Responsive behaviours

What are responsive behaviours?

Responsive behaviours is a term, preferred by persons with dementia, representing how their actions, words and gestures are a response, often intentional, that express something important about their personal, social or physical environment. They are the result of changes in the brain affecting memory, judgment, orientation, mood and behaviour.

A common challenge for caregivers is coping with behaviours associated with anxiety, anger and aggression. This can include verbal outbursts such as shouting, swearing, or name-calling. It can also involve physical contact such as scratching, pushing, kicking or hitting.

These behaviours can occur suddenly and can occur at any stage of the disease. Their anger can be directed at the caregiver or at themselves. In some cases, the person with dementia may not be aware that their behaviour has changed.

Possible causes of responsive behaviours

People who have dementia are susceptible to the same kinds of pain as everyone else, the difference being that they may not understand what is causing their own discomfort (physical, environmental or emotional discomfort). Oftentimes, this tends to be the cause for the behaviour.

Rather than using medication as a solution, first try and understand the reason for the behavior and find ways to cope with the situation. For the caregiver, identifying, understanding and adapting to the behaviour can help decrease the occurrence of the challenging behaviour.

Here are some potential causes of responsive behaviours:
  • Declines in one's abilities may result in frustration. 
  • The person with dementia may feel humiliated by increased reliance on their caregiver. 
  • They may feel that they have little or no control over their life. 
  • Environmental noise or unfamiliar environments could be causes for outbursts. 
  • Frustration at not being able to complete tasks that were previously familiar. 

Coping strategies

  • Plan outings only when the person with dementia feels rested. 
  • Try not to cause sudden movements, avoid startling noises. 
  • Make sure that the person with dementia feels comfortable (for example, make sure that they are wearing loose clothing, and are not too hot or too cold). 
  • Reduce noise in the environment (this could include limiting the number of people in the room, reducing noise and removing clutter). 
  • Keep furniture and items in the same place to avoid confusion. 
  • Have hearing and vision checked. 
  • Calm the person with dementia by playing relaxing music or give them reassurance with the touch of the hand. 
  • Distract the person with food or an activity. 
  • Reduce change; try to stick to schedules and routines. 
  • Ensure that the person with dementia exercises regularly to help reduce stress. 
  • Speak slowly and in a clear, loud and reassuring voice. 
  • Try not to express your anger or frustration (aggression and anger is often a symptom of the disease and not a deliberate response). 
  • Focus on the feelings of the person with dementia, rather than the behaviour. 
  • Do not take the aggression personally (it is not the person who is being reactive; it’s a result of their disease).
  • Ensure that the environment is safe for you and for the person with dementia.

Additional resources

Last Updated: 11/08/2017