Behaviour changes

Causes of changes in behaviour in people with dementia

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When a person with dementia behaves differently, this is often mistakenly seen as a direct result of the dementia or simply as another symptom of the condition. However, this is often not the case. The behaviour may have many causes, including difficulties relating to dementia (such as memory loss, language or orientation problems), but also mental and physical health, habits, personality, interactions with others and the environment.

The possible causes of someone behaving out of character may be divided into biological (eg being in pain), psychological (eg perceiving a threat) or social (eg being bored).

The person with dementia may be influenced by an environment that is unable to support or meet their needs. Disorientation is a common feature of dementia, so an environment that is difficult to navigate and confusing can increase distress.

When supporting a person with dementia who is behaving out of character, it's important to see beyond the behaviour itself and think about what may be causing it. Sometimes behaviour can be a result of frustration in the way others around the person are behaving, a sense of being out of control, or a feeling of not being listened to or understood.

People with dementia have the same basic needs as everyone else. However, they may be less able to recognise their needs, know how to meet them, or communicate them. Behaviour may be an attempt to meet a need (eg removing clothing because they are too hot or walking around because they are bored or feel they need to be somewhere), or to communicate a need (eg shouting out because they need the toilet).

Dementia can make the world a confusing and frightening place as the person struggles to understand what is going on around them. Though it may confuse the carer, the behaviour will have meaning to the person with dementia. It is likely to be an attempt to enhance and maintain a sense of wellbeing and ease distress. Any response should involve trying to see things from the person's perspective.