Behavioral and Psychological Changes in Dementia

Caregivers are often unprepared to deal with problematic changes in behavior and mood in their family members diagnosed with dementia. These problems are common and occur in most dementia patients living in the community. They include but are not limited to increasing agitation, aggression, depression, apathy, hoarding, leaving the house without telling anyone, wondering, and getting lost. These changes occur due to disruption of the pathways between neurons responsible for memory, communication, and regulation of behavior.

Some factors have to do with pre-existing anxiety, depression, and irritability that unfortunately intensify in dementia. The good news, however, is that with the help of a trained neuropsychologist, caregivers can learn adjustment strategies to help their family members with dementia reduce problematic symptoms and behaviors and improve their own well-being. Several examples of common causes of problematic symptoms and behaviors in dementia and adjustment strategies are listed below.

First, physical discomfort due to chronic medical conditions, medications’ side effects, pain, constipation, or urinary problems can trigger a worsening mood and problematic behaviors. Regular medical check-ups and proper medication management can help.

Second, identifying and addressing an ineffective communication style between caregivers and a patient is essential. Ineffective communication occurs when caregivers unintentionally pressure patients to do something they can no longer do (e.g., asking them to remember something, expecting them to take care of their personal hygiene or communicate their needs). Another example of ineffective communication is reacting to the patient’s discomfort only after they “act out,” which unintentionally “teaches” patients to behave in a problematic way to get help.

Third, knowing what the patient needs to be comfortable in their environment is critical. A comfortable room temperature, access to preferred food and drinks, reduced clutter, and companionship are common needs that, if not met, can cause problems for people living with dementia.

Finally, patients do better when they have a balance between staying active and getting enough rest, and it is important to avoid sensory overstimulation. For instance, giving family members with dementia the opportunity to complete some easy household chores, engage in gardening, listen to their favorite music, or look at old photo albums can help. On the other side, loud noises, too much TV, and crowded environments can create overstimulation and contribute to problematic behaviors.

At NRS|Lifespan, caregivers can learn adjustment strategies to decrease problematic behaviors due to dementia in their family members as part of Medical Adjustment Counseling®.

If you have any questions, give us a call at 732-988-3441.


Eleonora Gallagher, Psy.D.
Licensed Clinical Psychologist #7297
Neuropsychology Post-Doctoral Fellow