Behaviors Thought to be Dementia-Related Actually Signal Emotional Distress

Dementia is one of the most frequent diagnoses among nursing home residents. The Alzheimer’s Association reports that more than 50% of those in nursing homes or assisted living facilities have some form of the disease.

Despite its prevalence, dementia is a frequently misunderstood illness, even by those who care for elders on a daily basis. One of the most common misconceptions is that all behaviors associated with dementia or cognitive impairment are symptoms of the disease itself. Years of research has led experts to conclude that many vocal and physical expressions are not actually behaviors, but are cues that those suffering from dementia are unable to clearly express.

Distress Signals Mistakenly Believed to Be Dementia-Related Behaviors
As dementia progresses, those suffering find it harder and harder to express needs and wants. These needs and wants can include help relieving physical discomfort and pain, conveying emotional distress (grief, fear, shock, boredom), and basic┬áhuman needs such as assistance using the restroom, with temperature control, or satisfying hunger, and thirst. Not being able to communicate the most basic thoughts causes upset to those suffering from the disease, leaving them with no other way to express themselves than by making noises, gesturing, or carrying out actions that may seem illogical or aggressive. Caregivers should remember that each ‘behavior’ typically has a logical reason behind it, even if that reason may not always seem logical or clear to the caregiver.


How to Provide Care That Will Minimize Upset
Human decency calls for those witnessing someone in distress to provide comfort and relief. For elder caregivers, knowing that many things typically classified as dementia-related behaviors are actually signs of distress can help determine what kind of care is needed. Caregivers can help someone suffering from dementia feel more comfortable by doing several simple things.

  1. Focus on the basics first: Is the room temperature comfortable? Is the person hungry or thirsty? Do they need to use the restroom? Is there too much noise/activity that might be distressing?
  2. Watch a resident or your loved one for situations that seem to cause upset. This could be anything from certain types of foods, to tv shows, to activities, to certain people’s presence, or types of clothing.
  3. Keep things consistent from day-to-day. Routines that eliminate any unexpected events will help someone suffering from dementia to feel more secure.
  4. Talk to someone suffering from dementia as a person. Do not get upset. Ask questions and calmly communicate that you are there to help and want to make them feel comfortable. Explain as much as possible in an effort to reduce fear.
  5. Include or encourage the person to take part in social activities, even if it is with just you. Meeting their psychosocial needs is just as important as meeting their basic physical needs.


Caring for someone in any capacity is hard work, both physically and emotionally. However, caring for a person with dementia or Alzheimer’s can be as rewarding as it is challenging. The key is learning as much as possible about what makes someone suffering from the disease happy, sad, or upset. This kind of knowledge can only be gained when approaching caregiving with an open heart and willingness to accept that the process involves a significant amount of trial and error. The positives that come from meeting the basic needs of someone suffering from dementia are endless, making deliberate care planning well worth the time and effort.


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