Coping With Complex Needs of Dementia & Behaviours That Challenge

Caring for a loved one that’s living with dementia can be challenging, and everyone’s journey is completely unique. Though filled with love and compassion, families quite often experience a mix of emotions, from grief to stress, and can lose patience with the person they’re caring for. As a person’s dementia develops, behaviours change and need to become more complex, often resulting in those closest to them searching for answers, reassurance and additional support. 

Barchester care homes provide supportive environments for people living with dementia, offering high-quality care and support to thousands of individuals and their families across the UK. With ongoing dementia training for all staff in our homes, our tailored care and support plans are up-to-date with best practices, and focus on a person’s life story and personal preferences, as well as their dementia care needs.

What Makes Dementia Needs Complex?

Dementia affects more than memory. It can change how a person thinks, feels, and interacts with the world. These changes can lead to behaviours that challenge people, like mood swings and confusion, making everyday care more demanding for families. 

Beyond Memory Loss: How Dementia Affects Behaviour

There are a number of things which dementia can affect, outside of memory loss. For example, you may notice your loved one becoming disorientated or off balance, which damages their independence. They may repeat questions, become agitated, or withdraw from activities they once enjoyed. It’s important in managing challenging behaviours to remember that these behaviours are part of the condition and not a reflection of who they are.

Understanding Changes in Personality and Perception

Through truly getting to know the people in our care and their unique personalities, our dementia care teams recognise when someone doesn’t seem like their usual selves and learn potential triggers that may lead to challenging behaviours. Families play a huge part in this too and are always involved in their loved one’s care.

Dementia can often alter how someone sees and understands their surroundings, and Barchester’s specialist dementia communities include visual prompts to help with perception through use of contrasting colours, and memorabilia or themed areas to support wayfinding.

Sometimes sounds or gestures can also be misinterpreted. For instance, someone living with dementia might hear the hum of a vacuum cleaner and believe it’s a growling animal, or they may see a friendly wave from a carer as an aggressive gesture. These misinterpretations can cause unnecessary worry, fear, or even defensive behaviour. Recognising these changes helps loved ones and carers to respond with empathy, and make necessary adjustments when managing behaviours that challenge.

Recognising Behaviours That Challenge

Some behaviours may appear alarming at first, such as shouting, pacing, or refusing care. However, these actions are often a response to something the person with dementia is experiencing rather than a deliberate choice. 

Pain, discomfort, confusion, or even feeling overwhelmed by their environment can all lead to behaviours that challenge. By looking beyond the behaviour itself and considering the possible causes, carers and loved ones can respond with greater understanding and compassion.

Aggression, Repetition, and Wandering

Aggressive outbursts or frustration can sometimes be the result of pain, discomfort, or an inability to communicate needs clearly. Repetition, such as asking the same question over and over, often reflects a search for reassurance or the comfort of routine. Wandering may not always be aimless. It can be a way of seeking something familiar, reliving past routines (such as going to work), or simply releasing restlessness. 

Hallucinations, Confusion, and Emotional Shifts

Your loved one might see or hear things that aren’t there, or experience sudden mood changes. These symptoms can be distressing, but understanding them is the first step to managing them.

Why These Behaviours Happen

Dementia changes how the brain processes information, which can make it difficult for those living with dementia to communicate, understand their surroundings and regulate emotions. Challenging behaviours in people with dementia usually happen because the person is trying to express unmet needs or emotions, or is experiencing changes to their routine. As a result, behaviours that might seem difficult are often signals of something deeper. Understanding dementia behaviour changes can help carers to minimise any distress their loved one might be experiencing but also to realise that this is not a reflection of how their loved one wants to behave.

Unmet Needs and Emotional Triggers

People with dementia may struggle to recognise or communicate basic needs. Something as ordinary as a headache, an infection, or even needing the toilet can become very distressing if they can’t put it into words. Pain, illness, hunger, thirst, or being too hot or cold can all trigger distress if the person can’t explain what’s wrong. 

As a person’s dementia progresses, care needs usually increase too – ensuring even the most basic needs are met when they are no longer able to communicate.

Environmental Factors and Changes in Routine

A noisy room or a change in daily routine can be overwhelming for a person living with dementia, and being in a calm, predictable environment can help to reduce distress. At Barchester, we have dedicated Memory Lane Communities which provide comfortable surroundings and are designed to promote way-finding and independence.

