Dementia & Difficult Behaviors: Help for the Caregiver of Aging Parents


Dementia & Difficult Behaviors: Help for the Caregiver of Aging Parents 

As more and more adult children are helping care for parents, they are realizing that there is a steep learning curve to elder care. Seeing a parent change can be incredibly difficult to witness. Particularly if a parent has developed dementia, it can be challenging to address difficult behaviors that begin to arise such as wandering, incontinence, agitation and outbursts, or difficulty communicating. Understanding why these behaviors arise is the first step to responding effectively. 

According to the book, Understanding Difficult Behaviors, changes taking place in the brain and factors in the environment can trigger difficult behaviors.

Examples of Physical & Mental Health Factors:

  • Effects of Medications
  • Impaired Vision or Hearing
  • Acute/ Chronic Illness
  • Dehydration
  • Fatigue
  • Depression
  • Physical Discomfort

Environmental Factors:

  • Environment is too large and disorienting
  • Too much clutter
  • Excessive Stimulation
  • No Orientation Information or Cues
  • Unstructured Environment
  • Poor Sensory Environment or Unfamiliar Environment

The breakdown of communication can often be the most pervasive issue when caring for a parent with dementia. It effects the relationship, how people are understood, and how disagreements are resolved. Here are a few tips to help address difficult behaviors and communicate effectively with a person with dementia.


Don’t Argue: It is human nature to try and correct someone when they say something that is untrue or just didn’t happen; however, it is important not to argue unnecessarily. Engage in their world by asking questions about what they are feeling or remembering.

Develop a rhythm with your loved one. Continuity is really important when a loved one has dementia. A consistent schedule will help reduce outbursts or agitation due to disorientation.  

Use Gestures: Especially if a loved one has hearing loss or is suffering from changes in the brain that effect communication, it is important to incorporate multiple senses when communicating. The added visual of gestures can help illustrate the meaning of words and ideas.

Use Positive Language: When directing your loved one to do something use positive language. For example, say in an inviting tone, “Come join me Dad” instead of frustratingly saying, “No Dad, you can’t go outside.” This will help maintain a sense of dignity and choice as well as safety.

When communicating something important, choose a familiar environment and make sure that it is free from distractions such as background noise. Look directly at the person and make eye contact.

Allow information to be repeated and let it sink it. Speak slowly and clearly. Whenever possible use simplified questions and sentences.

Begin conversations or activities with orienting details, such as names of people, relationships to the person, and locations. For example, if a family member is visiting say, “You must be excited to see your daughter Susan tomorrow?”

If your loved one is resisting care or refusing certain activities of daily living such as bathing, music can be a wonderful tool. Create a playlist of songs that your loved one enjoys or has fond memories of. Play the music before beginning the task and use it to set the tone and associate the activity with good memories. If they continue to refuse to do an activity, don’t push it. Let some time pass and try again later.

Break down tasks into 3 manageable steps. If a response is necessary, allow plenty of time to respond. Avoid having them respond to multiple questions or statements at once. Avoid asking questions that rely heavily on memory.

Allow for your loved one to make a few decision throughout the day to maintain a sense of autonomy; however limit choices to 2-3 options. Too many options can be overwhelming.

Changes in a loved one can happen gradually over time and it can be easy to miss new manifestations of dementia. Consider keeping a log our journal to track your loved ones capabilities and give attention to new needs that are occurring.

One of the best ways to maintain safety, consistent interaction and a regular schedule is to use in-home care services. A Certified Nursing Assistant trained in dementia support can assist with activities of daily living, and encourage activities that engage the mind and lift spirits. For more service information visit






Published on July 30, 2013.