Date Revised:

This is part of the Carers Road Map online guide for anyone who cares for someone with dementia and wants to know about managing challenging behaviour.

Positive strategies for managing changes in behaviour 

During the middle and later stages of dementia the person you care for may struggle to understand the world around them and communicate their feelings and wishes. People with dementia can develop unusual behaviours which may include becoming angry or agitated, pacing, experiencing a different sense of reality to ourselves, repeating themselves and sometimes displaying a lack of inhibition.

It is important to recognise that behaviour is a form of communication. There is usually a good reason for the unusual behaviour, and understanding why someone is behaving in a certain way can make managing their situation easier. 
A change in the behaviour of the person you care for can be an indication that they are not feeling well. Visit the GP to rule out the possibility of other medical conditions. Information on managing changing behaviours is available from the Alzheimer’s Society. Local carers and dementia services will be able to give ongoing information, advice and in some areas training. In some cases the GP may refer to the community mental health team for further support.

Support in managing changing behaviour 

Don’t be afraid or embarrassed to bring up the subject of difficult behaviours with health professionals involved with the person you care for. They will do what they can to help you continue to care at home if that is what you wish to do. It is always better to ask for advice or extra support early to prevent a difficult situation becoming overwhelming. 
As a carer it is important to recognise the emotional impact behaviour changes can have on you and taking a break can be crucial. Carers groups and the Admiral Nurse Helpline can be a useful place to discuss your feelings and pick up invaluable tips.

Support with night care

Providing care at night and having to manage frequent night time disturbances can be exhausting. It may be worth exploring the options of night time services with your local social services or care services. Get advice on funding the care by asking for an assessment from a social worker. Funding options could include personal budgets, NHS continuing care, and in some areas Admiral Nurses.  See replacement care in England on Alzheimer's Society.
‘Sundowning’ is the term used to describe the increased confusion and disorientation many people with dementia experience in the evening. It can be particularly difficult for carers who are by this time of the day feeling exhausted. For information on ‘sundowning’ contact Dementia UK or Alzheimer’s Society.


  • Get advice and information on managing changing behaviors. 
  • Ask for help early, it is always better to be prepared. 
  • Join a local dementia or carers group for support.
  • Find out about local replacement care in your area.
  • Speak to your GP to rule out any other health conditions.
  • Ask the GP about drug treatments that may help.

Next in the Carers Road Map guide: When the carer's own circumstances change