2.6 Respond to the behaviour of an individual with dementia

This guide will help you answer 2.6 Respond to the behaviour of an individual with dementia.

Working with individuals who have dementia can be challenging, rewarding and emotional. People with dementia may show changes in their behaviour due to the condition’s progression, health problems, environmental factors, or unmet needs. As a worker, responding effectively helps maintain dignity, safety and wellbeing for the person and for others.

This guide covers practical ways to respond to varied forms of behaviour. It also covers why some behaviours occur and how you can use communication, observation and empathy to respond in a safe and respectful way.

Behaviour in Dementia

Dementia affects the brain and can lead to changes in memory, thinking, mood, and communication. Behaviour is often a form of communication, especially when the person has difficulty expressing themselves with words.

Behaviours can include:

• Restlessness or pacing
• Repetition of words or actions
• Aggression or shouting
• Withdrawal or silence
• Agitation or distress
• Reduced inhibition, such as speaking openly about private topics
• Wandering indoors or outdoors

These behaviours are not random. They can be reactions to pain, discomfort, noise, a change in routine, fear or confusion.

The Need to Identify Triggers

Observing and identifying triggers helps you respond appropriately. A trigger is something that sets off a certain behaviour.

Common triggers can be:

• Physical pain or hunger
• Tiredness
• Loud noises or busy environments
• Changes in carers or surroundings
• Feeling unwell
• Emotional distress or boredom

Keeping a record of situations that lead to behaviours can help spot patterns. This allows changes to be made that may prevent distress in the future.

Using a Person-Centred Approach

A person-centred approach means focusing on the individual’s needs, preferences, and personal history. Familiarity reduces anxiety for a person with dementia.

Ways to follow a person-centred approach:

• Learn about their life story, interests and values
• Use familiar routines wherever possible
• Offer choice in everyday activities
• Respect personal space and boundaries
• Listen to preferences about food, clothing and environment

This approach reduces frustration and builds trust.

Effective Communication

Clear and kind communication can reduce behavioural issues. Many people with dementia struggle to understand complex instructions or fast speech.

Tips for effective communication:

• Speak slowly and use short sentences
• Maintain eye contact
• Use the person’s name
• Smile and use positive facial expressions
• Avoid raising your voice unless the person has hearing loss and requires more volume
• Use gestures to support spoken words
• Allow extra time for a reply

Avoid contradicting or correcting minor mistakes, as this can cause embarrassment or defensive reactions.

Responding to Agitation

Agitation may look like pacing, fidgeting, irritability or verbal aggression. It can result from discomfort, confusion, too much stimulation or boredom.

Responses can include:

• Speak calmly and use a soothing tone
• Reduce noise and create a quiet environment
• Offer a drink, snack or rest
• Distract with a preferred activity
• Check if clothes, temperature or seating are causing discomfort
• Avoid confrontation and step back if the person’s agitation increases

Responding to Aggression

Aggression may be verbal or physical. The person is likely expressing fear, frustration, pain or confusion. Physical aggression can put both the person and others at risk.

Actions to take:

• Keep your voice calm and steady
• Maintain a safe distance
• Use open body language without sudden movements
• Do not argue or try to overpower the person
• Remove potential hazards from the immediate area
• If safe, give them space until they settle
• Report the incident in line with organisational procedure

After the episode, review possible causes to reduce the chance of a repeat.

Responding to Wandering

Wandering can happen indoors or outdoors. For some people, it is linked to restlessness, confusion about time and place, or past habits such as going to work at a certain time.

Helpful responses:

• Install clear signs for rooms and toilets
• Use locks or alarms on doors if safe and in line with care plans
• Offer supervised walks or activities to reduce restlessness
• Keep comfortable walking shoes available
• Redirect with another activity if safe
• Check if the person is looking for something or someone

Wandering can become dangerous, so safety plans are important.

Responding to Withdrawal

Withdrawal may show as being quiet, avoiding activities, or staying in bed. This may relate to depression, illness, embarrassment about symptoms, or lack of stimulation.

Responses include:

• Engage in conversation about topics they enjoy
• Offer one-to-one activities they can manage
• Involve them in daily tasks like folding washing or meal preparation
• Encourage gentle physical activity
• Monitor their wellbeing and mood and report concerns to senior staff or healthcare professionals

Managing Repetitive Behaviour

Repeating questions, words or actions is common. It can be due to memory loss, anxiety, boredom, or needing reassurance.

Ways to respond:

• Answer calmly, even if the question is repeated often
• Use visual aids like clocks or noticeboards to remind them of time and events
• Engage them in a distracting activity
• Acknowledge feelings rather than focusing on the repetition itself

Keeping Everyone Safe

Safety is a top priority. Some behaviours, such as violent outbursts, can pose immediate risks.

Safety actions to take:

• Remove sharp or dangerous objects from reach during episodes of aggression
• Keep walkways clear to prevent falls
• Support mobility where needed with walking aids
• Use agreed safety equipment such as sensor mats in care plans
• Call for help if a situation becomes unsafe to manage alone

Recording and Reporting

Accurate records allow patterns to be spotted. This helps the wider care team respond better.

When recording behaviour:

• Write down what happened before, during and after the incident
• Note who was present and the time
• Include any actions taken and their impact
• Record physical signs such as flushed skin or signs of pain
• Use factual language without personal opinions

Follow your organisation’s reporting procedures.

Involving Family and Friends

Family members and friends can give valuable information about the person’s past, preferences and triggers.

Good practice includes:

• Keeping in regular contact to share updates
• Asking for advice on calming or reassuring the person
• Encouraging visits and participation in activities
• Inviting them to care plan reviews where appropriate

Working with the Wider Care Team

Many professionals may be involved in supporting someone with dementia, such as nurses, occupational therapists or psychologists. Sharing information and strategies helps maintain consistent care.

Ways to work effectively together:

• Attend team meetings or handover sessions
• Share observations respectfully and confidentially
• Learn from the strategies others have found effective
• Agree on consistent responses for recurring behaviours

Managing Your Own Emotions

Responding to challenging behaviours can be tiring or upsetting. It is normal to feel stressed or frustrated at times.

Tips for managing your own emotions:

• Take short breaks after difficult incidents where possible
• Discuss feelings with a trusted colleague or supervisor
• Use training opportunities to improve confidence
• Focus on the person’s needs rather than the behaviour itself
• Remember challenging behaviour is linked to the condition, not to you personally

The Role of the Environment

The environment can influence behaviour. Bright lights, clutter, or too many people can cause overstimulation.

Useful environmental changes:

• Keep rooms well lit but without glare
• Reduce background noise such as TV or radios
• Use calm colours and simple decor
• Arrange furniture for safe movement
• Create quiet areas for rest and privacy

Final Thoughts

Dementia affects people differently. Behaviour is often a way of communicating something the person cannot express in words. Responding to behaviour means looking past the action to find its meaning. It requires patience, empathy and observation.

By using calm communication, recording incidents, involving family and adapting environments, you can reduce distress and help the person feel safe and valued. Each positive response supports their dignity and quality of life, and also makes your role more effective and rewarding.