Understanding Behavioral Changes in Dementia Patients

Dementia is more than about memory loss — it’s a progressive brain disorder that affects a person’s ability to think, communicate, and behave as they once did. For adult children caring for parents with dementia, the reality of this disease can be heartbreaking, especially when it changes the personality of someone they love deeply. This disorder is distinct from normal aging. So, if your loved one struggles with day-to-day memory or mood changes, it could be more than just “getting old.”

There are many types of dementia — Alzheimer’s disease, vascular dementia, Lewy body dementia, and others — each affecting the brain in unique ways. Statistics show 6.9 million Americans are living with Alzheimer’s.

Besides the physical or mental decline, the behavioral symptoms of dementia are a tricky thing to manage. This article explores how you can support an older family member with cognitive loss in the best way by understanding how they behave.

Overview of Behavioral Changes in Dementia

If you start to notice shifts in your loved one’s behavior — perhaps they’re more irritable, withdrawn, or constantly asking the same questions — these could be a cue for worsening dementia. These changes are a normal trajectory of the disease. They’re direct results of the disease rewiring the brain, making it harder for them to process emotions and memories.

Dementia behavioral changes vary from person to person. However, the common thing is these symptoms worsen as the disease progresses through stages. While it’s a tough reality, knowing how these changes develop later on can help you prepare for their future care needs.

Types of Behavioral Changes in Dementia

As dementia advances, it brings a variety of behavioral shifts that can be challenging for both the patient and those who care for them. These changes aren’t just quirks but are responses to confusion, frustration, or changes in the brain that make it harder for them to communicate.

Understanding these transformations can help you respond with compassion. Here are some of the most common behavioral symptoms of dementia and ways you can support them.

1. Aggression and Agitation

If your parent has always been kind and gentle, it can feel unsettling when they suddenly snap or act out. They might yell at you or push you away when you’re just trying to help. Aggression in dementia patients happens at a later stage of the disease. It stems from frustration, confusion, or even physical discomfort they’re unable to express.

Remember to take a deep breath when these outbursts happen. Instead of reacting, stay calm and think of things to redirect their attention. Show them a favorite photo, talk about something they enjoy, or simply give them a little space. It’s not easy, but these small actions can help diffuse aggressiveness and agitation.

2. Mood Swings and Depression

Mood swings and depression are common in dementia, especially in the initial disease stage when your loved one may still be aware of the changes in the brain. They may feel a deep sense of loss, sadness or frustration. You might see your mom laugh and socialize with others one second and isolate themselves next. She also eventually loses interest in the things she once loved. These shifts are linked to chemical changes in the brain, making emotions harder to manage and incredibly difficult for you to witness.

What can you do? Sit quietly, hold her hand, and listen to her troubles. It can make a huge difference in their emotional state. Your presence can provide a sense of calm and safety during episodes of dementia-related anxiety and sadness.

3. Repetitive Behavior and Wandering

You know how repetitive actions, like asking the same question over and over, can be a test of patience. They may ask, “What time is it?” every few minutes or wander around the house directionless. It’s common in dementia, often as a way to cope with anxiety or confusion.

Most families relocate their aging parents to a memory care unit when they start to wander, which is a sign the home may no longer be safe. In the community, they receive 24/7 care and are supervised by dementia caregivers. If this isn’t an option, think of ways to ensure their safety. Accessories with GPS trackers can help you monitor their location if they’re still active outside, giving you peace of mind.

4. Hallucinations and Paranoia

Hallucinations and paranoia can be especially tough to handle. Your loved one may think they’re seeing people who aren’t there, or they might accuse you of stealing. Instead of arguing — which rarely works — try to validate their feelings.

Say something like, “I know you’re worried. Let’s check together to make sure everything’s here,” can help calm them down. Make them feel heard, even if it doesn’t seem logical to you.

Why Behavioral Changes Happen

Understanding why these behavioral changes occur can make it a little easier to cope with them. Dementia doesn’t just impact memory — it physically changes the brain, affecting areas responsible for emotions, behavior, and personality.

On top of that, factors like physical discomfort or unfamiliar environments can trigger behaviors you might not expect. Knowing the root causes can help you manage these changes more effectively and respond with empathy when they arise.

1. Brain Degeneration

The cognitive changes in dementia are directly tied to the way Alzheimer’s and other forms of cognitive disorders alter the brain over time. In Alzheimer’s, two main proteins — amyloid and tau — begin to build up in the brain years before symptoms appear.

Amyloid plaques gather between neurons, and tau tangles form inside them, disrupting communication among brain cells. These issues typically start in the hippocampus, the area crucial for memory, and slowly spread to other regions controlling emotions and behavior. As more neurons die, affected areas of the brain shrink, leading to intensified memory loss, mood changes, and personality shifts as the disease progresses.

By the later stages of dementia, damage is widespread, and the brain’s ability to function normally diminishes significantly. Although hard to witness, knowing these behaviors stem from physical brain changes — not choices — can help you approach symptoms with patience and compassion.

2. Physical and Emotional Triggers

Hunger, cold, and tiredness can evoke big reactions from your loved one. Physical discomforts can prompt emotional outbursts simply because they can’t express what they feel. Loud noises, a new environment, or even bright lights can also lead to dementia-related anxiety.

By noticing these small triggers and adjusting the environment, you can help them feel a bit more relaxed. It’s amazing how simple adjustments can have a big impact on their responses.

3. Disease Progression

As dementia progresses, symptoms evolve through early, middle, and late stages, each bringing new challenges:

• Early stages: Memory lapses are common. Your loved one might repeat questions, struggle to remember recent events or make impulsive decisions. They may still function independently but with noticeable gaps in memory and occasional confusion.
• Middle stages: Confusion and memory issues deepen here. They might forget familiar faces or places and struggle with complex tasks. This stage often brings paranoia or suspicion, and emotional outbursts become more frequent, making it difficult to leave them unsupervised.
• Late stages: By the late stages, communication and cognitive functions are severely impaired. Physical abilities decline — mobility is often limited. Basic activities like eating and dressing require full-time assistance. Emotional responses may lessen as cognitive decline advances, though agitation or anxiety may still surface, especially when routines are disrupted.

Being aware of these stages can help you support your loved one with patience and understanding as they move through each phase.

Overcoming Behavioral Changes in Dementia Patients

For family caregivers, caring for a loved one with dementia is more than a responsibility, but a testament to their love. Dementia behavioral changes are part of the disease, but they don’t define the person.

Each moment of patience, calming gesture, and effort to show up with kindness makes a positive difference in their care. If caring starts to get overwhelming and you don’t know what to do next, Senex Memory Advisors has experts to help you navigate the complex care system and planning for dementia. Drop us a note and we’ll be happy to help. Remember, you’re not alone.

Syed Rizvi

Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.