Supporting changed behaviour when a person...

Last Updated: August 27, 2025

Beth Britton writes about how dementia can change a person’s behaviour and how to provide the best support as a family member

It can be really worrying when you start to notice a loved one’s behaviour changing due to their dementia. For the person living with dementia it is likely to be even more distressing in a world that is already confusing for them.

I know we found it difficult when my dad’s behaviour started to change. Initially he just became more reclusive, but that progressed to barricading doors and believing that people on TV were real, in the room and either a friend (which just meant not sitting in their chair and making sure they had a place at the table) or a foe (which resulted in expressions of anger and my dad feeling threatened).

As dad’s dementia progressed, he did at one point try to strangle someone in his first care home. He also smashed a TV onto the floor, although I took this as him not wanting the TV and we got him a CD player instead, with music becoming a wonderful escape and communication method for him.

How changed behaviour is viewed and talked about

Dementia brings numerous physical and mental health challenges for anyone living with any of the 100+ types of dementia. Alongside losing memories, changes associated with behaviour are amongst the most talked about and distressing symptoms. They are often also very stigmatising and isolating both for the person and those closest to them.

People often label the person as having ‘challenging behaviour’, or use more specific terms like agitation or aggression. However, with the advent of Dementia Language Guidelines we’ve been asked to reframe this terminology by people living with dementia. For me, this process begins with understanding why a person’s behaviour may change when they have dementia.

Why and how behaviour changes when a person has dementia

As any type of dementia progresses more parts of the person’s brain become damaged. Different parts of the brain regulate different functions, and amongst these is behaviour. This can affect a person in any number of ways, the common ones being that the person may verbally or physically express themselves in ways they haven’t before – for example shouting or swearing, pushing others away or throwing items. The person may lose inhibitions, which can be particularly common in frontotemporal dementia, they may struggle with paranoia and hallucinations (like my dad did) or they may experience restlessness, feeling that they need to be constantly on the go, even during the night, and find concentration difficult.

Changes in behaviour may also manifest themselves in ways that are talked about less – for example the person experiencing anxiety or becoming quieter or withdrawn. It is, however, just as important for us to recognise, understand and support both subtle and more overt changes in behaviour.

Supporting a person with changed behaviour

Because changed behaviour can manifest itself in many different ways, responses need to be individualised to each person and their experiences to have the best chances of success. However, there are some overarching principles to help families:

Don’t blame the person. This is really difficult if you are a family carer and trying to cope alone with little or no support. It’s so important to remember that whatever behaviour your loved one is experiencing it’s A) going to be due to the damage their dementia is causing in their brain and isn’t about the person trying to annoy or upset you, and B) incredibly difficult for the person themselves. In this Care Choices blog I shared Sheila’s experiences of supporting her husband. If you’re living Sheila’s experiences today, know that you are not alone.
Seek support. Many family carers try to cope alone out of fear of having to explain what is happening at home, being judged as someone who isn’t coping (making it more likely that their loved one may have to go into a care home), or simply from being too exhausted to seek help. I would urge any family carer to seek support from Admiral Nurses and Dementia Carers Count at their earliest opportunity when they notice behaviour is starting to change for their loved one. Without good coping strategies that are personalised to each person with dementia and their family carer, things can escalate to a crisis situation for everyone involved.
Find strategies that will help the person. This will often come from having the conversations suggested above, and will mostly revolve around understanding the need behind the person’s behaviour and supporting them in different ways. Non-drug therapies are often more helpful than medication. A person with dementia needs a way to express themselves that won’t involve upsetting verbal or physical expression, and there is great work going on around therapies including art, music, dance, exercise, reminiscence and sensory to name just a few. Some of this is replicable at home, some may require online or in-person support.
Obtain professional care/support. Having a professionally trained care worker, companion or even a befriender can make a big difference to the dynamic between a person who has dementia and their family carer. The input of someone with different skills and experience, who can model different approaches and provide advice for a family carer, is really important. It’s also a chance for a person with dementia and their family carer to have a break from each other, and for the person with dementia to have a relationship with someone else who reacts/responds differently to them. The more fatigued a family carer becomes, the more likely they are to feel angry, offended, upset or bereft by the changes their loved one is going through.
Discover additional ideas/information online. This isn’t easy if you’re overwhelmed and finding you have no time to yourself, but discovering ways to understand what is happening to your loved one and how you can work with them differently can be a real lightbulb moment that makes caring easier. This Teepa Snow film is one example that may help you find that lightbulb moment