Caring for a loved one with dementia or other memory-related cognitive conditions can be challenging at times. Your loved one may display various emotions or behaviors as their condition progresses, including anger, depression, confusion, and even aggression. These can be physically and emotionally difficult for caregivers to manage.
As the brain changes, your loved one may have trouble finding the words they need to communicate. They may become confused or ask the same question repeatedly. They may even lash out or make accusations. It’s vital to understand that these behaviors result from their condition and should not be taken personally.
These behavioral symptoms may be a sign of frustration, discomfort, fear, or an unmet need. Taking the time to try and understand the reason behind the behavior may help minimize occurrences; making time spent together more productive, successful, and enjoyable.
Here are some helpful tips to keep in mind when dealing with these common behaviors.
Common Behaviors Dementia Caregivers Encounter
Some of the most common challenges dementia caregivers face can also be some of the most difficult. Learning to manage behaviors like confusion, aggression, accusations, and repetition requires time and patience.
Individuals with Alzheimer's or another type of dementia can become irritable or combative without apparent warning or reason. They may act confused and disoriented – not recognizing who you are or remembering where home is.
Your loved one may wander or take the car out for a drive without a clear destination in mind. These behaviors can be dangerous for both you and your loved one, but there are ways to manage them successfully.
As their disease progresses, many people living with dementia experience an inability to remember loved ones’ names and faces. Confusion may express itself in questions like, “Who are you?”, “Why are you here?”, or “I want to go home!”
Your loved one may forget how to use everyday items, like utensils or a pen. Or, they may become confused about where they live, which is a concern if they wander and become lost.
Confusion can be frightening for caregivers and their loved ones to experience. The Alzheimer’s Association recommends the following strategies for managing confusion.
How to Manage Confusion
- Do remain calm and supportive.
- Do remain proactive by introducing yourself and using visual cues.
- Don’t take their confusion personally.
- Don’t attempt to make long, complicated explanations.
People living with dementia sometimes second-guess themselves. One way you can help alleviate this stress is to concentrate on what they can do rather than what they cannot do.
Remember to let your loved one know they are doing okay and provide positive reinforcement throughout the day. Some easy examples include telling them, “That’s right, nice job,” as they complete a task or thanking them for their help.
People living with Alzheimer’s disease may become aggressive due to several factors. These include overstimulation, physical pain, lack of sleep, and even medication side effects, which can all lead your loved one to experience either a physically or emotionally aggressive outburst.
It is important to remember that your loved one’s ability to process their surroundings and communicate what is happening to them is impaired. The television turned on coupled with dinner conversation may seem normal to you; however, it may be overwhelming for your loved one – causing them to experience a “catastrophic reaction.”
While aggressive behaviors like hitting, kicking, shouting, and crying are common and sometimes challenging to deal with, it can be beneficial to understand they are not meant to be personal.
How to Manage Aggression
- Do seek out the cause of what is triggering the aggression.
- Do try to remove or reduce possible environmental stimulation, like loud noises, bright lights, or alarms.
- Don’t try to restrain your loved one; instead, redirect their attention and avoid contact until they have calmed down.
- Don’t lose your temper or put unnecessary pressure on your loved one.
When your loved one shows aggression, speak to them in a calm, lower tone. Validating that they are upset is important.
You can validate their distress by saying something like, “I am sorry that happened.” Pay attention to your body language, too – try standing or sitting to the side in a supportive stance.
Mirror the behavior you want your loved one to exhibit. Always remember that your loved one cannot control how they react, but you can.
It can be particularly hurtful to have a loved one you are caring for make a false accusation towards you or another family member. Accusations typically stem from paranoid delusions, which are common in the middle to late stages of Alzheimer’s disease.
Your loved one might accuse you of stealing their purse or wallet when they are unable to remember where it has been placed. Remember that for individuals with dementia, perception is reality, and their accusations are often the result of poor memory or the gradual deterioration of cognitive function.
How to Manage Accusations
- Do separate your own emotions of being accused from how you respond to the behavior.
- Do validate that an object is missing and suggest looking for it together.
- Don’t accuse your loved one of lying or manipulation.
- Don’t get into heated, ongoing arguments about their accusations.
It is essential to promote a relationship based on trust. If you know the purse in the example above is important to your loved one, be proactive. Keep the purse in view and provide reminders that it is there to help minimize confusion or mistrust.
Perceived lack of independence and control can also foster or lead to accusatory behaviors. Make sure to offer opportunities to make choices and promote as much independence as possible.
As your loved one’s condition progresses, you may notice them engaging in repetitive behavior. It might be saying the same word or phrase, or doing a task repeatedly. Experts believe a need for comfort, security, and familiarity drives this behavior.
While it is frustrating to answer the same question several times in a row or to witness your loved one repeatedly making their bed, try to remember they are attempting to make sense of their surroundings. In many cases, they may not recall having asked the question before or completed the task.
How to Manage Repetitive Behaviors
- Do search for the cause of the repetitive behavior.
- Do remain patient.
- Do use activities to engage your loved one in a positive way, such as household chores, singing, exercise, or gardening.
- Don’t react to how your loved one is behaving; instead, try to understand what they are feeling.
- Don’t argue or try to use logic — if the behavior isn’t harmful, do your best to accept it.
Know When to Reach Out for Help
Caring for someone with dementia can be difficult and can take a toll on the physical and mental health of the caregiver. Experiencing feelings of resentment, depression, or fatigue is common. Ensure that you are managing your own health and well-being by reaching out to a counselor, friend, or family member for support.
While there is currently no cure for Alzheimer’s disease, memory care programs, therapies, and medications are available to help you support and manage your loved one’s care. Work with a medical professional to explore these options as your loved one's condition changes.
Learning to delegate is important. Ask a friend or family member for assistance. People may think you are doing a great job and do not need help. Join a support group in your area. Many are now offered virtually, so it’s easy to meet from the comfort of your own home.
Download Your Free Caregiver Resource Guide
Would you like to view more information and tips on caring for a loved one with Alzheimer’s or other types of dementia? Download our free resource, A Caregiver’s Guide to Alzheimer’s Disease and Dementia. This guide includes over 20 pages of information to help you prepare and care for a loved one living with Alzheimer’s or dementia.
This blog was originally published in December 2020. It was updated in July 2023.