Behaviors
®
behaviors
What causes
dementia-related
behavior like aggression,
and how to respond
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Alzheimer’s disease and related
dementias can cause a person to
act in different and unpredictable
ways. Some individuals with
Alzheimer’s become anxious or
aggressive. Others repeat certain
questions or gestures. Many
misinterpret what they hear.
These types of reactions can lead
to misunderstanding, frustration
and tension, particularly between
the person with dementia and the
caregiver. It is important to
understand that the person is not
acting that way on purpose.
Behavior may be related to:
• Physical discomfort
Illnesses or medication
• Overstimulation
Loud noises or a busy environment
• Unfamiliar surroundings
New places or the inability to recognize home
• Complicated tasks
Difficulty with activities or chores
• Frustrating interactions
Inability to communicate effectively
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Use this three-step approach to help
identify common behaviors and their causes:
1. Identify and examine the behavior
• What was the behavior? Is it harmful to the
individual or others?
• What happened just before the behavior
occurred? Did something trigger it?
• What happened immediately after the behavior
occurred? How did you react?
• Consult a physician to identify any causes related
to medications or illness.
2. Explore potential solutions
• What are the needs of the person with dementia?
Are they being met?
• Can adapting the surroundings comfort
the person?
• How can you change your reaction or your
approach to the behavior? Are you responding
in a calm and supportive way?
3. Try different responses
• Did your new response help?
• Do you need to explore other potential causes
and solutions? If so, what can you do differently?
Dementia affects each person differently.
Inside, the Alzheimer’s Association
describes five common behaviors with
recommended responses:
1 Aggression
page
4
2 Anxiety or agitation page 5
3 Confusion
page 6
4 Repetition
page 8
5 Suspicion
page 10
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1 Aggression
Aggressive behaviors may be verbal (shouting,
name-calling) or physical (hitting, pushing). These
behaviors can occur suddenly, with no apparent
reason, or can result from a frustrating situa-
tion. Whatever the case, it is important to try to
understand what is causing the person to become
angry or upset.
How to respond:
Try to identify the immediate cause
Think about what happened right before the
reaction that may have triggered the behavior.
Focus on feelings, not facts
Try not to concentrate on specific details; rather,
consider the person’s emotions. Look for the
feelings behind the words.
Don’t get angry or upset
Be positive and reassuring. Speak slowly in a
soft tone.
Limit distractions
Examine the person’s surroundings, and adapt
them to avoid other similar situations.
Try a relaxing activity
Use music, massage or exercise to help soothe
the person.
Shift the focus to another activity
The immediate situation or activity may have
unintentionally caused the aggressive response.
Try something different.
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2 Anxiety or agitation
A person with Alzheimer’s may feel anxious
or agitated. He or she may become restless and
need to move around or pace. Or the person
may become upset in certain places or focused
on specific details. He or she may also become
over-reliant on a certain caregiver for attention
and direction.
How to respond:
Listen to the frustration
Find out what may be causing the anxiety, and
try to understand.
Provide reassurance
Use calming phrases. Let the individual know
you’re there for him or her.
Involve the person in activities
Try using art, music or other activities to help the
person relax.
Modify the environment
Decrease noise and distractions, or move to
another place.
Find outlets for the person’s energy
He or she may be looking for something to do.
Take a walk, or go for a car ride.
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3 Confusion
The person with Alzheimer’s may not recognize
familiar people, places or things. He or she may
forget relationships, call family members by other
names or become confused about where home
is. The person may also forget the purpose of
common items, such as a pen or fork. These
situations are extremely difficult for caregivers
and require much patience and understanding.
How to respond:
Stay calm
Although being called by a different name or not
being recognized can be painful, try not to make
your hurt apparent.
Respond with a brief explanation
Don’t overwhelm the person with lengthy
statements and reasons. Instead, clarify with
a simple explanation.