We carefully design lighting, colour schemes and furnishings to the highest standards, creating spaces that not only help residents feel orientated and at ease, but also provide a welcoming environment they can truly be proud to call home.

Everything in our Memory Lane communities has been carefully curated to help with moving someone with dementia into a care home. We understand how difficult this transition can be, so we want to make sure our environments can ease this process as much as possible.

How to Respond With Care and Confidence

Your response can make a world of difference. By staying calm and compassionate, you can ease distress and help your loved one feel safe, understood, and valued. Even small adjustments in the way you communicate or the environment you create can have a powerful impact.

Communication Tips and Calming Techniques

Speak slowly, use simple words, and maintain eye contact. Gentle reassurance and redirection can help soothe anxiety. Redirecting attention, such as guiding them toward a favourite activity, playing soft music, or changing the subject, can help ease frustration without confrontation.

Creating a Safe, Familiar Environment

Familiar surroundings help reduce anxiety and confusion. Displaying treasured photos, favourite ornaments, or familiar scents can spark positive memories and create a sense of comfort and belonging. Keeping routines consistent, such as mealtimes, walks, or bedtime rituals can also provide structure and security.

At Barchester, our person-centred approach to care includes maintaining independence, dignity and choice for as long as possible. Staffing levels reflect care and support needs and people living with dementia are offered a range of activities to help preserve life skills, support interactions and retain a sense of purpose and selfhood.

When to Seek Extra Support

Sometimes, professional help is the best way forward. Specialist dementia care is vital to retaining the greatest quality of life, ensuring the relevant levels of engagement are available. Barchester’s commitment to person-centred care guides how we deliver our specialist dementia support, particularly within our Memory Lane Communities. 

Knowing the Signs It’s Time for Professional Care

Coping with dementia's behaviour changes can be a struggle, especially as the condition develops over time. Dementia care in a specialist setting such as a Barchester home not only helps to give your loved one the best support, but it will provide you with peace of mind and relieves some of the pressure caring for a loved one brings. If your loved one’s safety is at risk, or if their needs exceed what you can manage, it may be time to consider additional support.  

How Care Homes Support Complex Dementia Needs

Specialist care homes like those offered by us at Barchester Healthcare provide tailored environments and expert staff. Our team understands the complexities of dementia and offers compassionate, personalised care.

It’s important that those living with dementia have the opportunity to enjoy life-enriching activities. Our activities team prepares a weekly activity plan which includes physical, mental and social stimulation, tailored to residents’ interests, abilities and cultural diversity – with each activity designed to enhance life skills and provide a feeling of purpose and self-worth. 

Food and hydration also form a huge part of a person’s general well-being, and as a person’s dementia progresses, changes in their tastes and appetite can change too. Our talented chefs create nutritious meals based on personal preferences and dietary requirements, with no request ever too much. Our teams ensure mealtimes are never rushed, and support people to dine with dignity using specialist cutlery if ever required.

You're Not Alone: Finding Help and Reassurance

Support is available for both you and your loved one. You’ll find a wide range of helpful resources in our Dementia Carers Support Guide, created with input from our dementia care specialists. And when the time comes to explore the move into a care home, our team is always here to talk through your options.

Support Networks and Expert Advice

We know it can be difficult to know where to turn after a dementia diagnosis, or when caring for a loved one living with the condition. That’s why many of our care homes work closely with local communities and dementia charities to host regular support groups and events, such as Dementia Cafés, which are free to attend. These groups provide practical advice, emotional support, and the chance to share experiences with others in a welcoming, relaxed setting.

Managing Dementia & Behaviour That Challenges FAQs

What behaviours are common in people with complex dementia needs?

Common behaviours include aggression, wandering, repetitive speech, hallucinations, and emotional outbursts. These often reflect unmet needs or confusion.

How do you manage the complex needs of people living with dementia?

A combination of our highly trained teams and approach to dementia care ensures that those living with dementia live in a safe and welcoming environment.

What can trigger distress in someone with complex dementia?

Triggers include pain, hunger, loneliness, unfamiliar environments, and changes in routine. Identifying and addressing these can help reduce distress.

How can families support a loved one with complex dementia needs?

Offer emotional support, maintain consistent routines, and seek expert guidance. Don’t hesitate to reach out to care professionals or support networks for help.