Anxious behaviours

What are anxious behaviours?

Changes in the behaviour of people with dementia are very common. Some people may become worried and anxious, but are unable to tell you what is upsetting them. The person may be restless and pace or fidget. It can sometimes seem as if they are stuck in a groove and unable to move on. They may cling to you if you attempt to leave the room, or the house.

Another common anxious behaviour is shadowing – following you closely around the house like a shadow. Some families and carers have described the stress of being shadowed constantly, unable to find any privacy, even in the toilet.

What causes these behaviours?

There are many reasons why behaviours change. Every person with dementia is an individual who will react to circumstances in their own way. Sometimes the behaviour may be related to changes taking place in the brain. In other instances, there may be events or factors in the environment triggering the behaviour. In some instances a task may be too complex. Or the person may not be feeling well. 

Understanding the behaviours

It is important to try to understand why the person with dementia is behaving in a particular way. If family members and carers can determine what may be triggering the behaviour, it may be easier to figure out ways to prevent the behaviour happening again. 

Some frequent causes of anxiety are outlined below:

Changes within the brain

These may directly cause feelings of anxiety.

Feelings of loss and tension

As people understand less of what is happening around them, they may become more anxious. They may feel concerned about people from the past or seek an environment that is familiar to them, particularly places that were familiar to them at an earlier time in their life.

Sense of failure

A person with dementia may feel pressured because they can no longer cope with everyday demands and worry about doing something incorrectly. They can also become anxious if they attempt a task and fail.

Responding to the tension of others

Anxiety can result from recognising the tension or negative feelings of people and situations around them.

Grief

Anxiety, loss and grief are closely related emotions. Individuals with dementia can be aware that something is wrong even if their insight otherwise seems poor. This level of awareness of loss can lead to anxiety and distress. 

What to try

  • A medical examination will help identify any physical problems, or undesirable side effects of medication
  • Anxiety can be a symptom of depression. If you suspect that depression may be a problem talk to the doctor. It is important that where depression is suspected it is investigated and treated
  • Reassure and support the person
  • Try to respond calmly and gently
  • Address the underlying feeling if possible
  • Try to reduce the demands made on the person
  • Give the person something like coins or worry beads to fiddle with
  • Make sure that the person gets enough exercise
  • Try changing from caffeinated to non-caffeinated drinks
  • If you have developed some strategies for managing anxious behaviours, try to make sure that they are understood and used by any other people who are also caring for the person with dementia.

Coping with shadowing

Ensure that you have time and space away from the person with dementia by sharing the care with others. This will help them become accustomed to you not always being there.

Have a way to escape when things are getting on top of you – a walk around the block, a neighbour you can pop in to see, or a room where you can be alone.

Dealing with these behaviours on a day-to-day basis can be extremely demanding for families and carers. The behaviours are symptoms of dementia and are not meant to deliberately upset you. Remember to look after yourself and take regular breaks.

Who can help?

Discuss with the doctor your concerns about behaviour changes and their impact on you.