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Understanding Dementia Behaviors

Why they do what they do, and how to respond with compassion and calm

Parent Care Guide © 2026

The Key Insight

Behavior is communication

"Every behavior has a reason. When someone with dementia acts in ways we don't understand, they're telling us something they can no longer say with words."

People with dementia aren't trying to be difficult. Their brain changes make it hard to communicate, process information, and regulate emotions. Understanding the "why" behind behaviors helps us respond with patience instead of frustration.

Repeating Questions

Why This Happens

Short-term memory loss means they genuinely don't remember asking. Anxiety or uncertainty can also trigger repetition, they're seeking reassurance.

What to Try
  • Answer calmly each time, to them, it's the first time
  • Write answers on a whiteboard or card they can see
  • Address the emotion behind the question ("Are you worried about the appointment?")
  • Redirect to an activity
What to Avoid

"I already told you!" or "Don't you remember?", this creates shame without solving anything.

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Agitation & Aggression

Why This Happens

Often triggered by overstimulation, pain, fear, or feeling out of control. They can't express what's wrong, so frustration explodes.

What to Try
  • Stay calm, your energy affects theirs
  • Check for pain, hunger, bathroom needs, discomfort
  • Reduce noise and activity in the environment
  • Give them space; don't crowd or touch unexpectedly
  • Speak slowly, use simple phrases
What to Avoid

Don't argue, correct, or try to reason. Don't take it personally, it's the disease, not them.

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Wandering

Why This Happens

May be looking for something familiar, trying to fulfill a past routine (going to work), boredom, restlessness, or responding to an unmet need.

What to Try
  • Ensure they get regular physical activity
  • Secure the home with locks, alarms, or GPS devices
  • Place "STOP" signs on doors they shouldn't open
  • Create a safe walking path indoors
  • Consider ID bracelet or GPS tracker
What to Avoid

Don't lock them in a room, this increases agitation. Don't leave them unsupervised if wandering is severe.

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Sundowning

Why This Happens

Confusion and agitation that worsens in late afternoon/evening. May be related to fatigue, low light, disrupted body clock, or overstimulation from the day.

What to Try
  • Increase lighting as daylight fades
  • Limit caffeine and sugar, especially after noon
  • Keep a calm, quiet routine in evenings
  • Limit naps during the day
  • Play soothing music or do calming activities
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Accusations & Paranoia

Why This Happens

"You stole my wallet!" When memory fails, the brain fills gaps with explanations. If they can't find something, someone must have taken it.

What to Try
  • Don't argue or try to prove them wrong
  • Acknowledge their feelings: "That's really upsetting"
  • Help look for the item together
  • Keep duplicates of commonly lost items
  • Distract and redirect after a few minutes
What to Avoid

Don't take accusations personally. Don't try to convince them they're wrong, logic doesn't work here.

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Seeing/Hearing Things

Why This Happens

Visual hallucinations are common in some dementias (especially Lewy body). The brain misinterprets what the eyes see.

What to Try
  • If not distressing, don't contradict, just listen
  • Improve lighting (shadows can cause confusion)
  • Check medications (some can cause hallucinations)
  • Offer reassurance: "You're safe. I'm here."
  • If frightening, gently redirect attention elsewhere

The DICE Approach

When behaviors are challenging, use DICE: