When a family member is diagnosed with dementia, families are prepared for memory impairment, confusion, or communication difficulties. But most people don’t anticipate — and find most stressful — the appearance of behavioral disturbances. These are bewildering, scary, and emotionally exhausting, particularly when it seems to emerge suddenly.
This article provides a lucid, humane handbook for families and caregivers to manage the dementia with behavioral disturbance challenge — what it is, why it occurs, and how to respond with care and compassion.
What Does “Dementia with Behavioral Disturbance” Mean?
Dementia is a broad term for a collection of conditions that impair memory, thinking, and social skills sufficiently to interfere with daily life. Some common forms are Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia.
When a person is diagnosed with dementia with behavioral disturbance, it indicates that aside from cognitive impairment, they are also displaying behaviors that are disruptive, inappropriate, or hard to handle. These behaviors are not intentional — they are manifestations of brain disease.
Behavioral Disturbances in Dementia
Not all individuals with dementia will have the same behaviors, but here are some of the most prevalent ones:
- Agitation or restlessness
- Verbal or physical aggression
- Wandering or pacing
- Yelling or frequent calling out
- Paranoia or delusions (e.g., believing someone is stealing from them)
- Hallucinations
- Mood swings
- Resistance to bathing, dressing, or medication
Some individuals will appear withdrawn or apathetic, while others may become impulsive or socially inappropriate. These behaviors are usually associated with damage in certain areas of the brain, particularly those involved in regulating emotion, judgment, and impulse control.
Why Do These Behaviors Occur?
Behavioral disturbances due to dementia may be caused by multiple biological, environmental, and emotional causes such as:
Brain changes: Dementia kills brain cells, particularly in brain locations responsible for behavior and personality.
Frustration: The individual understands something is amiss but is unable to communicate it.
Unmet needs: Pain, hunger, thirst, tiredness, or the need to urinate may cause agitation if unnoticed.
Environmental stress: Loud sounds, strangers, or a change in routine may be distressing.
Medication side effects or medical conditions themselves (such as infections) may also play a role.
Recognizing that these actions are not deliberate is an essential first step in responding with compassion instead of anger or fear.
How Families and Caregivers Can Respond
1. Remain Calm and Reassuring
When a loved one becomes agitated, your calm presence can de-escalate the situation. Speak softly, in simple terms, and do not argue or correct them.
2. Identify the Trigger
Ask yourself: What was happening right before the behavior began? Was there a loud noise? An unfamiliar person? Were they tired or in pain?
3. Have a Routine
Individuals with dementia tend to feel more secure when their days are on a routine schedule. Consistent wake-up times, meals, activities, and bedtimes minimize confusion.
4. Redirect, Don’t Confront
If a person is agitated about something that is not true (such as thinking someone has stolen their purse), don’t correct them. Comfort them and redirect them to something pleasant — a snack, a walk, or music.
5. Establish a Calm Environment
Dim lighting, calming music, and reducing clutter or loud noises can decrease agitation. Have familiar objects within reach to offer a sense of security.
6. Collaborate with Healthcare Providers
If behaviors are extreme or hazardous, talk to a physician. Medications can be employed cautiously to treat severe agitation, anxiety, or psychosis, but non-drug approaches are preferable whenever possible.
Care for the Caregiver
Caregiving for a person with dementia is a challenging, emotional process. When behavioral disturbances are in the mix, caregiver stress can be extreme. That’s why self-care is not a choice — it’s necessary.
Take breaks with the help of respite care or family support.
- Join a support group — online or in person — to share and learn from others.
- Talk to a counselor or therapist if you’re feeling depressed, anxious, or burned out.
- Celebrate small wins — a calm day, a smile, a connection.
You’re doing one of the hardest and most meaningful jobs there is.
Final Thoughts
Dementia with behavioral disturbances is tough, but it’s also part of a medical condition that can be worked with and helped. With a good support network, patience, and compassion, you can help your loved one feel safe, seen, and cared for even when faced with challenging behaviors.
Don’t forget: You are not on your own, and help is available for the individual with dementia as well as the person who is walking alongside them.