Unlocking Understanding: A Practical Guide to Explaining Dementia Behaviors

Dementia presents a profound shift in a person’s cognitive and behavioral landscape. For family, friends, and caregivers, these changes can be perplexing, upsetting, and even frightening. Understanding why certain behaviors occur is the first crucial step toward effective support and maintaining connection. This guide aims to equip you with the knowledge and practical strategies to explain dementia behaviors clearly, empathetically, and constructively, fostering a more compassionate environment for everyone involved.

The core principle to grasp is this: Dementia behaviors are not intentional acts of malice or stubbornness. They are often attempts to communicate unmet needs, fear, confusion, or discomfort, filtered through a brain that is changing due to disease. When you explain this fundamental truth, you shift the narrative from judgment to understanding, paving the way for more effective responses.

Why Explaining Dementia Behaviors Matters

Before delving into the “how,” it’s vital to recognize the impact of clear explanations:

Reduces Misunderstanding and Frustration: Others, lacking insight, may interpret behaviors as deliberate, leading to anger, impatience, or feelings of being personally targeted. Explaining the underlying cause helps reframe their perception.
Fosters Empathy and Patience: When people understand the neurological basis of a behavior, their capacity for empathy grows, leading to greater patience and a more supportive approach.
Empowers Caregivers: Providing actionable explanations gives caregivers tools to respond effectively, reducing their stress and burnout. They move from reacting blindly to responding with purpose.
Maintains Relationships: Unexplained behaviors can strain relationships. A shared understanding helps preserve the dignity of the person with dementia and strengthens bonds with their support network.
Promotes Consistency in Care: When everyone understands the “why,” they are more likely to adopt consistent strategies, which is crucial for the well-being of the person with dementia.

The Foundation: Setting the Stage for Understanding

Effective explanation begins with the right mindset and approach.

The “Brain Disease, Not Bad Behavior” Framework

This is your core message. Always emphasize that dementia is a physical disease of the brain, similar to how heart disease affects the heart.

Actionable Explanation: “Think of Grandma’s brain like a complex computer that’s starting to have hardware issues. It’s not that she doesn’t want to remember or wants to be difficult; it’s that the parts of her brain responsible for memory, reasoning, and impulse control are being affected by the disease. Her behaviors are symptoms of that brain disease, not choices she’s making.”

Concrete Example: If a family member says, “Mom is just being stubborn, she refuses to shower,” you might respond: “It’s understandable to feel frustrated. But it’s not stubbornness. Her brain is losing the ability to process complex tasks like showering, and the unfamiliar sensations or loss of control can be genuinely frightening for her. Her refusal is her brain’s way of saying ‘I’m scared’ or ‘I don’t understand how to do this.'”

Keep It Simple, Concrete, and Analogous

Avoid medical jargon. Use relatable analogies that paint a vivid picture.

Actionable Explanation: “When explaining, use short, clear sentences. Break down complex ideas. Compare what’s happening to something familiar. Focus on one point at a time to avoid overwhelming your listener.”

Concrete Example: Instead of, “Her temporal lobe atrophy is causing anomia and confabulation,” say: “Sometimes Dad struggles to find the right words, like a word is just ‘on the tip of his tongue’ but he can’t quite grab it. And because his brain is trying to make sense of things it can’t remember, he might make up stories to fill in the gaps, even if they’re not true. It’s not lying; it’s his brain trying to make sense of what’s happening.”

Focus on Emotions, Not Just Facts

People with dementia retain their emotional capacity even as cognitive functions decline. A behavior often stems from an underlying feeling.

Actionable Explanation: “Encourage others to consider the emotion behind the behavior. Is the person scared? Frustrated? Bored? Lonely? Validating these feelings can be more helpful than correcting the ‘facts’ of their delusion or confusion.”

Concrete Example: If someone states, “Aunt Mary keeps saying strangers are in her house, even though it’s just us,” you could explain: “It sounds like Aunt Mary is feeling really unsafe and frightened. Her brain might be misinterpreting familiar faces or shadows, making her genuinely believe there are intruders. Arguing with her about who’s there won’t help; instead, let’s focus on reassuring her that she’s safe and we’re here to protect her. Say things like, ‘You’re safe here with us,’ and perhaps gently redirect her attention.”

Timing and Environment Matter

Choose a calm, private moment to explain, free from distractions.

Actionable Explanation: “Don’t try to explain complex issues in the middle of a challenging behavior. Wait until things are calm. Ensure the person you’re speaking with is receptive and has time to process the information.”

Concrete Example: If a relative is visibly exasperated after an episode of wandering, pull them aside later and say: “I know that was incredibly stressful to witness. Can we talk for a few minutes about what might be happening with Uncle John? It might help to understand why he wanders and what we can do.”

Explaining Specific Dementia Behaviors: Practical Breakdowns

Now, let’s tackle common dementia behaviors with clear explanations and actionable advice.

Repetitive Questioning or Actions (Perseveration)

Explanation: “When someone with dementia repeats questions or actions, it’s often due to short-term memory loss and difficulty processing new information or retaining answers. They genuinely don’t remember asking the question before, or they may be seeking reassurance or trying to fulfill an unmet need.”