Managing Challenging Behaviors

People living with dementia can be affected in a multitude of ways, creating unique experiences that the individual may find difficult to express and lead to unusual behaviors for their character. It can be hard for the person, as well as families and loved ones who have known them for a long time, to accept the diagnosis and the changes it brings. When navigating new feelings, patience and adopting a person-centred approach is key.

It may be comforting to know that you are not alone in facing a number of common behaviors that are seen in people with dementia, which there are mechanisms to deal with.


People with dementia often walk around, leaving their safe environment and getting lost. This could be due to them needing to get something, look for someone or perhaps boredom. To reduce their restlessness, regular exercise will allow for the individual to expend this energy in a safe manner when other people are aware and able to keep an eye out. For their safety and your peace of mind, you could encourage the person to wear a form of ID / attach it to their clothing. You could also look into the Alzheimer's Association Safe Return program and other tracking devices.


Agitation is common in people with dementia and refers to a range of behaviors, such as sleeplessness, irritability, repetitive behavior (in both speech and action) and aggression, which can be triggered by environmental and physical factors. Aggression can be especially difficult for the main person providing dementia care. Sleeplessness may be related to sundowning, which you can read more about here.

Try to identify what may have caused the individual distress and acknowledge their feelings, then redirect their attention. If it is safe to do so, remove yourself to allow the person to calm down. Maintaining structure in their day can help this, alongside calming music and reducing sugar and caffeine intake. As distress is often seen when the person feels control is being taken away from them, allow them to do things for themself and support their independence.


Ranging between anxiety, confusion, suspicion and paranoia, these feelings can manifest in a variety of ways. Changes in themselves may cause a person with dementia to feel confused and anxious, presenting as physical symptoms or resulting in the individual shouting out. Accusatory behavior is common but can be hurtful and it is important to remember not to take it to heart.

Once again, being aware of potential triggers and being patient and reassuring is best. Do not attempt to argue or reason, help them look for their “missing” items or focus on distracting them with a different activity. Providing clues in their environment can be beneficial to help with their confusion. Relaxing music or gentle exercise are also great to get the person to engage with.

That being said, it is important not to overlook new behavioral problems and dismiss them as 'common' as they may indicate an issue (for instance, that the person is in pain) so checking with the doctor is recommended if you have any concerns.

If you are a caregiver of a person with dementia, you could look at whether there are support groups in your area or online. You may be able to share experiences, tips and build a community for yourself and your loved one. Remember: you are doing a great job!

Dr. P. Heir

Sources: Family Caregiver Alliance; Alzheimer's WA; Alzheimer's Society.