Dementia and Distressed Behaviour: How Behaviour Support Plans Work at Home

When someone lives with dementia, changes in behaviour can be one of the hardest things for families to manage. A loved one who was once calm may become agitated, suspicious, angry, or withdrawn. Sometimes they may shout, pace, resist personal care, or try to leave the house.

These behaviours are often described as “challenging”. However, they are usually a response to something—pain, fear, confusion, boredom, unmet needs, or a sudden change in routine.

A behaviour support plan helps you respond with structure and compassion. Instead of reacting in the moment, everyone follows the same agreed approach at home.

What Do We Mean by “Distressed Behaviour” in Dementia?

“Distressed behaviour” is an umbrella term for actions that may cause worry, distress, or risk to the person or those around them. It can include:

• Shouting, calling out, or verbal aggression

• Physical aggression such as hitting, pushing, or grabbing

• Repeated questioning or following someone around

• Wandering or trying to leave the house

• Refusing support with personal care or medication

Importantly, distressed behaviour is not deliberate misbehaviour. In many cases, it is the person’s best attempt to communicate or protect themselves in a world that no longer feels familiar.

Why Behaviour Support Plans Help at Home

Without a plan, families and staff can fall into a cycle of:

• Crisis moments

• Disagreements about what to do

• Guilt or helplessness afterwards

A behaviour support plan helps because it:

• Creates a shared understanding of what may be driving the behaviour

• Sets out specific strategies everyone can follow

• Reduces risk and improves safety

• Builds confidence through consistency

As a result, the person is more likely to feel secure—and carers feel less alone.

Step-by-Step: Creating a Behaviour Support Plan

A good plan starts with knowing the person, not just the behaviour.

1) Understand the person’s history and preferences

Begin by exploring:

• What kind of person were they before dementia?

• Which routines, hobbies, roles, or interests mattered most?

• Are there cultural, spiritual, or personal values to respect?

This background helps you interpret behaviour more accurately. It also makes care feel more familiar and dignified.

2) Spot triggers and early warning signs

Next, keep simple notes about distressed episodes, including:

• What happened just before the behaviour started?

• Who was present at the time?

• What time of day did it occur?

• Were there possible factors like noise, visitors, TV, hunger, thirst, pain, or fatigue?

Over time, patterns often appear. Then, you can focus on prevention—not just reaction.

3) Agree on strategies that work for everyone

Once patterns are clearer, agree on:

• What to do (for example, approach slowly, use a calm voice, offer choices)

• What to avoid (for example, rushing, arguing, too many questions)

• Distraction or comfort techniques that often help

• Safety steps if behaviour escalates

Finally, write the plan in clear, simple language so every carer can follow it.

Practical Strategies That Often Help

Every person is different. Still, some approaches commonly reduce distress at home.

Communication

• Use short, simple sentences

• Avoid long explanations

• Allow extra time for responses

Environment

• Reduce noise and clutter

• Adjust lighting to reduce shadows

• Remove obvious hazards where possible

Routine

• Keep daily patterns predictable

• Prepare for changes in advance

• Limit sudden surprises where you can

Activity and meaning

• Offer familiar activities linked to past roles and interests

• Build in gentle movement where appropriate

• Avoid long periods of boredom

Validation and reassurance

• Acknowledge feelings rather than arguing about facts

• Use supportive phrases like: “You seem worried—how can I help?”

The aim isn’t to “control” someone. Instead, it’s to reduce distress and protect dignity.

Keeping the Plan Alive and Under Review

Behaviour support plans are not one-and-done. They should change as the situation changes.

Review the plan when:

• Dementia progresses and needs shift

• New behaviours appear

• Old strategies stop working

Regular reviews with family, home care teams, GPs, or mental health professionals help keep the plan effective.

If behaviour becomes more frequent, severe, or risky, specialist advice may be needed—for example from dementia services, old age psychiatry, or behaviour support teams.

How Aeon Nursing Uses Behaviour Support Plans at Home

Our nurse-led teams use behaviour support planning to make daily care safer and more consistent. In practice, we:

• Work closely with families to understand the person behind the dementia

• Use behaviour support plans to guide communication and everyday support

• Train staff to respond calmly, consistently, and compassionately

• Link with memory services and mental health teams when needed

Distressed behaviour can be frightening and exhausting. With a thoughtful plan and a steady approach, it can often be reduced—and managed in ways that protect wellbeing for everyone at home.

Worried About Distressed Behaviour at Home?

If you’re struggling with changes in behaviour and don’t know what to try next, we can talk you through your options. We can also explain how behaviour support planning could help in your situation.

For an informal chat with our team, contact info@aeonnursing.co.uk.

Important Information

This article is for general career information only and does not form part of any job offer or employment contract with Aeon Nursing. Roles, duties and benefits described are examples only and may vary by position, location and service needs. All employment is subject to Aeon Nursing’s usual recruitment procedures, professional registration requirements and safeguarding checks. For current vacancies and full terms, please contact our recruitment team or visit our careers page.

Author & Content Writer: Dr Naeem Aslam