Understanding and supporting the needs of persons living with dementia

Posted: February 22, 2021

Memory Support

Understanding The Evolving Needs Of A Person Living With Dementia

Dementia is a collection of symptoms that cause brain change, affecting cognition, memory, language, sensory and functional abilities. These changes can be frightening and frustrating for persons living with dementia; and may lead to outbursts, self-protective actions, changes in personality and withdrawing from people and daily activities. Supporting people with dementia can be very difficult for caregivers and family members.

A person living with dementia may experience a variety of changes as they progress in their dementia journey. These changes are expressed in different ways, and are often labeled as “behaviors.” We refer to these behavior expressions as unmet needs or distress. As care partners, it is our job to be the best unmet need “detectives” to understand and identify these needs, their triggers and the best way to fulfill each individual’s need.

Changes to the Brain and Body

Dementia is the loss of cognitive functioning that interferes with a person’s daily life and activities. There are many illnesses and conditions that cause dementia, including Alzheimer’s Disease. To best care for and support a person living with dementia it is important to have a diagnosis from a medical professional. This can help identify the type of dementia symptoms and even offer some medication to reduce symptoms such as delusions and hallucinations.

It is normal for our hearing and vision to change as we age. For someone who is living with dementia, these changes are more acute. An individual might reach and grab for objects that are not there or startle easily when you enter a room because they didn’t hear you approaching. They may have trouble eating or drinking because they can’t see their food or utensils, due to severe vision changes. This can lead to hunger or dehydration, anger and withdrawal without supportive care.

People living with dementia may experience frequent falling, hallucinations, and excessive sleep, which could be symptoms of a UTI, or Urinary Tract Infection. According to the Alzheimer’s Association, women are more prone to ‘silent UTIs’ often experiencing no symptoms of pain, but displaying profound changes in activity and demeanor.

Communication challenges are common in many types of dementia. The inability to find the right words, can cause feelings of frustration which may lead to emotional outbursts. Difficulties communicating about pain or discomfort, or embarrassment over incontinence can also trigger an expression of an unmet need.

Environmental Triggers

It can be difficult for individuals living with dementia to make sense of their environment. Even a person who has been living at home for many years can wake up one morning and not recognize their home. This may cause much anxiety and fear for that person and for their caregiver.

Unmet needs such as expressions of aggression (self-protective acts) and agitation can occur when a person living with dementia transitions into a new unfamiliar environment, such as going to a doctor’s office. Changes in routine can also trigger an emotional response. A cluttered and disorganized space is ‘visual noise’ that can lead to hoarding and rummaging. As an unmet need detective, what do you think is the feeling that driving the person living with dementia to hoard and rummage? What might you as the caregiver do to reduce that person’s distress and meet their need? Read more on how to help declutter and organize the living space for someone living with dementia.

Identifying Unmet Needs

Hunger, pain, dehydration, the environment, fatigue, and chemical imbalances may lead to expressions of unmet needs. When someone living with dementia begins to act uncharacteristically, don’t just assume it is a symptom of their disease. Delusions, hallucinations, wandering, sleep or appetite changes are also expressions of an unmet need.

To begin addressing unmet needs, it is vital to check basic needs first, such as hunger, toileting, discomfort, or pain, then address those needs. If a person living with dementia is experiencing emotional distress, sometimes redirection or a change of activity, like going outside or putting on calm music can help reduce the distress.

Boredom, loneliness, lack of social interaction, and the lack of purposeful activity are also unmet needs. If this is what your loved one is experiencing, you might consider a memory support community that can provide meaningful social interaction and offer a variety of activities that will add a sense of purpose to their days. Read more about how to know if it is time to consider a memory support community..

Tips for Caregivers

Knowing your loved one’s history and present interests and preferences, being proactive and creating routines and habits, knowing what calms your loved one, is essential to understanding unmet needs and reducing distress. A person with combative and disruptive episodes can be frightening and emotionally exhausting for caregivers. Once the situation has been diffused and the person is safe, it’s important to take time to calm yourself and decompress. During an episode, you may lose your patience and say things you don’t mean or regret. Be kind to yourself, and take a few deep breaths. Forgive yourself. You are not alone in this journey. This is hard!

Creating a calm environment, avoiding environmental triggers, and monitoring personal comfort can help prevent agitation. Read more from the Alzheimer’s Association about dementia-related behaviors and tips for family caregivers..

Person-Centered Dementia Support

Dementia is more than just memory loss. It causes changes in mood, judgement and personality, balance, perception, language, and vision. These changes often require increased structure and routine as well as additional care and support to meet the needs of a person living with dementia. At Walnut Crossing, our Marysville dementia care services strive to be the anchor that keeps your loved one connected to their unique personality, purpose and joy. Here, we are committed to individualized person-centered care, creating meaningful relationships with each resident, and supporting families and residents to find joyful connections.



Our Rhythms Dementia Philosophy and Program recognizes that dementia changes the way a person experiences the world around them. Our job is to create environments where each person can navigate the world successfully and create worlds where life is worth living. We are committed to honoring people wherever they are in the rhythm of their life.



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