Understanding Behaviour Guide
Learn to recognize that behaviour is a form of communication and develop compassionate, effective responses to common behaviours encountered in dementia care.
Core Principles of Behaviour Analysis
Behaviour is Communication
- • All behaviour has meaning
- • Look beyond the action to understand the message
- • Consider what needs might be expressed
Person-First Approach
- • Focus on the person, not the behaviour
- • Consider the individual's history and preferences
- • Recognize that behaviours are not deliberately difficult
Environmental Factors
- • Assess how the environment might contribute
- • Consider triggers that may prompt certain behaviours
- • Adapt surroundings to support needs
Behaviour Analysis
Agitation and Restlessness
Pacing, fidgeting, or appearing anxious and unable to settle
Possible Causes
- • Physical discomfort or pain
- • Medication side effects
- • Overstimulation from noise or activity
- • Unmet needs (hunger, thirst, toileting)
- • Feeling lost or insecure
Select Your Approach
Practical Tips for Responding to Behaviours
Do
- ✓ Look for patterns in when behaviours occur
- ✓ Consider physical causes first (pain, hunger, etc.)
- ✓ Respond with calm, reassuring communication
- ✓ Adapt the environment to reduce triggers
- ✓ Use validation rather than correcting or arguing
- ✓ Document behaviours to identify patterns
Don't
- ✗ Take behaviours personally or as intentional
- ✗ Argue or try to use logic to correct
- ✗ Rush or force compliance with care
- ✗ Use restraint or punishment for behaviours
- ✗ Label the person as "difficult" or "problematic"
- ✗ Overmedicate to manage behaviours without trying other approaches first
Professional Assessment Tools
Use these evidence-based tools to systematically assess and respond to behaviour changes, aligned with NICE NG97 guidance.
ABC Behaviour Chart
Systematic recording of Antecedent → Behaviour → Consequence to identify patterns and triggers.
A - Antecedent (What happened before?)
Time, location, people present, activities, environment
B - Behaviour (What exactly happened?)
Specific, objective description without interpretation
C - Consequence (What happened after?)
Response from staff/family, outcome, resolution
📋 Printable ABC Chart Coming Soon
Pain Assessment
Unrecognised pain is a common cause of behaviour changes in dementia.
PAINAD Scale Indicators:
- • Breathing patterns (laboured, rapid)
- • Negative vocalisation (groaning, crying)
- • Facial expression (grimacing, frowning)
- • Body language (tense, guarding)
- • Consolability (unable to comfort)
Action Required:
Score ≥2: Consider pain relief and medical review
De-escalation Pathway
Assess Safety
Ensure immediate safety for all. Remove or reduce triggers if possible.
Validate Feelings
"I can see you're upset" - acknowledge without agreeing or disagreeing.
Redirect Attention
Use meaningful activities or familiar topics to shift focus.
Follow Up
Monitor, document in ABC chart, and review patterns.
⚠️ Anticholinergic Burden Check
High-Risk Medications:
- • Antihistamines (e.g., diphenhydramine)
- • Tricyclic antidepressants
- • Antipsychotics (especially older ones)
- • Bladder medications (e.g., oxybutynin)
Signs of Anticholinergic Effects:
- • Increased confusion
- • Dry mouth, constipation
- • Drowsiness or agitation
- • Increased fall risk
🔍 Always collaborate with pharmacist to review medication burden when behaviour changes occur.
Choose Your Next Module
Continue your learning journey with any of our interactive training modules
Interactive Dementia 101
Foundation knowledge & understanding
Sensory Shift Empathy
Experience sensory changes
Communication Builder
Effective communication techniques
Understanding Behaviour
Behaviour as communication
Person-Centred Care
Individual preferences & dignity
Safety & Environment
Creating supportive spaces