Handouts · Dementia & Caregiving
Managing Challenging Behaviors
Difficult behaviors are usually the person's way of saying something is wrong. Look for the unmet need behind the behavior, and it becomes far easier to ease.
The ABC Approach
- A — Antecedent: what happened just before? (noise, hunger, a question)
- B — Behavior: what exactly did they do?
- C — Consequence: what happened after, and did it help?
Spotting the pattern points you to the trigger to change.
Check Unmet Needs First
Before anything else, rule out the basics:
- Pain, hunger, thirst, or needing the bathroom
- Too hot, cold, tired, or overstimulated
- Boredom or loneliness
- A new medication or infection
Agitation & Aggression
- Stay calm; keep your voice low and body relaxed.
- Don't argue or restrain — give space and safety.
- Redirect to a soothing activity or another room.
- Reduce triggers: noise, crowds, rushing, being quizzed.
Sundowning
Late-day confusion and restlessness are common. To ease it:
- Keep afternoons calm; limit naps and caffeine.
- Turn on lights before dusk to cut shadows.
- Hold a soothing evening routine.
- Plan demanding tasks for the morning.
Wandering & Repetition
- Wandering often means restlessness or looking for something — offer a walk or a task.
- Ensure doors are secured and they carry ID.
- For repeated questions, answer calmly and briefly, then redirect.
- Try not to show frustration — each time feels new to them.
Track a Behavior
Behavior & when it happens:
What came just before (A):
What helped:
Try comfort and environment changes before medication. Calming approaches are the first-line response. If a behavior is unsafe, sudden, or severe, contact the clinician — and rule out pain or infection, which frequently drive new agitation.