Caregiver guide
Weird things dementia patients do: understanding behavior and personality changes
Hiding things, pacing, sudden anger, wearing the same clothes every day: the "weird" things people living with dementia do are usually the disease, not the person. Most behavior has a reason, and once you find it, you can often make things easier for both of you.
Why does dementia change behavior?
Alzheimer's and other dementias damage brain cells over time. As the brain changes, so does the way a person thinks, feels and acts. Someone who was always calm may now snap over small things. Someone who loved to dress up may not want to bathe.
It can feel like your mom, dad, husband or wife has become a different person. That's one of the hardest parts of caregiving, and it's normal to feel hurt, embarrassed or worn out.
Here's what helps to remember: the person isn't doing it on purpose. Behavior is often their way of telling you something they can no longer put into words, such as "I'm in pain," "I'm scared" or "I'm bored."
Common behavior changes in dementia
Mood swings and anger
Getting upset, anxious or angry more easily, sometimes over things that never bothered them before. See our guide to dementia agitation and aggression.
Losing interest
Seeming sad, flat or uninterested in hobbies, friends or food.
Hiding things or accusing others
Tucking items away, then believing someone stole them. See our guide to why people with dementia hide things.
Seeing or believing things that aren't real
Hallucinations, false beliefs or suspicion of others. See our guide to hallucinations and paranoia.
Pacing and wandering
Walking back and forth, or trying to leave the house. Give your person a safe place to walk, and keep doors secure.
Late-day confusion
Becoming more restless or confused as evening comes. See our guide to sundowning.
Changes in self-care
Not wanting to bathe, change clothes or brush teeth, or wearing the same outfit every day.
Misreading the world
Mistaking a reflection for a stranger, or misunderstanding what they see or hear.
Unusual sexual or social behavior
Saying or doing things that seem out of character or inappropriate, without realizing it.
First signs of dementia personality changes
Behavior and personality changes can be some of the first things families notice, sometimes before memory problems are obvious. Early signs can include:
- Being more irritable, anxious or short-tempered
- Pulling back from friends, church or hobbies
- Losing interest in things they used to love
- Being more suspicious of people
- Making unusual decisions, such as with money
- Seeming less caring or aware of others' feelings
These changes can have many causes, including depression, medicine side effects and other health problems. If you notice them, start with a visit to the doctor. Our Alzheimer's and dementia FAQ explains early signs and stages in more detail.
What stage of dementia is personality changes?
Small personality changes can show up early. Behavior changes such as anger, suspicion, wandering and sundowning are often most noticeable in the middle stages. In later stages, many people become quieter and less active.
Every person is different, and the type of dementia matters too. Rather than focusing on the stage, watch for patterns: what happens, when, and what seems to set it off.
What can trigger behavior changes?
The disease itself changes the brain, but other things often make behavior worse. Before you assume it's "just the dementia," check for:
- Feelings: fear, sadness, stress, loneliness or confusion.
- Health problems: pain, an infection, constipation, a new medicine or poor sleep.
- Basic needs: hunger, thirst, needing the bathroom, or being too hot or cold.
- Senses: glasses or hearing aids that are missing or don't work well.
- Surroundings: too much noise, a crowded room, an unfamiliar place or a change in routine.
If behavior changes suddenly, or you can't find the cause, call the doctor. It could be a medical problem that can be treated.
How to handle dementia behavior changes
Look for the reason
Ask yourself: Are they in pain, hungry, tired, scared or bored? Did something change today? Fixing the cause often fixes the behavior.
Respond to the feeling, not the words
If your person says something that isn't true, skip the correction. Try "You seem worried" or "That sounds frustrating."
Keep it simple
Say or ask one thing at a time. Use short sentences, a calm voice and a friendly face.
Don't argue
You can't win an argument with the disease. Agreeing, changing the subject or taking a short break works better.
Keep a routine
Doing things at about the same time each day helps your person know what comes next and feel safe.
