Sometimes, people with dementia can become upset. This can take many forms, such as pacing or asking repeated questions. In these situations, caregivers can have a hard time understanding what might be contributing to the behavior and knowing how to react in a way that preserves the person’s dignity.

It’s important to remember, though, that when a Senior with dementia becomes upset, it isn’t because they are trying to be difficult. In fact, it is usually a sign that they are struggling with an unmet need that  they aren’t able to communicate to a caregiver or loved one. This is called a “behavioral expression” and more accurately describes what a person with memory loss experiences.

“Behavioral expressions are simply a person’s expression of an unmet need or desire,” says Rita Altman, Senior Vice President of Memory Care & Program Services at Sunrise Senior Living. “Don’t we all get a little frustrated when we don’t feel understood?”

Diminished verbal skills make it tough for a senior with dementia to express what they need. As a friend or family member, investigating potential reasons for their behavior is usually the best approach.

Common Triggers That Can Upset Seniors with Dementia

By taking time to explore and consider each of these triggers, you will likely uncover the deeper reason that your senior loved one is upset.

Here are a few of the most common ones:

• An environment that is overwhelming their senses, often because it is too loud or too crowded
• Being surrounded by too many unfamiliar faces, including having too many caregivers at a time
• A change in environment (e.g., going to visit a place they haven’t been before or making changes to their assisted living apartment or suite)
• Being hungry or thirsty or in need of a bathroom
• Having someone approach too quickly or from the side where their peripheral vision might be impaired
• Being confused about their location and how they got there (even in a once familiar environment)
• Having someone talk too loudly or forcefully to them
• When personal space is invaded, whether it is by a friend or family member or a stranger when you are out in a public place
• Misunderstanding directions or questions from a loved one or a conversation that is occurring nearby
• Being startled by a loud noise or by loud voices
• When the environment is too hot or too cold to get comfortable
• Feeling demeaned or disrespected by friends, family, or caregivers
• Low self-esteem caused by an inability to communicate and care for themselves
• Side effects from, interaction with, or adverse reaction to medications

As you are trying to pinpoint what might be causing your senior loved one's negative reactions, it might help to keep a journal. Document the events that happened prior to them becoming upset, along with any changes in the environment or daily routine.

Once you get to know your loved one’s triggers, you can create a personalized plan to avoid those situations.  And, you can better manage your loved one’s emotions when they arise.

“You should discover ways to help fulfill your loved one’s desire to feel safe, secure and heard,” says Altman. “That may involve using open-ended questions, creating structured daily routines, and using a calm voice. They key is verbal and nonverbal communication – always meeting them where they are.”

Listen to The Senior Caregiver Podcast

Looking for more information on behavioral expressions and how to connect with your loved one? We invite you to listen to The Senior Caregiver Podcast. This podcast can help you learn more about the many nuances of Alzheimer’s disease and how to navigate the journey with your loved one.