Dementia 6: understanding distressed behaviours in people with dementia

The term ‘behavioural and psychological symptoms of dementia’ refers to a range of neuropsychiatric disturbances, such as agitation, aggression, depression, apathy, psychosis, wandering, repetitive questioning and sleep problems. More often than not, these behaviours are a sign of distress and an attempt by the person living with dementia to communicate an unmet need. This article, the sixth in a series on dementia, suggests some of the possible causes of distressed behaviour. Using a fictitious scenario, it demonstrates how early and accurate identification of the possible causes of distressed behaviour can dramatically improve outcomes for people living with dementia.

This article has been double-blind peer reviewed

In this article…

• Why people are more likely to communicate their needs non-verbally as dementia progresses

• How behavioural and psychological symptoms of dementia are often a communication of need

• Why it is important to rule out any physical causes for a person’s behaviour

Key points

Distressed behaviour can be how a person with dementia communicates an unmet need

Changes in behaviour can be an indication of delirium - this is important as people living with dementia are at high risk of developing delirium

Person-centred, non-pharmacological interventions are effective ways of managing distressed behaviour

Antipsychotic medication should be a last resort that is only considered if a person is experiencing severe distress or at risk of harming themselves or others