Dementia Personality Changes: Early Signs, What to Expect, and How to Cope

In this article, you’ll learn about the changes your loved one is exhibiting, how to support them through these changes, and what these changes might mean for the future care of your loved one.

Dementia symptoms are the result of damage to the brain — neurons damaged for a variety of reasons lose their ability to communicate properly. As the problem grows more widespread, you may notice behaviors in your loved one that would otherwise be inconsistent with who they were prior to the disease’s onset. While symptoms may be expressed differently across men and women, there are some general symptoms to stay aware of as a caregiver.

Each lobe of the brain is responsible for different mental faculties, and damage to each results in different symptoms:

• The frontal lobe is the part of the brain responsible for intelligence, judgment, and behavior. Damage here can result in aggression, paranoia, and other extreme changes. These changes are often the ones that cause the most distress to caregivers and family members.
• The temporal lobe is the seat of memory, and much of the memory loss, which is the symptom people are most familiar with, is due to damage in this region.
• The parietal lobe is responsible for language. When the parietal lobe is damaged, your loved one may struggle with word recall. This is why you may notice your loved one becoming tongue-tied and struggling to communicate their thoughts.^[01]

Knowing how to respond to unexpected personality changes will help you keep your loved one safe as you strive to understand and help them regulate their emotions.

Let our care assessment guide you

The initial symptoms of dementia are often more straightforward and expected: Anxiety, depression, confusion, and irritability are all common. As dementia progresses and begins to affect different areas of the brain, including the frontal lobe, you may notice more extreme changes in your loved one’s behaviors. Knowing how to cope with your loved one’s unpredictable behaviors can make a big difference in quality of life for you and your loved one.

Lowered inhibitions

A common personality change in dementia patients is diminished impulse control. This can manifest as saying or doing inappropriate things, such as making rude comments about other people, undressing, or even acting out in sexual ways.^[02]

What to do:

Strive to not take things too personally. Your loved one may say unkind things when they are agitated, afraid, or confused. Do your best to remember that their behaviors are symptoms of their illness. Though their words and actions may seem malicious, they don’t mean to hurt you.

Irritability and restlessness

Your loved one with dementia may become easily agitated or have trouble sitting still. It’s quite common for unsupervised dementia patients to wander, or even leave the home.  You may also find that they are prone to pacing within the home.

What to do:

If your loved one needs to pace, do your best to let them. It may be difficult to get used to at first, but be patient with yourself and with your loved one. Make sure they have a safe pathway in the home to pace, and do your best to keep them hydrated and fed so that they don’t become too exhausted or lose excessive weight.

Compulsive behavior

Some people with dementia exhibit behaviors that may not make sense to us. A few common ones are repeating certain behaviors or hoarding food and other items.

What to do:

Redirect them. If your loved one is stuck in a mental loop or remains fixated on something, change the subject. Get them focused on an activity or a small household task. Remember that it’s OK to make up a little fib to put their mind at ease, if the occasion calls for it.^[03]

Aggression

Your loved one may become agitated to the degree that they begin hitting or biting. These types of behaviors may be most common during bathing and grooming or other personal care tasks that make the care recipient feel as though they don’t have control or privacy or that they are being violated.

What to do:

Address their feelings rather than their words. Instead of arguing with your loved one or taking what they say at face value, try to gently get underneath their words to find out what need is driving them. Perhaps they are agitated because they are uncomfortable, not feeling well, hungry, cold, or in pain. A reassuring touch on the hand or arm and a few gentle questions may help to calm them enough to tell you what they need.

If your loved one is not able to communicate well, try to be as observant as possible in instances that have previously resulted in aggression. Look for triggers that you can address to head off any potential future problems. For example, if it’s been a while since a meal, have a variety of small snacks handy. If your loved one seem restless, be prepared to take a walk, maybe even around the block.^[02]

If your loved one is prone to hitting or biting, be prepared to incorporate redirection. Put something in their hands that can’t hurt them or you, or get them focused on a safe activity. If you can do so without compromising your loved one’s safety, step away and give yourself a few minutes to reset.

Rapid changes in mood

The changes that occur in a dementia patient’s brain can make it difficult for the person to regulate their emotions. You may notice your loved one becoming frustrated quite suddenly or having outbursts of anger. They can also exhibit sadness or worry more readily than they once did.^[03]

What to do:

Take care of your own mental health. As a person with dementia loses their emotional faculties, they often mirror the emotions of those around them. If you are anxious, stressed, or agitated, it may increase your loved one’s own distress. Eat well, get plenty of sleep, take breaks, build a good support system, and do whatever you can to manage your own stress as you care for your loved one.

While such personality changes in people with dementia are common, they’re not guaranteed to occur. Which behaviors your loved one exhibits may depend on their specific type of dementia and how it develops, as well as their environment, routine, and other external factors.

Talk with a Senior Living Advisor

Knowing to expect personality changes in your loved one with dementia can help alleviate some of your anxiety. However, some changes may create more serious situations.

• The person with dementia may cause harm to themselves or others. Make sure your loved one does not have access to sharp objects, medications, or items that could cause them or someone else harm.
• The person with dementia may wander or run away. Keep all doors of the home secured. You can install motion detector alarms on the doors or install other safety features designed for securing the homes of individuals with dementia. Let a neighbor know that if they see your loved one exiting the home unsupervised, they should call you or another emergency contact immediately.
• The symptoms, particularly delirium and confusion, occur suddenly and persist for longer than usual. A sudden onset of behavioral changes and other dementia-like symptoms may indicate that something else is going on. Confusion and disorientation can be caused by a urinary tract or other type of infection, medications, dehydration or malnourishment, sleep deprivation, or other physical problems. If your loved one’s symptoms seem particularly unusual or drastic and persist for more than an hour or two, or they are accompanied by a fever, call your loved one’s doctor and explain the situation. Their physician may recommend you bring your loved one into the office or to an urgent care center. Or, if you are able to connect with the physician via telemedicine, they may be able to help you identify the cause through the process of elimination.

If your loved one’s behavior is often aggressive, unsafe, or more than you’re able to manage, it may be time to consider other care options. An in-home caregiver can offer part-time respite care to give you a break during the week, or more full-time care for your loved one to age in place. If your loved one is no longer able to live at home, memory care may be a good fit for them. A Senior Living Advisor at A Place for Mom can help you find the right fit for your family.