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Dementia Behaviors Aren’t the Problem—It’s the Emotions That Cause Them

by Judy Cornish

Anyone who has spent time with someone experiencing dementia knows that dealing with dementia behaviors (or Alzheimer’s behaviors) causes tremendous stress. For families caring for someone with dementia at home, caregiving is in itself debilitating because of round-the-clock demands and the difficulty of finding someone who can step in to give the primary caregiver a break. However, it’s behaviors such as exit-seeking, pacing, excessive talking, combativeness, hallucinations, and repetitive actions that can reduce even the most rested and devoted caregiver to tears before breakfast is over.

We believe families can provide excellent dementia care at home - The DAWN Method - Strength-Based Dementia Care for Families

Appropriately, when I look at books on how to provide dementia care, I find entire sections devoted to Alzheimer’s behaviors and how to deal with them. Advice is organized by situation, or task, such as how to deal with behaviors that occur when bathing, eating, dressing, or using the toilet. The consensus is that behaviors have multiple causes and are difficult to understand—that dementia-related behaviors are the real problem in dementia care.

I agree that behaviors have multiple causes, but that’s all. I see a pattern that makes dementia-related behaviors predictable and resolvable. I think they are no more than the symptoms of unmet emotional needs. When we think of behaviors as symptoms, we can look deeper for their causes and respond in a way that alleviates the behavior. For example, both a refusal to shower or an attempt to leave the home or care facility could be the result of fear. Or the same two behaviors could be caused by the need for autonomy, the desire to feel in control, or the insecurity that results from confusion. Thinking of behaviors as understandable expressions of emotional needs—symptoms of an underlying problem—allows us to deal with them. As symptoms, behaviors are no longer inexplicable.

My background is in literature, languages, and law—not medicine or social work. I learned when studying languages that I should expect to find logic behind errors. I learned from my study of the law that although a set of facts may seem random or unrelated, looking deeper will often uncover a unifying principle or rule. So, when I began working with people experiencing dementia, I expected dementia-related behaviors to be expressions of something underlying and logical.

What all my clients had in common was feeling emotionally distressed due to undergoing progressive cognitive impairment—specifically, the loss of their rational thought processes. What I began to do was to meet their emotional needs and support their rational thought processes. When I did this, my clients became happy and relaxed and their behavior problems melted away.

Meeting the emotional needs of dementia

the DAWN Method includes 7 Tools: The 7 Tools of the DAWN Method: Mood Management, Security in Confusion, Security in Care, Social Success, Sense of Control, Sense of Value, Secure Future

The DAWN Method is a set of seven tools which help us support someone’s rational thought losses and the emotional needs that accompany progressive cognitive impairment. My method is unique in that it identifies the problem caused by dementia as being the emotional distress a person experiences when undergoing progressive cognitive impairment, and provides caregivers with precise tools matched to those emotional needs. When we look at emotional distress as the problem and the person’s behavior as a symptom, being a caregiver becomes companionable. That’s the magic of the DAWN Method.

What are some of the common behaviors that are a result of Alzheimer’s disease?

Alzheimer’s disease and/or dementia can cause many distressing behaviors. These behaviors can include excessive talking, repetitive actions, exit-seeking, pacing, anger, combativeness, hallucinations, anxiety, depression and sleep disturbances. These behaviors are almost always the result of the emotional needs that result when someone loses skills to Alzheimer’s or dementia. If caregivers learn how to emotionally support the person with Alzheimer’s, the person can become more relaxed and happier in their care.

How do I deal with dementia related behaviors?

Dementia-related behaviors can include exit-seeking, pacing, excessive talking, combativeness, hallucinations, and repetitive actions. These behaviors are often outward expressions of the emotions we feel when we lose cognitive skills to dementia or Alzheimer’s disease. It is not surprising that people who are experiencing the loss of rational thought are afraid, embarrassed and frustrated. If their caregivers understand this and find ways to support their rational thought losses as well as meet their emotional needs, there is less stress and more companionship in the caregiving relationship. The DAWN Method teaches practical tools and techniques that help families and caregivers meet the emotional needs caused by dementia.

Learn more

Are you caring for someone with dementia who is aggressive or combative? If so, you are most likely scared, tired and frustrated. We’ve recently posted a 3-part series of articles addressing mean dementia that might give you ideas on how to minimize the anger that often results from dementia.


Is there a better way to navigate dementia?

The odds are against you if you rely on your gut. Working with people who are experiencing dementia requires a new way of interacting. Family members and caregivers (even incredibly empathetic ones) who don’t truly understand this will inadvertently embarrass, frustrate or undermine their loved ones and clients. Learn why that is and how to navigate dementia more successfully in our DAWN Method courses and books.

Are you a professional caregiver or organization?

Dementia care at home with less stress and less anxiety is possible... the DAWN Method - Strength-Based Dementia Care for Families