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Am Fam Physician. 2016;94(4):online

See related article on behavioral disorders in dementia

What kinds of problems do people with dementia have?

Dementia (duh-MEN-shuh) is a medical problem where the brain loses abilities over time. People with dementia have trouble with memory and can have changes in their personality and in the way they act. People with dementia might not want to do things they used to like. They may not talk as much as they used to, and they might be tense or nervous. They might be sad, cry easily, or have trouble sleeping and eating. These problems can be helped with support from family members and by being in a safe environment.

Many people with dementia will have problems called psychotic (sie-COT-ik) symptoms. They might believe, see, or hear things that are not real. They might argue with you if you try to reason with them. Many people with these problems get upset and say they want to go home, even if they are already home. They might say they are going to visit someone who has died. If someone you know who has dementia has these problems, it does not mean he or she is mentally ill.

Will these problems get worse?

As the dementia gets worse, these problems happen more often. They are caused by the same things that cause the memory loss. Other illnesses may make the problems worse. The problems may get worse no matter what is done to treat them.

Can my doctor tell if some other illness is causing the problems?

It is important to find out if these changes are because of an illness or a reaction to medicine. If someone in your family starts acting differently, take him or her to the doctor. The doctor will want to know when the problems started and will ask other questions to find out how the problems are affecting the family.

How are these problems treated?

Watch for things that trigger the problems, and do your best to avoid them. Teach your family to compromise and not argue with a person who has dementia. It is important that family members make things as easy as possible for the person who has dementia. Medicines can be used if behaviors are dangerous. They might help make the problems a little bit better, but they usually do not cure dementia.

What should I expect?

Some people with dementia can be helped by having set routines. They should eat meals at the same times each day, and go to bed and wake up in the same place and at the same times. You should avoid making big changes around the house.

As the disease gets worse, people with dementia will not be able to take care of themselves, make others understand them, or even walk. Family members may need to get extra help to care for their loved one. This might mean putting him or her in a nursing home.

Can I do anything to stop these problems?

No. These problems are part of dementia. The anger and confusion that your family member feels are part of the illness. It does not mean their feelings about you have changed.

Where can I get more information?

Your doctor

The Alzheimer's Association

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