framework
Why has their behaviour changed so much?
4 min read
Difficult behaviour is usually an unmet need expressed in the only way left. Dementia removes the ability to identify a need, put it into words, and wait — so thirst can look like agitation, pain can look like aggression, and fear can look like refusal. Ask what the behaviour is asking for before asking how to stop it.
What to try
- 1Run the quick checklist: uncomfortable, needing the toilet, hungry, thirsty, too hot or cold, too loud, too tired, frightened, bored, lonely.
- 2Note the time of day it happens — patterns reveal causes that single incidents hide.
- 3Change one thing in the environment before changing your approach: noise, glare, clutter, or how many people are in the room.
- 4Keep telling them what is happening — just make it shorter, and show as well as say it.
What to avoid
- Treating the behaviour as the problem to eliminate. The behaviour is the message.
- Arguing, or building a case for why they are wrong. A reasoned case rarely overturns anything in the moment.
The four common drivers
- Physical discomfort of some kind. You do not have to work out which — that is a question for their doctor or care team, and a new or sudden change needs one promptly.
- Environmental — noise, clutter, glare, poor lighting, unfamiliar places, too many people.
- Emotional — fear, boredom, loneliness, loss of control, being talked over.
- Interpersonal — being rushed, corrected, tested, or approached too fast from behind.
Where this way of reading things stops
This way of reading behaviour has one limit. If what they are telling you is that someone has hurt them, taken something, or has been coming into the house, do not treat it as a symptom to be understood. It may be. It may also be true, and people with dementia are among those most likely to be taken advantage of. That needs someone else to look at it, not an explanation from you.
A note on blame
They are not choosing this, and neither are you. When you lose your temper — and most caregivers do — that is exhaustion, not a failure of care.
How this guide was made
Written by
Written independently for Riparo. It is not copied or adapted from any organisation’s material.
Evidence checked
Some key points have been checked against published national dementia guidance; others have not been.
Reviewed by
Not clinically reviewed. No clinician has checked this guide.