Responsive behaviours represents how actions, words and gestures are a response, often intentional, to express something important about the personal, social or physical environment.

Responding to Dementia-Related Behaviour

Published: September 4, 2019
Last Updated: January 18, 2021

For many caregivers, one of the most difficult aspects of caring for a loved one with dementia is coping with the changes in behaviour and personality that set in as the disease progresses. To those unfamiliar with how dementia affects the brain, these actions, words and gestures might seem extreme or uncalled for. But in reality, the person with dementia is expressing something important about their personal, social or physical environment. It’s for this reason that these behaviours are called responsive behaviours.

Types of responsive behaviours could include, but are not limited to:

• agitation/restlessness
• physical aggression
• pacing/fidgeting
• wandering/exit seeking
• hurting self or others
• sexually expressive behaviours
• hoarding/hiding
• disruptive sleep patterns
• inappropriate language/cursing
• negativity
• repetition
• suspicion/paranoia
• hallucinations
• sundowning (late-day confusion)

Madeline D’Arpino, RN, supervises and oversees the Adult Day Program at Circle of Care.

“It’s understandable that for some caregivers, family members or friends, these reactions can lead to many emotions including frustration, embarrassment, sadness, and even fear,” says RN Madeline D’Arpino, supervisor at Circle of Care’s Adult Day Program. “Even though we might not be able to see a reason for the behaviour and it seems irrational to us, it’s important to validate the feelings that come along with it.”

For example, a person with dementia might excitedly claim that their mother will be coming to visit them in the afternoon, even though you know their mother passed away fifteen years prior. Or they may fearfully accuse you of starving them; however, you just fed them lunch only fifteen minutes earlier. It’s really important to listen and hear the words they are saying. Being present and calm may be all that is needed to de-escalate a situation, D’Arpino says, because those statements accurately reflect their reality and their emotions at the current time.

“It’s important to meet people where they’re at instead of trying to reorient them to reality since this usually causes distress. Instead, try asking them to tell you about their mother, or talk about their favourite foods. This can help deescalate the situation, and help maintain your relationship and trust with your loved one.”

Additional Supports for Family Caregivers

  • Circle of Care’s Adult Day Program provides evidence-based programming to clients with dementia and Alzheimer’s disease who live in the community. During the Ontario lockdown, the Adult Day Program is closed for in-person activities; however we are running virtual programming for our members from Monday to Friday.
  • For more information about responsive behaviours and ways to identify and work through them, read the online booklet Shifting Focus from the Alzheimer’s Society.