Anxious behaviours

Anxious behaviours?

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

Anxious behaviours can include:

  • restlessness, pacing or fidgeting
  • doing the same things over and over
  • clinging to someone when they try to leave
  • shadowing (following someone around closely).

Possible causes

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

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

Anxiety and agitation can escalate when left untreated. Figuring out what triggers anxious behaviour can help you find ways to prevent it from happening again.

Feelings that may trigger anxious behaviour

Loss and tension. When someone understands less of what is happening around them, they may become anxious. They may feel concerned about people from their past, or search for places that were familiar to them at an earlier time in their life.

Failure. A person may worry if they are no longer able to cope with everyday demands. Attempting a task unsuccessfully, or thinking a task is too complex, can also increase anxiousness.

Responding to tension in others. Anxiety may be felt in response to the tension or negative mood of people around them.

Grief. Grief may cause someone to feel anxious and distressed. Even if their awareness seems low, they may still recognise that something is wrong.

What to try

  • Arrange a medical examination, with the person’s consent, to help identify any physical problems or side effects of medication.
  • Talk to their doctor if you suspect the person is feeling depressed.
  • Anxiety can be a symptom of depression.
  • Provide reassurance and support.
  • Respond to changes in behaviour calmly and gently.
  • If possible, address the underlying feeling triggering the behaviour.
  • Reduce activities that may trigger the behaviour.
  • If a daily activity becomes challenging, talk through the activity in advance, and provide reassurance and support to build confidence.
  • Give the person something to fiddle with, like coins, worry beads or a box of treasured possessions.
  • Make sure the person is getting enough exercise.
  • Change from caffeinated to non-caffeinated drinks.

Share any strategies for responding to anxious behaviours with other family members or carers who may also find them useful.

Shadowing behaviour

Sometimes family and carers struggle with constantly being followed, or ‘shadowed’. It can be hard to find privacy.

What to try:

  • Consider why the person is behaving this way. They may be indicating that they do not feel safe or are unsure of what to do next.
  • Try to avoid expressing irritation about being followed. Showing irritation is likely to make the person feel even less safe.
  • If it is appropriate, share a hug, use reassuring touch, and let the person know they are safe and loved.
  • Plan daily activities to help build a sense of comfort and familiarity. Consider using a noticeboard to display the day’s activities.
  • Consider taking a break together, go for a walk or listen to music.
  • Share the care with others to give you time and space away from the person living with dementia. This will also help the person get used to you not always being there.
  • Take time away when things feel overwhelming. This could be taking a walk around the block, visiting a neighbour, or going to a room where you can be alone.

Responding to shadowing behaviour can feel challenging. It can help to remember that this behaviour is a symptom of dementia and not meant to deliberately upset you. Make sure you look after yourself and take regular breaks.

Where to get help

  • Discuss with the person’s doctor your concerns about changes in behaviour, and the impact on you and the person you care 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