I Need Help With Difficult Dementia Behaviors

Look for What Comes Right Before

Behavior often has a trigger or unmet need.

Ask:

• What time of day is it?
• Are they hungry, tired, cold, or needing the bathroom?
• Is the room loud, crowded, or dark?
• Were they rushed, or being bathed, changed, or moved?
• Did something upsetting happen just before?

Changing the trigger may work better than trying to manage the reaction.

A bath at a different time of day can be a real change in the care plan.

What May Help in the Moment

Avoid arguing, correcting, or quizzing.

Say less. Use short sentences and give the person time to respond.

If a task is turning into a fight and it can safely wait, stop and try again later.

Changing the room, the subject, or the activity may help more than continuing the argument.

When You’re About to Lose It

If the person is safe, you can walk out of the room for a few minutes. That’s often safer than staying when you’re about to lose control.

If you’ve yelled, grabbed an arm, or said something you regret, tell someone.

“I lost my temper. This is happening more. What has to change?”

That’s the point when the plan needs to change, not the point when you try harder.

If the person may hurt you, get to safety and use I Am Afraid of the Person I Am Caring For →

If the person is hitting, grabbing, or hurting you during care, tell the care team exactly that. It changes what help is available.

Ask the Care Team for Real Help

Behavior is something the care team needs to know about.

Describe it plainly:

“This is what happens, this is when it happens, this is what I’ve tried, and this is what it’s doing to the household.”

Ask whether medications should be reviewed, whether a dementia-care or behavioral specialist can help, and whether a nurse or social worker can observe what’s happening.

Ask whether an occupational therapist can watch a difficult bath, transfer, or other care task. They may be able to change how the task is done.

If Medication Is Suggested

Ask:

• What symptom is this meant to change?
• What non-medication approaches have been tried, and what happened?
• What are the risks?
• Could this medication make falls, sleepiness, confusion, or movement problems worse?
• Is the type of dementia known, and does it change which medications are safe?
• How will we know if it’s helping?
• When should it be reconsidered?
• Has pain or another medical cause been checked?

If It Gets Worse at the Same Time Every Day

Tell the care team when it happens.

Ask whether the timing of meals, medications, sleep, activity, or the daily routine may be contributing.

Then plan the hardest hours around it. If 5 p.m. is consistently the worst time, that may be the hour to ask a family member, friend, aide, or other helper to be there.

When It’s More Than One Person Can Manage

The real question is whether the household can safely keep absorbing the behavior.

Say it plainly:

“This is happening every day. I can’t keep doing it alone. What changes?”

Ask whether the person needs more help at home, respite, a different daily routine, another evaluation, or another level of care.

For more help or a different setting:

I Need Help Caring for Someone →

I Need a Break from Caregiving →

I Need Help Finding a Care Facility →

Before This Happens Again

Know:

• whether a medical cause has been checked
• what seems to trigger it
• what you told the care team
• what can change during the hardest time of day
• who you’ll call if you can’t safely manage it again