Caring for a loved one with Alzheimer’s or dementia often feels like navigating a world where the rules of communication have suddenly changed. When an older adult acts out through aggression, agitation, or repetitive behaviors, it isn't a personal attack or a sign of “difficult” personality; it is a physical symptom of a brain under siege.
These behaviors are often the only way a person with cognitive decline can signal that they are in pain, overwhelmed, or frightened. By learning to look past the action and identify the underlying trigger, you can transform moments of high-tension conflict into opportunities for connection and comfort.
Why do Alzheimer’s and dementia symptoms cause difficult behavior?
The person with Alzheimer’s or dementia can’t express what’s wrong or what they need, so they act out. An aging adult may act in strange, annoying, or scary ways, but these difficult behaviors often have a real, physical cause.
Step-by-step guide from the Alzheimer’s Association
To help you deal with these challenging issues, we recommend this free guide from the Alzheimer’s Association.
You can turn directly to the specific behavior that you’re currently dealing with. In a single page, clear instructions walk you through understanding and managing the situation.
The guide has practical advice on how to deal with these 7 common behaviors:
- Aggression
- Anxiety or agitation
- Confusion
- Repetition
- Suspicion
- Wandering and getting lost
- Trouble with sleep
Why can’t they just tell me what’s wrong?
Because communication is difficult for the Alzheimer’s or dementia patient, you’ll have to play detective to figure out what’s really causing this behavior. It’s usually a signal that there’s a problem.
Respond in a calm, soothing tone while you follow the guide’s steps to check for:
- Pain or discomfort
- Signs of overstimulation
- Feeling disturbed by strange surroundings
- Being overwhelmed by complicated tasks
- Frustration because of the inability to communicate
Quick Reference: Decoding Dementia Behaviors
When a difficult behavior arises, it is helpful to have a framework for understanding what your loved one might be trying to communicate. Use the chart below to help identify common physical or environmental triggers and find the best way to respond in the moment.
Quick Reference: Decoding Dementia Behaviors
When a difficult behavior arises, it is helpful to have a framework for understanding what your loved one might be trying to communicate. Use the chart below to help identify common physical or environmental triggers and find the best way to respond in the moment.
It feels like they’re acting this way on purpose!
It’s natural for you to feel frustrated and angry, but try to remember that aggressive and/or annoying behavior is not done on purpose to annoy you.
An older adult is trying hard to communicate, but they're unable to do so properly. Take a deep breath, count to 10 slowly, and use the tips in the guide to calmly handle the situation.
Final Thoughts About Difficult Alzheimer's and Dementia Symptoms
While the journey of dementia caregiving is undeniably challenging, you do not have to walk it alone or without a map. Understanding that difficult behaviors are a form of communication is the first step toward reducing the stress for both you and your loved one.
As you implement these strategies and use expert resources like the Alzheimer’s Association guide, remember to extend the same patience to yourself that you give your loved one.
With the right tools and a supportive community, you can navigate these complex symptoms while maintaining the dignity and quality of life your loved one deserves.
Recommended for you:
- 3 Stages of Dementia: What to Expect
- How Do You Calm Down Someone with Dementia? 4 Expert Tips [Video]
- 10 Fun, No-Fail Activities for People with Dementia
About the Author
Connie is the founder of DailyCaring.com and was a hands-on caregiver for her grandmother for 20 years. (Grandma made it to 101 years old!) She knows how challenging, overwhelming, and all-consuming caring for an older adult can be. She also understands the importance of support, especially in the form of practical solutions, valuable resources, and self-care tips.
My 84yo grandmother has dementia and she lives alone. She still thinks she can do anything herself She has 6 different eye drops 3 for her glaucoma, 2 for her servere dry eyes, and one for inflammation. It’s so crazy, I can’t even keep up with all of them, how is she supposed to? She keeps on losing her eye drops and thinks she only has 2 it’s so frustrating She also rummages through everything and never sits still. How do you know when it’s time to put a loved one in an assisted living or nursing home? Which is better an assisted living, nursing home, or a home health aid? They’re all really expensive, but is there a way for you to get help paying for long term care without long term care insurance? Where or who do I contact to get help paying for care? Thank you for your help. I appreciate it.
Unfortunately, what you’re describing is common behavior in Alzheimer’s and dementia. It sounds like living alone and managing her own medications may not be safe for her anymore.
Someone with dementia has damage in their brain because of the disease. They’re no longer able to be fully logical and reasonable. Because of this she will likely continue to believe that she’s completely fine and can care for herself. It’s unlikely that logical explanations or showing proof that she’s not ok will change her mind.
It may help you to learn more about the disease, what to expect, ways to deal with common challenging behaviors, and learn new ways to communicate. Here are some helpful articles:
— 3 Stages of Dementia: What to Expect https://dailycaring.com/3-stages-of-dementia-what-to-expect/
— 6 Ways to Help Someone Who Doesn’t Know They’re Ill: Anosognosia in Dementia https://dailycaring.com/6-ways-to-help-someone-who-doesnt-know-theyre-ill-anosognosia-in-dementia/
— 9 Ways to Manage Dementia Rummaging Behavior https://dailycaring.com/9-ways-to-manage-dementia-rummaging-behavior/
— More dementia communication tips https://dailycaring.com/tag/alzheimers-dementia-communication/
Managing medications is tough. Like you said, it’s even challenging for you to keep straight. A simple system may help her, you, and any other caregivers. But depending on how advanced her dementia is, any system or reminders may not work.
