home to assisted living, may cause anxiety and fear. Establishing calm, predictable and familiar surroundings is extremely beneficial for persons with dementia.


Emotional distress such as continued or prolonged sadness, crying and/or irritability could mean the person is depressed and may benefit from an antidepressant medication. Talk to your doctor.


It’s hard to communicate if your loved one can’t express basic needs and may not understand what is being asked or said. Agitated behavior is a cue that something is wrong. Try responding to behaviors by anticipating what the person may need.