Dementia Care Do’s and Don’ts: Effectively Managing Difficult Symptoms

The most frustrating part of caring for someone with Alzheimer’s or other memory impairment is handling the difficult symptoms and behaviors that arise throughout the progression of the disease. Sometimes they’re just “out of the blue” and you aren’t prepared to handle them. Or all of a sudden your mother may start swearing constantly, or your father is suddenly paranoid and suspicious of you. It’s exhausting, draining and can be very upsetting for caregivers because no matter how hard you try, you just can’t get through to them.

Erica Labb, Executive Director of Bridges® at Westford, says communication difficulties are one of the most challenging aspects of dementia for both the individual with the disease and the caregiver. “Because dementias change the brain so much, it can be hard for us to always know the right way to care for or communicate with dementia patients.”

Some experts suggest that these difficult symptoms or behaviors are actually forms of communication. Individuals with memory loss have a lot of similarities to small children when it comes to communication. They don’t always have the words to describe how they’re feeling, so they act out due to confusion, pain or a feeling of helplessness.

Persistence and patience are a caregiver’s most effective tools for managing these difficult symptoms and behaviors, Labb says. “You may have to go through process of elimination to rule out straightforward issues like an underlying sickness, uncomfortable clothes, pain or general discomfort. Then you can move on to different strategies to try and minimize symptoms and foster helpful behaviors. By understanding some of the common symptoms of dementia, you’ll know how to react effectively and calmly.”

Difficult Symptom #1: Agitation and Aggression

Your loved one suddenly refuses to take a shower. She becomes agitated when you make her dinner and shrieks that she won’t eat. She has flares of anger that can escalate quickly into aggressive behavior such as hitting or biting. More than 30 percent of caregivers report experiences such as this, and although this is a natural progression of the disease, it’s stressful for both you and the person you’re caring for.


  • Understand that the agitation has a very real cause, oftentimes fear. Try to identify the cause and remedy the situation as soon as possible.
  • Use a soothing voice to reassure, letting her know that you’re aware she is upset and you will do your best to help.
  • Let the anger and aggression run its course (as long as your loved one is not at risk of hurting herself or someone else).
  • Distract her by redirecting her attention to something that makes her happy.


  • Argue or force an issue, which can make the situation worse.
  • Try to restrain her – in fact, it’s best to avoid any physical touch until she has calmed down.
  • Take what she says or does personally, and remember that these symptoms are not who she is.

Difficult Situation #2: Confusion and Repetitive Actions

Your loved one may start asking questions over and over again, or not be able to understand why things are happening. He may find it difficult to ask questions and become easily confused when asked to perform a new task.


  • Answer questions calmly and simply, even if they’ve been asked several times already.
  • Redirect his attention if he isn’t moving past a particular point or keeps asking about something.
  • Introduce other people, places or situations to help reduce confusion and remind the senior where he is.
  • Recognize his feelings and allow him time to formulate responses.


  • Make lengthy explanations or try to reason with him.
  • Give him all the steps at once for a task – instead, walk him through it step by step.
  • Reduce noise levels, especially if having a conversation – individuals with dementia can have difficulty filtering out ambient noise

Difficult Situation #3: Suspicion, Paranoia and Poor Judgment

Your mom forgets where she put her purse and is convinced you stole it. Your dad is convinced the government is tapping his phone and is stockpiling supplies. Your loved one has started talking to telemarketers when they call – and worse, donating money to them. Some of these statements are rooted in the fact that the senior’s memory is poor, and others are caused by the gradual deterioration of brain cells.


  • Stay calm and assess the situation. Offer reassurance and do what you can to help.
  • Find out if there is a real issue, such as someone trying to scam them.
  • Consider duplicating easily-misplaced items like keys.
  • Listen to the person and try to understand his or her view of the situation (no matter how illogical it may be).


  • Accuse or try to argue, which can exacerbate the problem.
  • Question the person’s judgment, which can put them on the defensive.
  • Overwhelm him or her with lengthy questions or explanations.

There are many other symptoms and behaviors that come with dementia and Alzheimer’s disease, but many of them can be addressed using similar techniques as listed above. Here are some overall ways to help make the caretaking experience more rewarding for you and your loved one.


  • Use redirection generously, as it’s a proven way to calm, soothe and relax the individual with dementia.
  • Bring up happy memories or engage your loved one in a familiar or much-loved activity.
  • Keep notes on what works for your loved one (because every individual is different) and incorporate them into your caregiving strategies.


  • Take things personally or take their words or actions to heart.
  • Argue or try to reason with them, as it will only make the situation worse.
  • Shout or let your frustration show, as your loved one will pick up on your nonverbals.
  • Become socially withdrawn (either you or your loved one).
  • Forget about your needs, because your health is important, too.

If you would like more information about how to manage difficult symptoms and behaviors of dementia, contact us at 978.692.9541.

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Bridges® by EPOCH at Westford provides assisted living memory care that is comfortable, positive, safe and engaging. Exclusively dedicated to caring for those with Alzheimer’s disease and other forms of dementia or memory impairment, we’ve created a wellness-focused lifestyle that promotes dignity and individual preferences. Our memory care professionals receive specialized and ongoing training designed to help residents maximize their independence in a secure, calm environment – making a truly positive impact on the lives of our residents each and every day.

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At Bridges® by EPOCH at Westford, we know no two residents are alike. That’s why we’ve designed our services to address the distinct challenges each resident faces. With comfort, safety and happiness as our top priorities, residents receive unmatched personalized attention, no matter the stage of memory loss.

Community Amenities

Bridges® by EPOCH at Westford features a beautiful residential design. Every inch has been thoughtfully designed to enhance the lives of those with memory loss. Soft colors, directional cues, aromatherapy and interactive life stations are placed throughout the community to create a peaceful and secure environment so residents may enjoy great comfort, familiarity and security.

Call us today at 978.692.9541 to learn more about Bridges® by EPOCH at Westford or to schedule a personal tour.

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