Agitated behaviours

Agitated behaviours

Dementia affects people in different ways and changes in the behaviour or emotional state of someone living with dementia are common.

Agitated behaviours include:

  • getting upset
  • crying
  • pacing
  • fiddling
  • constant or repetitive talking
  • repeating words, phrases or questions
  • swearing
  • screaming.

These behaviours can also be distressing and frustrating for families and carers. It is important to understand why these behaviours occur and ways to respond.

Possible causes 

There are many reasons why behaviours change. Every person living with dementia reacts to circumstances in their own way.

Sometimes changes in behaviour may be related to changes in the brain. Or there may be something in their living environment that triggers the behaviour. Other times, a task may be too complex, or the person may not be feeling well. 

Triggers for agitated behaviour

Understanding the causes of the behaviour can help you find ways to prevent it from happening again.

Some frequent causes of agitated behaviour in someone living with dementia are listed below.

Health

Agitated behaviours may be caused by changes in health, including:

  • fatigue
  • tiredness due to disrupted sleep
  • physical discomfort (such as pain, fever, illness, infections, hunger, thirst or constipation)
  • physical changes in the brain
  • adverse side effects of medication
  • impaired vision or hearing causing the misinterpretation of sights and sounds
  • hallucinations
  • urinary tract infection

Feeling defensive

Someone may feel humiliated because they need help with personal tasks like bathing, toileting and dressing. They may feel their independence and privacy are being threatened.

Failure

A feeling of failure and worry may occur when they can no longer carry out or complete everyday tasks.

Misunderstanding

Someone living with dementia may not understand what is going on around them. This can lead to misunderstandings and distress over their declining abilities.

Fear

Someone living with dementia may be frightened because they no longer recognise certain people or places. Or they may have recalled an earlier life experience that is frightening or uncomfortable to remember.

In need of help or support

Your loved one may be trying to let someone know that they need help or support because they are bored, distressed, have excess energy or feel unwell.

Tips to minimise agitated behaviours

  • Visit their doctor to investigate possible causes, such as changes in physical health, possible side effects of medication, an underlying illness or depression. It is important to investigate and treat depression whenever it is suspected.
  • Be aware of any specific warning signs of agitated behaviour. Develop strategies to stop it from developing.
  • Break big tasks down to smaller more manageable tasks and allow time to complete tasks.
  • Try to maintain an unrushed and consistent routine.
  • If possible, address the underlying cause of the behaviour.
  • Spend time explaining what is happening, step by step. Use simple sentences. Even if they cannot understand the words, your calm tone will be reassuring.
  • Avoid confrontation. If confrontation is likely, try distraction or suggest an alternative activity.
  • Encourage regular exercise and participation in enjoyable activities.
  • Maximise feelings of comfort and safety.

Despite your best efforts, agitation may still occur. Concentrate instead on handling the situation as calmly and effectively as possible.

Ways to respond to agitated behaviours

  • Stay calm and speak in a reassuring voice.
  • Distraction is a useful approach. Suggest having a cup of tea, going for a walk or looking at a magazine together.
  • Use strategies that work for you. For example, if questions are being repeated, answering the questions may help. Others find that ignoring the questions works best. Consider the intention behind the questions. The person may need reassurance about something they are unable to express.

Support for families and carers

Observing agitated behaviours can be very distressing for families and carers. Changes in behaviour are symptoms of dementia and are not meant to deliberately upset you. Remember to look after yourself and take regular breaks.

  • Discuss with the person’s doctor your concerns about changes in behaviour, and the impact on you and the person you are caring for.
  • Call the National Dementia Helpline on 1800 100 500 to learn about support services and education programs, including carer support groups, counselling, and services and programs to assist you to understand and respond to changes and maintain your health and wellbeing.
  • Call the Dementia Behaviour Management Advisory Service on 1800 699 799. They support people living with dementia who experience changes in behaviour that impact their care or the carer.

Additional reading and resources