When Words Fail: Understanding Dementia-Related Responses

I recently caught up with a friend, and she shared something that had been weighing on her mind. Her easygoing 81-year-old father had become argumentative lately. She described how simple conversations would sometimes take an unexpected turn. If she asked him a question, he’d snap back with, "Why are you asking me that?" or insist, "Of course, I know that!"

At first, she chalked it up to aging, and was surprised when I suggested that it might be a sign of cognitive decline or dementia. "He seems fine," she told me. "I haven’t noticed any big changes in his memory. He still manages everything okay."

I pressed a little further. " Does he stick to the same routine every day without much variation? Does he say he’ll do something but then never follow through?" 

She paused. "Well, yes..."

Recognizing Behavioral Changes 

Many people assume that memory loss is the first and most obvious sign of dementia, but behavioral changes can also be early indicators. In my friend’s case, her father’s defensiveness could be his way of expressing frustration—perhaps he’s aware that he’s struggling but isn’t ready to acknowledge it. Maybe he’s having trouble keeping up with the conversation, finding the right words, or processing information. His argumentative responses could be an emotional reaction to these challenges.  She hadn’t noticed any memory changes because as long as he  followed a routine, he could manage well on his own. 

Behavior as a Form of Communication 

As dementia progresses, verbal communication often becomes more difficult. Feelings of confusion, fear, frustration, or anxiety can manifest in unexpected behaviors. While these moments can be challenging for caregivers, they are also opportunities to understand what’s really going on beneath the surface.

A colleague of mine once shared a similar concern about his mother. Some days, she refused to get up from her armchair. The family assumed she just wasn’t feeling well, so they got her a cushion and a standing rail to help—but nothing changed. When they tried to assist her, she resisted.

"Has she ever fallen before?" I asked.

He thought for a moment. "Actually, yes. A few months ago."

Her reluctance to stand might not have been about physical pain, but rather fear—fear of falling again and getting hurt. I suggested that the next time they help her up, they take it slow, reassure her that she’s safe, and talk her through each step as they support her.

Strategies for Responding to Dementia-Related Behaviors 

If you’re navigating similar situations with a loved one, here are some gentle and effective ways to respond:

1. Check Their Basic Needs First 

   Sometimes, agitation or confusion stems from something simple—hunger, thirst, discomfort, needing the restroom, or fatigue. Before reacting, take a moment to assess their basic needs.

   
   

2. Acknowledge Their Emotions 

   Even if their feelings don’t seem to match the situation, they are real to them. Validating their emotions can help:

   • "It sounds like you’re really worried. I’m here to help."

   • "I can see that this is upsetting for you."

   • "That sounds frustrating—tell me more."

3. Avoid Arguing or Using Logic 

   It’s natural to want to correct a misunderstanding, but logic often doesn’t help and can escalate frustration. Instead, go along with their reality and gently redirect:

   • If they insist they need to go to work (even if they retired years ago), try saying, "That’s important. Let’s have some breakfast first, and then we’ll figure it out."

4. Offer Reassurance and Comfort 

   They may feel unsafe or uncertain—even in familiar surroundings. Small gestures can make a big difference:

   • Speak in a calm, soothing tone.

   • Offer a reassuring touch, like placing your hand on theirs.

   • Let them know they are safe: "I’m here, and I’ll take care of everything."

5. Keep Communication Simple 

   Complex instructions can be overwhelming. Try:

   • Giving one-step directions.

   • Offering simple choices: "Would you like water or tea?"

   • Allowing extra time for them to respond.

     
     

6. Give Them Space When Needed 

   If tensions rise, it’s okay to step away. A short break can help both of you reset. If safe, leave the room for a few minutes and return with a warm smile.

   
   

7. Look for Patterns 

   Pay attention to when certain behaviors occur. Are they more anxious at specific times of the day? Do particular situations trigger frustration? Identifying patterns can help you anticipate and prevent distressing moments.

Caring for someone with dementia requires patience, compassion, and flexibility. While there will be challenging moments, approaching them with understanding can make all the difference. Your loved one may not always remember what you say, but they will always feel the warmth and kindness in how you say it.

If you need support, Mellie is here to help. Reach out to learn about the resources available for family caregivers.