What is Challenging Behaviour in Dementia
Challenging behaviour dementia Durham is a term that describes how residents with dementia may act when they are distressed, confused, or overwhelmed. At Durham Nursing Homes, we recognise that these behaviours are not acts of defiance, but a form of communication. Our goal is to understand what residents are trying to express and support them with dignity and care.
As dementia progresses, many residents struggle to express their needs or understand their surroundings. This can result in behaviours that appear difficult or unusual. However, these are often coping mechanisms that arise from frustration, fear, or confusion.
What does challenging behaviour look like?
Challenging behaviour can include a wide range of actions. These may include shouting, hitting, pacing, resisting care, repeated questioning, swearing, or emotional withdrawal. While these behaviours can be upsetting, they often serve a purpose. For example, shouting may be a response to pain, while pacing might signal anxiety.
Why do these behaviours happen?
People with dementia experience changes in memory, reasoning, and sensory processing. As a result, they may misinterpret what is happening around them. For example, someone may think they are in danger or believe they need to go home. When their reality doesn’t match the current situation, fear and confusion can trigger a behavioural response.
Behaviour as communication
When someone can’t say “I’m scared” or “I need help,” their behaviour becomes their voice. Recognising this allows carers to respond with understanding rather than frustration. For instance, a resident who refuses to bathe may feel vulnerable or cold rather than simply being uncooperative.
Common triggers of challenging behaviour
Several factors can lead to behavioural changes in residents with dementia. These include physical discomfort, environmental changes, unfamiliar people, changes in routine, or overstimulation. Pain, hunger, fatigue, or infection can also increase the likelihood of challenging behaviour.
How we respond to early signs
At Durham Nursing Homes, we train our carers to recognise early signs of distress. If a resident begins pacing, fidgeting, or raising their voice, we act quickly. Redirecting attention, offering comfort, or simply providing space can help prevent escalation.
Using structure to prevent distress
Residents with dementia benefit from clear routines. Familiar daily schedules, consistent carers, and predictable environments help reduce anxiety. For example, eating meals at the same time each day or maintaining a morning care routine gives residents a sense of stability.
The role of environment in behaviour
The environment plays a significant role in supporting emotional wellbeing. Loud noises, harsh lighting, or cluttered spaces can be overwhelming. We ensure that spaces are calm, well-lit, and easy to navigate. Soothing colours, familiar decor, and personalised items also help residents feel more comfortable.
Communication strategies that support residents
We adapt how we communicate based on each resident’s needs. This includes using short, clear phrases, maintaining eye contact, and speaking in a calm tone. In addition, we use gestures, pictures, and visual prompts to support understanding. Sometimes, simply holding a hand or offering a smile can be more reassuring than words.
Understanding patterns and keeping records
We keep detailed logs of behavioural incidents. This helps identify patterns — for example, if a resident becomes agitated at the same time each day, or when interacting with certain stimuli. This information allows us to make informed adjustments to care routines.
The value of personalised care
Each resident has their own history, preferences, and life experiences. We take time to learn what calms or distresses each individual. For example, music from a person’s youth, a favourite scent, or access to a garden can significantly improve mood and reduce agitation.
Involving families in behavioural support
Family members provide valuable insights into a resident’s history, routines, and preferences. Their knowledge helps us personalise care and avoid potential triggers. We involve families in care planning and regular updates to ensure a consistent approach.
Training makes all the difference
Our carers receive ongoing training in dementia care and behavioural management. They learn how to remain calm during challenging situations and how to use evidence-based strategies to support residents. This training empowers them to respond with empathy and professionalism.
Balancing safety with independence
We always aim to maintain residents’ independence while ensuring their safety. This balance is achieved by offering choices, encouraging participation in activities, and adjusting care based on ability. A sense of control helps reduce feelings of frustration and isolation.
At Durham Nursing Homes, we understand that challenging behaviour in dementia is not about being difficult — it’s about expressing unmet needs. By listening closely, acting early, and providing a calm, structured environment, we help residents live with greater dignity and comfort.
If your loved one is displaying signs of challenging behaviour and needs professional dementia support, contact our Nursing Homes. We’re here to offer expert care with compassion and understanding.
