Dementia Behaviors: The Why & Strategies

Why is my husband starting to wander? Mom is resisting every suggestion I give her for problems she is having! My dad denies he needs any help, but he is losing weight and his hygiene is poor! These are just a few of the issues families face when they have a loved one with a dementia such as Alzheimer’s disease.

In the early stages of progressive cognitive illnesses, struggles with short-term memory and maybe some issues with judgment are what stand out, but for the most part, things may run smoothly once you have learned how to interact with those two obstacles. However, as the brain becomes more challenged due to changes in its structure and chemicals, other behaviors start to surface. Not all individuals have the same challenges, but challenges do increase with time.

Resistance is a big issue for adult children and spousal caregivers alike. However, the approach that each takes will be different. You might be 60 years old, but your parent might still see you as an eight-year-old child. “Who takes direction from a child?” may be their innate response. Likewise, if your spouse with dementia always did the household finances, he or she is unlikely to let you take over easily.

Areas of the brain from reptilian brain, to limbic system and neocortex, known as the triune brain hypothesis shown with cross section of a human brain on dark background. Dementia behaviors are related to the section of the brain functioning are various stages of the disease.

To understand these responses in your loved one with a dementia, think of the brain as a Triune Brain. When the human brain is in its healthy state, the neocortex (most of the brain) is using language, abstract thought, imagination and consciousness. You can reason and rationalize with this brain. The next section of the brain is the limbic system, which is the operating brain of those in the middle stages of a dementia, controlling emotions, memories, and habits. The reptilian brain includes the brain stem and cerebellum, controlling the flight or fight response only and running on autopilot. The latter behaviors are seen in the end stages of a dementia.

Understanding the brain and how it is impaired with the progression of the disease helps families and professionals find ways that don’t frustrate but still continue to provide a safe environment that respects dignity and is as stress-free as possible. My free Zoom class titled, Dementia: Managing Behavioral Challenges focuses on those strategies, as well as how changing our approach with the person who is affected can be the answer without using medications.

Learning the “Communication Dos and Don’ts” as well as how to be a detective when new behaviors present themselves will be a big assist to families. In my book, I cover these issues in detail, and you will want to share what you learn with everyone in the circle of your family member’s life.

Here are just two of the “Dos and Don’ts” from my list:

My book also covers “Playing Detective”. When trying to determine the cause of a particular behavior, it may help to ask the questions in the graphic below.

The answers to these questions may help you find the “why” so you can change the antecedent.

There are many resources either in day programs or with individual coaches to help families manage challenging situations. We will discuss many of those in the Zoom class, but I have two very good resources listed at the end of this newsletter. Keeping your family member socialized without frustration is the goal, and activity helps reduce wandering and makes for a better night’s sleep.

Affirmation: “I have information and resources needed when problems arise.


The Connected Horse: A four-week program using horses for both the caregiver and the dementia person. Current locations include Orinda, CA, Pleasanton, CA, Calistoga, CA, and Minden, NV.

Positive Approach to Care by Teepa Snow: This site includes resources for both people living with dementia and their care partners.