— Medication Management Tips Help Seniors Take the Right Pills at the Right Time https://dailycaring.com/medication-management-tips-help-seniors-take-the-right-pills-at-the-right-time/
Moving to assisted living or other type of care community is a tough and complex decision. Here are some articles that can help you think through the considerations around the different types of care so you can make the decision that’s right for your grandmother and family:
— Moving to Assisted Living: 5 Ways to Know When It’s Needed https://dailycaring.com/moving-to-assisted-living-5-ways-to-know-when-its-needed/
— When Should a Senior Move to Assisted Living? Get Advice from a Social Worker https://dailycaring.com/when-should-a-senior-move-to-assisted-living-get-advice-from-a-social-worker/
— Assisted Living for Alzheimer’s and Dementia: Memory Care https://dailycaring.com/alzheimers-dementia-memory-care-basics/
— 3 Tips to Help You Choose Between Assisted Living vs In Home Care https://dailycaring.com/3-tips-to-help-you-choose-between-assisted-living-vs-in-home-care/
These articles discuss ways to pay for care:
— How to Pay for Assisted Living: 6 Options https://dailycaring.com/paying-for-assisted-living/
— 8 Ways to Lower the Cost of In Home Care for Seniors https://dailycaring.com/8-ways-to-lower-the-cost-of-in-home-care-for-seniors/
For more information from local organizations, contact your county’s Area Agency on Aging. Get more info and where to find them them here: https://dailycaring.com/local-community-resources-for-seniors-and-caregivers-area-agency-on-aging/
It may also help to join a caregiver support group for people caring for someone with Alzheimer’s or dementia. They’ll understand what you’re going through and may have helpful tips and suggestions. Here are some private Facebook groups we recommend — https://dailycaring.com/11-caregiver-support-groups-on-facebook-youll-want-to-join/
How long does sun downing usually last, I know it can’t be pinned down exactly. My wife wants to go to the other home and gets very restless and anxious, paces the floor. Very hard to calm down. Any helpful info is appreciated.
You’re right, each person and each day can be different in terms of sundowning symptoms in someone with Alzheimer’s or dementia.
What you can do is try to identify triggers, create a calm environment, and stick to structured routines to try to reduce the intensity and frequency of sundowning symptoms.
We’ve got a couple of articles with helpful suggestions:
— 7 Ways to Reduce Dementia Sundowning Symptoms https://dailycaring.com/7-ways-to-reduce-dementia-sundowning-symptoms/
— 7 More Ways to Manage Dementia Sundowning Symptoms https://dailycaring.com/7-more-ways-to-manage-dementia-sundowning-symptoms/
Hi. I’m having issues getting my Mom to go to the doctors (she was diagnosed with Alzheimer’s in Oct.2016) She will let me make an appt. but wants to cancel because her back is killing her (dr. appt is for her back & 1 for her hearing aid). This has been going on for about 7/8 months. I’ve done everything I could think of to get her to go but to no avail. I’m beyond frustrated and need help. Any advise? Thanks, Teresa
It can be so tough to get someone with dementia to go to the doctor. It’s great that you’re persisting since it’s important that she goes. Because this has been going on for so long, you may need to try tricking her into going or just taking her there without her agreement. At this point, her judgement is compromised and her decisions are harmful to her health.
If she asks to cancel the appointment, just say OK and then don’t do it. When the day of the appointment arrives, you could lie and say that you’re going to lunch or to run errands and go directly to the doctor’s office. Tell her you need to make a quick stop to ask the doctor a question before lunch to get her into the office. But if she refuses to get out of the car, you may want to ask the doctor’s office for help, like bringing a wheelchair and waiting for her outside the office door. Or, bring another family member or close friend with you to help you get her into the doctor’s office.
Another option is to call the Alzheimer’s Association at 800-272-3900 (available 24/7) to get advice. They have a lot of experience with challenging situations and may know of creative ideas that have worked for others.
You may also want to consider hiring a 3rd party to help with the situation, like a geriatric care manager. Some people may listen to advice from an outside party more readily than from their own family (frustrating, but it can help solve problems).
Mom thinks she can drive. Everyday ask to fix her car.
It’s great that you aren’t letting her drive even though you have to repeatedly answer that question. This article has suggestions that may help — 8 Ways to Stop an Elderly Person From Driving When All Else Fails
I need help explaining to my family that moms hate of one gal caring for her , is hurting the whole day !!
Maybe it would be helpful to have your family observe firsthand what’s happening. If they can see for themselves, they may have an easier time understanding.
There was no “guide” when you click on the Alzheimer’s Association link in this article. WHAT are you supposed to see or look for when you get there??
Apologies for the confusion! The link to the Alzheimer’s Association guide is near the bottom of the article, in the “Next Step” section. Here’s the direct link: http://www.alz.org/documents/national/brochure_behaviors.pdf (that first link is to identify Alzheimer’s Association and take you to their website)
Thank you for all the very helpful information. It’s so nice to have somewhere to go to answer my questions, This is all new and scary for not only my Mom who is in late stage Alzheimer’s/ Dementia and Parkinson’s. But me as her caregiver as well… So thank you❤ again for answering alot of my questions and helping ease some of my fears😅. I’m Extremely Grateful💝Pam and Patsy Williams😪… God Bless!
I’m so glad this article is helpful! Caring for someone with serious health issues is scary. I’m sorry to hear about your mom’s conditions. She’s lucky to have you both to help her! Big hugs ❤️
It was a difficult decision, but with dads dementia and my elderly mother’s own health issues, she was not able to care for him at home. Her safety and his mental health were both at risk. This is a extremely cruel disease for the person suffering from it, and all family members that love and want to do all they can to make sure there family member is well cared for when you put them in the care of a managed facility. Heartbreaking!
It sounds like that was the right choice for the situation even though I’m sure it was a very tough decision to make. The most important thing is to make sure that everyone is as safe and healthy as possible 💜