Why Behavioural Changes Occur in Dementia

Dementia not only affects memory and communication—it also impacts behaviour. People may experience agitation, restlessness, anxiety, aggression, sleep disturbances, and withdrawal. These changes are not intentional; they are symptoms of brain changes caused by dementia. A proactive approach, guided by empathy and personalisation, can make all the difference in managing these behaviours effectively.

As Dementia Australia notes, understanding the triggers behind behaviours is essential to preserving dignity, reducing stress, and maintaining safety. Caregivers, family members, and clinical teams all play vital roles.

Understanding the Triggers

Medical and Physical Triggers

Pain, infection, constipation, hunger, medication side effects, and fatigue often underlie changes in behaviour. A sudden shift should always be assessed medically first.

Environmental Triggers

Noisy environments, unfamiliar routines, poor lighting, or crowded spaces may overwhelm a person with dementia. Creating a calm and consistent setting is vital.

Emotional Triggers

Feelings of fear, confusion, abandonment, or boredom can contribute to challenging behaviours. These may be expressed through restlessness or agitation.

Proactive Behavioural Planning

Rather than reacting to challenging behaviours, carers and families should create a behavioural care plan as part of broader advance care planning. Advance Care Planning Australia recommends integrating behavioural strategies into each person’s care documentation.

Identify Patterns Early

Note what times of day or activities trigger agitation. Keep a log that carers can refer to. Nurse Info provides practical templates and tools to support this.

Document Preferences and Comforts

What brings calm? A favourite song, warm blanket, hand massage, or a quiet space? These should be documented early and stored in a central, secure platform like Evaheld, where updates are accessible to family and medical teams.

Include Carers in the Plan

Empower carers with knowledge and confidence. Regular debriefs and emotional support for carers are key in preventing burnout and improving outcomes.

Legacy as a Tool for Behavioural Support

Knowing someone’s life story—hobbies, past professions, cultural values—can help redirect challenging behaviours. Reminiscence therapy, storytelling, and legacy sharing often soothe agitation and restore connection.

Platforms like Evaheld Legacy Vault allow families to upload personal history, stories, and video messages to help care teams better understand the individual beyond their diagnosis.

Insights from the Family Legacy Series show how family photos, memory books, and recordings can trigger recognition and ease frustration.

Integrating Behavioural Strategies with Advance Care Planning

Too often, behavioural care is reactive. Embedding behavioural preferences into Advance Health Directives can help reduce trauma and improve quality of life.

For instance, a directive might include:

• Preferred methods of redirection during agitation
• Consent for sensory interventions (e.g. music therapy)
• Restraint preferences and when/not to use them

This protects dignity and empowers carers to act compassionately and appropriately.

Support for Families and Guardians

Behavioural changes can be deeply distressing for families. They may feel guilt, grief, or helplessness. The Online Will Blog explores how early documentation of behavioural planning can prevent crisis-driven decisions and reduce carer stress.

The sandwich generation in particular—those managing both ageing parents and children—benefit greatly from proactive strategies stored and reviewed regularly on secure platforms like Evaheld.

Professional Support and Resources

Organisations such as Dementia Support Australia provide behaviour support programs, in-home assessments, and intervention tools based on evidence and empathy. These services can be lifesaving in high-stress scenarios.

Carers can also refer to the Evaheld blog for guidance on legacy-aligned behavioural planning and emotional coping techniques.

Technology and Non-Medication Interventions

Apps, wearables, and calming sensory technologies are increasingly used to support behavioural wellbeing. These tools often reduce reliance on medication and allow for a more personalised response. The key is introducing them early, while preferences can still be expressed and consent given.

Final Thoughts

Behavioural changes in dementia can be confronting—but with planning, empathy, and legacy-informed strategies, they can be managed respectfully.

Recording and regularly reviewing personalised behavioural care plans ensures that individuals continue to be seen, heard, and supported, no matter where they are in their dementia journey.