How Caregivers Can Respond to Common Dementia-Related Behaviors

If you’re caring for a loved one with dementia, you may notice some new behaviors that feel uncharacteristic of them. As memory and cognitive abilities shift, behaviors can shift as well.  

Some common changes include repetitive questions, resistance to personal care, sundowning (when confusion and agitation increases at the end of the day), and wandering. Here are compassionate and practical ways to respond that can comfort your loved one and ease caregiver frustration.

Common Scenarios & Practical Responses

1. Repetitive Questions

A common behavior for individuals with dementia is asking questions multiple times. Your loved one may repetitively ask questions like, “What time is dinner?” or “What time are we leaving?”

Why it Happens: Short-term memory loss may prevent individuals with dementia from retaining the answer. Depending on the question, it can also be a way to express anxiety, insecurity, or a desire for reassurance.

How to Respond: The best way to respond is by politely telling them the answer again. Their reality is different from yours, and they don’t realize they are repeating the question. Responses like “I already answered that” will only increase confusion and frustration. We recommend giving a simple, validating answer and redirecting the focus. This can look like: “Dinner is at 6 PM. How about we look at some old family photos until then?” 

You can also use a large calendar or whiteboard to provide visual cues on some of their most common questions. 

2. Increased Confusion and Agitation in the Evening (Sundowning)

As the afternoon fades into evening, some people with dementia become more restless, confused, or agitated. This can result in pacing, wandering, or becoming more prone to outbursts.

Why it Happens: This common phenomenon is believed to be caused by fatigue, changes in light, disruption of the body’s internal clock, or decreased visibility.

How to Respond: Stick to a consistent daily schedule, especially for meals, activities, and bedtime. This predictability can be very comforting. As a part of the daily routine, encourage physical activity and exposure to natural light during the day to promote better sleep at night. At night, create a calm atmosphere by gradually dimming lights, reducing noise, and playing soft music. 

3. Resistance to Personal Care

Your loved one may refuse to bathe, become agitated during dressing, or push away food.

Why it happens: When receiving assistance with personal care, your loved one may feel a loss of control, be cold, feel pain, or find the process confusing – and they may not have a way to express that to you. 

How to Respond: Try to give your loved one as much autonomy as possible. This can be done through:

• Offering choices such as “Would you like fruit or yogurt with your breakfast?”
• Being flexible and compromising on the timing or manner of personal care
• Checking for discomfort. Ask about water temperature, comfort of clothes, or trouble chewing throughout the day to get a better understanding of your loved ones’ stressors.  

4. Wandering

Individuals with dementia may try to leave the house, pace restlessly, or seem to be looking for something.

Why it happens: There are a number of reasons individuals with dementia may wander – including boredom, disorientation, seeking to fulfill a past routine such as going to work, looking for a familiar person, or responding to an unmet need. 

How to Respond: Install locks outside their line of sight on doors, use door alarms, and consider a medical alert system. 

Creating opportunities for exercise such as spending time in an enclosed backyard, supervised walks, or purpose-driven activities like gardening can reduce the tendency to wander.

If your loved one starts to wander, check on and address underlying needs like hunger, thirst, boredom or toileting needs. Take note if there is a need that seems to be a common trigger for wandering.   

Dementia-Related Behaviors Can Communicate Unmet Needs

Individuals with dementia have a reason behind every behavior, even if it’s not immediately obvious. These behaviors are often a form of communication when verbal expression becomes difficult. They might be trying to convey:

• Unmet Needs- Pain, hunger, thirst, needing to use the restroom, boredom, or feeling too hot or cold.
• Confusion or Fear- Disorientation about time or place, misinterpreting situations, or feeling unsafe.
• Overwhelm- Too much noise, too many people, or too much stimulation.
• Past Memories- Trying to live out a past routine or memory that feels real to them now.

Approach new behaviors by looking for the underlying message.

Embrace Caregiver Support

It takes incredible strength, patience, and resilience to care for a loved one with dementia. You don’t have to navigate these challenges alone.

At Avalon Memory Care, we understand the complexities of dementia care and are here to ensure safety and wellness. We provide specialized care, engaging activities, and compassionate support tailored to the unique needs of individuals with dementia.Interested in learning more about Avalon Memory Care? Schedule a tour.