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Dementia and Responsive Behaviours

What are Responsive Behaviours?

Responsive behaviours is a term that is often preferred by persons with dementia, mental health, substance use and/or other neurological disorders to describe how their actions, words and gestures are a response to something important in their personal, social or physical environment (Alzheimer Society of Ontario, 2014). These behaviours are often a result of changes in the brain affecting memory, judgement, orientation and mood.

Examples of Responsive Behaviours include, but are not limited to: 

  • Hitting, Kicking, Biting, Scratching, Spitting, Throwing things, Hurting self or others, Sexually expressive behaviours, Pacing/Wandering, Eating/Drinking harmful substances, Hiding/Hoarding, Repetitive vocalizations, Shouting

What is the meaning or trigger behind the behaviour?

All behaviour has meaning. A trigger is something in the internal or external environment that may cause the person with dementia to respond with a behaviour. First, consider whether the behaviour is upsetting or a risk for the person or others. If it is, then ask yourself, “What is the reason or underlying cause behind this behaviour?” A person exhibiting a responsive behaviour may no longer be able to verbally communicate their needs. Behaviours are a way to communicate their needs to the people around them.

Potential physical triggers:

  • Pain, Hunger, Thirst, Need to toilet, Sleep disruption

Potential psychological triggers:

  • Depression, Loneliness, Anxiety, Fear

Potential environment triggers:

  • Clutter, crowds, Overstimulation/understimulation, Unfamiliar environment and/or routine, Lighting, Inconsistency in caregivers

Which strategies might help?

It is important to take a person-centred approach to understanding and responding to responsive behaviours. Consider the person’s life story/roles. Do they have a history of trauma? What are their likes and dislikes; their cultural and spiritual needs? An individualized care approach is critical to success. Please note these strategies may not work for everyone. Unfortunately, there is no quick fix and often requires trial and error.

  • Treat the physical problems (for example, provide pain medications, routine toileting, offer food/drink, etc.). Make sure hearing aids and glasses are available.
  • Look at the environment. Reduce clutter, minimize noise. Place signs to help orient them to the environment (for example, put a picture of a toilet on the bathroom door, post their name on the door of the room). Provide a calendar for reorientation.
  • Use distraction. Go for a walk, involve the person in an activity they might enjoy. Use music, a picture book or a simple game.
  • Ease loneliness and anxiety by providing reassurance and gentle touch. Speak calmly and avoid arguing. Do not confront a false belief if it is harmless. Instead, validate the person’s feelings.  Maintain a consistent daily routine. Avoid changes to routine and the environment.
  • Support their independence as much as possible. Adapt tasks to meet capabilities. For more Information, Tips and Strategies on Specific Responsive Behaviours:

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