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# Caring for a person with dementia: communication, behaviours, wandering, safety and caregiver support

- Safe practice

Speak simply and with respect, look for the cause behind distress, keep routines and a safe space, prevent wandering and falls, and support the caregiver.

Updated Nov 13, 2026

## Key points

- Communicate face to face: eye contact before speaking or touching, simple words, one step at a time, yes/no questions, names instead of pronouns.
- Talk to the person as an adult; do not insist on correcting wrong memories.
- Distress, agitation or aggression: look first for pain, delirium, environment or inappropriate care, then use personalised activities.
- Evening confusion (sundowning): routine, calm activities, low noise at night, light enough to orient without shadows.
- Wandering and falls: supervised walks, identification, a safe environment; avoid restraints.
- Hospital admission increases delirium risk; ask the family for the person's usual routines and preferences.

## What it is

Dementia affects memory, thinking, communication, mood and behaviour, and the need for daily support grows as it progresses. Nursing care keeps the person's dignity and abilities for as long as possible: simple, adult-to-adult communication, routines, help with eating, hygiene and dressing, and a safe environment. Distress or agitation is a message: before any treatment, the team looks for causes such as pain, delirium, unmet needs or the care itself, and uses personalised psychosocial and environmental measures first. In hospital the risk of delirium is high. Family caregivers carry much of the care and need education, skills and support for their own health.

## What it requires

- A personalised care plan built with the person and family, including advance wishes.
- Structured observational pain assessment when the person cannot report pain.
- Glasses and hearing aids in use; regular eye and hearing checks.
- Psychoeducation and skills training for caregivers, and assessment for respite care.

## Components

- Communication and orientation.
- Daily care: eating and drinking, hygiene, dressing, toileting, sleep.
- Behaviour and distress: causes, personalised responses, safety.
- Caregiver support and planning ahead, including palliative care.

## How it is applied (and why)

- Reduce noise and distractions, make eye contact and say your name before speaking or touching — this avoids startling the person.
- Use short, simple sentences, a calm voice, known names and places, and choices with a visual cue; allow time to answer — this matches their pace.
- Break care tasks into small steps, guide gently and keep a regular routine for meals, hygiene and sleep — routine reduces confusion.
- Offer drinks often, supervise meals, reduce distractions at the table and use finger foods if utensils are hard — people with dementia forget to eat and drink.
- When distress appears, assess pain with an observational tool and look for delirium, hunger, thirst, toileting needs and the setting — behaviour signals a need.
- Respond with distraction, reassurance and personalised activities; do not argue or take it personally — psychosocial measures come before medicines.
- Prevent wandering and falls with supervised walks, a clear path to the toilet, good light and identification; avoid restraints — they raise injury and distress.
- Teach the caregiver what to expect, how to communicate and respond to behaviour and how to protect their own health, with respite — caregiver strain is common.

## In nursing practice

- A sudden change in confusion, alertness or behaviour suggests delirium: report it urgently.
- In dementia with Lewy bodies, antipsychotics can worsen movement and cause severe sensitivity reactions; report any planned use.
- Antipsychotics are reserved for risk of harm or severe distress, are reviewed regularly and are given only as prescribed.
- Check with the prescriber before any over-the-counter sleep aid: many worsen confusion.

## Common mistakes

- Speaking loudly or as if to a child.
- Giving many options or long instructions at once.
- Treating agitation with restraint before looking for pain or delirium.
- Ignoring the caregiver's exhaustion.

## Test yourself

Think of the answer, then tap the question to see it.

## What should the team do before treating distress in a person with dementia?

Do a structured assessment to explore the reasons and check for clinical or environmental causes such as pain, delirium or inappropriate care.

## Which three tips help when talking with a person with dementia?

Make eye contact before speaking or touching, use simple words and short sentences, and ask yes/no questions or give clear choices with a visual cue.

## What is sundowning and how can it be eased?

Increased confusion, agitation and poor sleep in the evening; a daily routine, calm evening activities, low night noise and suitable lighting help.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/nursing/caring-for-a-person-with-dementia-communication-behaviours-wandering-safety-and/)

## Elsewhere in DurgiPedia

- [Comprehensive geriatric assessment: function, cognition, falls](https://durgical.com/en/clinical-exam/comprehensive-geriatric-assessment-function-cognition-falls/)
- [Normal psychological ageing vs dementia](https://durgical.com/en/behavioral-science/normal-psychological-ageing-vs-dementia/)

## Connections

## Related 4

- [Nursing the older adult: functional assessment and geriatric syndromes](https://durgical.com/en/nursing/nursing-the-older-adult-functional-assessment-and-geriatric-syndromes/)
- [Preventing falls: risk assessment and measures](https://durgical.com/en/nursing/preventing-falls-risk-assessment-and-measures/)
- [Delirium: screening (CAM), prevention and nursing care](https://durgical.com/en/nursing/delirium-screening-prevention-and-nursing-care/)
- [Family assessment: structure, life cycle, genogram, ecomap and family APGAR](https://durgical.com/en/nursing/family-assessment-structure-life-cycle-genogram-ecomap-and-family-apgar/)

## Related conditions 5

- [Dementia (major neurocognitive disorder)](https://durgical.com/en/conditions/dementia/)
- [Alzheimer disease](https://durgical.com/en/conditions/alzheimer-disease/)
- [Vascular dementia](https://durgical.com/en/conditions/vascular-dementia/)
- [Dementia with Lewy bodies](https://durgical.com/en/conditions/dementia-with-lewy-bodies/)
- [Frontotemporal dementia](https://durgical.com/en/conditions/frontotemporal-dementia/)

[← All of nursing](https://durgical.com/en/nursing/)

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Dementia: assessment, management and support for people living with dementia and their carers (NG97), recommendations](https://www.nice.org.uk/guidance/ng97/chapter/Recommendations) (National Institute for Health and Care Excellence (NICE), 2018); [Dementia (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/dementia) (World Health Organization (WHO), 2026); [Dementia: daily care](https://medlineplus.gov/ency/patientinstructions/000030.htm) (MedlinePlus, U.S. National Library of Medicine, 2026); [Dementia: behavior and sleep problems](https://medlineplus.gov/ency/patientinstructions/000029.htm) (MedlinePlus, U.S. National Library of Medicine, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/caring-for-a-person-with-dementia-communication-behaviours-wandering-safety-and/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/caring-for-a-person-with-dementia-communication-behaviours-wandering-safety-and/