Show photos and other reminders
Use photographs and other thought-provoking
items to remind the person of important
relationships and places.
Offer corrections as suggestions
Avoid explanations that sound like scolding. Try
“I thought it was a fork,” or “I think he is your
grandson Peter.”
Try not to take it personally
Remember, Alzheimer’s causes your loved one to
forget, but your support and understanding will
continue to be appreciated.
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4 Repetition
A person with Alzheimer’s may do or say
something over and over again – like repeating
a word, question or activity. In most cases, he
or she is probably looking for comfort, security
and familiarity.
The person may also pace or undo what has just
been finished. These actions are rarely harmful to
the person with Alzheimer’s but can be stressful
for the caregiver.
How to respond:
Look for a reason behind the repetition
Try to find out if there is a specific cause for the
behavior.
Focus on the emotion, not the behavior
Rather than reacting to what the person is doing,
think about how he or she is feeling.
Turn the action or behavior into an activity
If the person is rubbing his or her hand across
the table, provide a cloth and ask for help
with dusting.
Stay calm, and be patient
Reassure the person with a calm voice and
gentle touch.
Provide an answer
Give the person the answer that he or she
is looking for, even if you have to repeat it
several times.
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Engage the person in an activity
The individual may simply be bored and need
something to do. Provide structure and engage
the person in a pleasant activity.
Use memory aids
If the person asks the same questions over and
over again, offer reminders by using notes, clocks,
calendars or photographs, if these items are still
meaningful to the individual.
Accept the behavior, and work with it
If it isn’t harmful, let it be. Find ways to work
with it.
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5 Suspicion
Memory loss and confusion may cause the
person with Alzheimer’s to perceive things in
new, unusual ways. Individuals may become
suspicious of those around them, even accusing
others of theft, infidelity or other improper
behavior. Sometimes the person may also
misinterpret what he or she sees and hears.
How to respond:
Don’t take offense
Listen to what is troubling the person, and try to
understand that reality. Then be reassuring, and let
the person know you care.
Don’t argue or try to convince
Allow the individual to express ideas.
Acknowledge his or her opinions.
Offer a simple answer
Share your thoughts with the individual, but
keep it simple. Don’t overwhelm the person
with lengthy explanations or reasons.
Switch the focus to another activity
Engage the individual in an activity, or ask for
help with a chore.
Duplicate any lost items
If the person is often searching for a specific
item, have several available. For example, if the
individual is always looking for his or her wallet,
purchase two of the same kind.
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Did you know? Six out of 10 people with
Alzheimer’s disease will wander and
become lost. The Alzheimer’s Association
Safe Return® program can help. To learn
more, call us toll-free at 1.888.572.8566 or
visit www.alz.org/safereturn
If you have questions about your loved
one’s changing behavior, the Alzheimer’s
Association is here to help. Contact your
local chapter directly or call our 24/7
Nationwide Contact Center Helpline,
which provides information, referral and
care consultation in 140 languages:
1.800.272.3900
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10 quick tips
Responding to behaviors
1 Remain flexible, patient and calm
2
Respond to the emotion, not the behavior
3 Don’t argue or try to convince
4 Use memory aids
5 Acknowledge requests, and respond to them
6 Look for the reasons behind each behavior
7 Consult a physician to identify any causes
related to medications or illness
8 Explore various solutions
9 Don’t take the behavior personally
10 Share your experiences with others
The Alzheimer’s Association,
the world leader in Alzheimer research,
care and support, is dedicated to finding
prevention methods, treatments and an
eventual cure for Alzheimer’s.
For reliable information and support,
contact the Alzheimer’s Association:
1.800.272.3900
www.alz.org
© 2005 Alzheimer’s Association. All rights reserved.
This is an offi cial publication of the Alzheimer’s Association but may be distributed
by unaffi liated organizations and individuals. Such distribution does not constitute
an endorsement of these parties or their activities by the Alzheimer’s Association.
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