Redirect with something they enjoy
Music, a snack, a walk, a photo album or a simple job like folding laundry can shift the mood.
Ask for help, kindly
Saying "Can you help me set the table?" can feel better to your person than being told what to do.
Take care of your own reactions
If you feel anger rising, pause, breathe and count to 10. If your person is safe, step out of the room for a few minutes. A little humor, when it fits, can help you both.
How to deal with dementia mood swings
Mood swings can come out of nowhere: laughing one minute, crying or yelling the next. Try to stay calm and give the feeling time to pass. Reassure your person that they're safe and you're there.
Some caregivers use what's called the 90-second rule: strong emotions often peak and fade within about a minute and a half if nothing adds fuel to them. Pause, breathe, and wait before you respond.
If mood swings come with hitting, biting, deep sadness or seeing things that aren't there, talk with the doctor. There may be a medical cause, and some behavior symptoms can be treated. This page is general information, not medical advice.
Help for caregivers in Central Florida
Caring for someone whose personality has changed takes a lot of patience, and patience runs short for everyone. You don't have to figure it out alone.
The Alzheimer's & Dementia Resource Center (ADRC) offers free help:
- Caregiver support groups, in person and online, where other caregivers share what works.
- Care Navigation, free one-on-one sessions to talk through a specific behavior and build a plan.
- Education services, workshops on communicating when words stop working and on understanding behavior.
Need to talk to someone right now, day or night? Call the Alzheimer's Association 24/7 Helpline at 800-272-3900. If anyone is in danger, call 911.
Dementia behavior changes: common questions
What are some weird things dementia patients do?
Common examples include hiding or hoarding items, repeating the same question, pacing, rummaging through drawers, wearing the same clothes every day, talking to a reflection, accusing people of stealing, and becoming restless in the evening. These are usually caused by brain changes, not stubbornness.
What are four common behaviors that people with dementia often exhibit?
Four that caregivers see often are agitation or anger, wandering, repeating questions or actions, and suspicion or accusing others. Late-day confusion (sundowning) and hiding things are also very common.
Why do people with dementia act like children?
As dementia progresses, people lose skills in roughly the reverse order they learned them, so they may need help with things like dressing or eating. But they are still adults with a lifetime of experience. Speak to them with respect, offer choices, and avoid talking down.
Do different types of dementia cause different behavior changes?
Yes. Frontotemporal dementia often changes personality and behavior early, sometimes before memory loss. Vascular dementia can bring mood changes such as depression or apathy. Lewy body dementia is often linked to hallucinations. Ask the doctor what to expect with your person's diagnosis.
What is the 90 second rule for dementia?
It's an informal caregiving tip, not a medical guideline. Strong emotions usually peak and fade within about 90 seconds if nothing adds to them. When your person, or you, gets upset, pause, breathe and give it a minute and a half before reacting.
When should I call the doctor about behavior changes?
Call if behavior changes suddenly, if your person seems to be in pain, if they hit or hurt someone, or if they seem very sad, fearful or see things that aren't there. A sudden change can be a sign of infection, pain or a medicine side effect.
How does dementia affect the family?
Behavior changes can strain marriages, sibling relationships and the caregiver's own health. Many caregivers feel grief, guilt and isolation. Talking with others in a caregiver support group can make a big difference.
Can I live a good life with dementia?
Many people live meaningful lives for years after a diagnosis, especially with routines, activity, social contact and support. For care partners, getting help early makes the journey easier for everyone.
Download the free guide to behavior changes
Keep this one-page tip sheet from the National Institute on Aging on hand for hard days. This page is based in part on National Institute on Aging guidance.
Free help for dementia caregivers in Central Florida
The Alzheimer's & Dementia Resource Center (ADRC) in Winter Park, Florida, offers free help for caregivers in Orange and Seminole counties. Call (407) 436-7750, Monday to Friday, 8:30 AM to 4:30 PM.