The journey of caring for a loved one with dementia is often marked by moments of profound uncertainty. When difficult behaviors like agitation, repetition, or confusion arise, family caregivers are left grappling with questions that feel both deeply personal and urgently practical: What is causing this? Is it the medication? Am I making things worse?
You are not alone in searching for answers. This post directly addresses four of the most pressing and common questions caregivers face, drawing on the collective wisdom of dementia care experts and those who have walked this path before.
It offers more than just explanations; it provides actionable strategies, from communication techniques to self-care essentials, designed to bring more calm and confidence to your caregiving role.
Understanding What’s Causing Troubling Behavior Reduces Conflict
Alzheimer’s and dementia are complex brain diseases that change a person’s behavior, abilities, and sense of well-being.
Understanding what’s causing challenging or confusing behaviors helps you respond without causing arguments. Minimizing conflict will make life easier and less stressful for both you and your older adult.
The Center for Dementia Care at Seniors At Home, the in-home care division of Jewish Family and Children’s Services, helped us answer these four top questions about managing challenging dementia behaviors.
The Top 4 Questions About Handling Difficult Alzheimer’s Behaviors
1. My loved one behaves so differently now. I feel like I don’t know who they are. How can I connect with them?
Dementia may change behavior, speech, and interactions, but a person’s identity doesn’t change.
Find new ways to connect with them, such as listening to their favorite music, looking at photos of their accomplishments, or enjoying simplified versions of their previous hobbies and interests.
2. I don’t understand my loved one's behavior. They’re doing things that are frustrating me because they could get hurt. How can I make them stop?
One family we worked with was frustrated by their mom’s constant pacing in the house. They had to follow her around to keep her from falling or hurting herself.
Constantly following her was exhausting for the family and wasn’t solving the problem. What helped was identifying the reason and emotion behind the behavior.
In this case, their mom needed a purpose or task to keep her occupied and reduce her pacing. Because she could no longer structure her own activities, we worked with the family to adapt some of her favorite activities so she could still participate in normal household activities.
Because her family found activities that kept her engaged, their mom’s need to pace was significantly reduced.
Important: Instead of telling a person with dementia what not to do, tell them what to do. Give clear instructions and modify previous hobbies or interests to fit their current ability level.
3. How do I get my mom to stop refusing food and help with necessary care tasks?
The short answer is that you can’t force her. It’s important to remember that a person with dementia isn’t a child, so as tempting as it may seem to order them to eat their dinner, it won’t work and will likely make them more resistant.
When someone with dementia refuses to do something, you’ll need to play detective and find out if there’s a valid reason behind their refusal – one they aren’t able to communicate.
Often, refusal comes from fear or physical discomfort. If you can find the reason, you’re well on your way to solving the problem.
For example, if someone refuses a meal, it could be because they:
- Need to use the bathroom.
- Are you feeling full from an earlier snack or beverage?
- Don’t know how to get started eating – too many food choices or utensils can be confusing.
- Can’t see the food well enough – make sure there’s a strong contrast between the food and the plate, like red tomatoes on a white plate.
Another thing to try is a structured daily routine. When different activities happen at different times each day, life can be unpredictable and frightening for your senior. They don’t know what’s coming next.
After getting used to a regular daily routine, they’ll instinctively know what activity is coming next and will feel more comfortable, safe, and ready to participate.
4. My mom says she’s afraid of things that clearly aren’t real. How can I soothe her?
The first thing to do is to treat everything she’s saying as real, because it is real for her.
Her reality is no longer the same as yours, so it’s important that you adapt. Contradicting her or trying to use reason to explain away the fear will only make her more scared or agitated.
After calmly agreeing with her, try to distract her with pleasant thoughts or activities. Looking at her favorite photos, eating a yummy snack, or drinking a warm beverage can help comfort and soothe her.
Final Thoughts on Handling Difficult Alzheimer's Behaviors
Ultimately, navigating dementia care is not about finding a single, perfect solution but about equipping yourself with a flexible toolkit of understanding and strategies. The expert insights shared here remind us that difficult behaviors are a symptom of the disease, not a choice, and that our response can significantly impact both our loved one's well-being and our own resilience.
From using validation to stepping away for a moment, these approaches prioritize connection over correction and sustainability over perfection. Remember, the goal is not to eliminate every challenge (an impossible standard) but to manage them with greater compassion and less stress.
By embracing support, prioritizing your own well-being, and focusing on what truly matters, you can find a path forward that honors both your loved one and yourself.
Recommended for you:
- 10 Ways to Respond to Dementia Hallucinations in Seniors
- Responding to 4 Common Dementia Accusations: Stealing, Poisoning, Being Held Prisoner
- Understanding and Managing Dementia Behaviors: A Comprehensive Guide
Guest co-author: Seniors At Home helps older adults live independently and provides peace of mind to their families. We partner with you to solve problems, enhance quality of life, and provide a safe, supportive living environment. Our comprehensive services include non-medical home care, geriatric care management, palliative care, dementia care, fiduciary services, and more.
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.
These articles have great suggestions! Thank you so much.
I’m so glad they’re helpful!