When Behaviour Is Really Communication: Understanding Pacing, Repetition and Restlessness in Dementia
Sometimes anxiety in dementia does not look the way we expect it to.
Instead, it may look like:
pacing
restlessness
moving things around
checking cupboards or drawers
repeatedly asking questions
following family members around
becoming irritated or unsettled
These experiences are often labelled as “challenging behaviour”.
But when we pause and really think about them, so many begin to make sense.
What if someone is trying to feel safe again?
Imagine not fully trusting your memory anymore.
Not always being certain:
what day it is
what should happen next
whether you’ve forgotten something important
whether you might upset somebody you love
Wouldn’t that create anxiety for most of us?
Sometimes pacing is not “wandering”.
Sometimes it is somebody trying to regulate themselves.
Don’t many of us “potter” when we feel unsettled? Tidying surfaces, walking around the house, rearranging things, opening cupboards - not necessarily because something needs doing, but because movement helps us process stress.
For somebody living with dementia, moving things around may sometimes be an attempt to make the environment feel more familiar or manageable again.
Repetition is often reassurance-seeking
Repeated questions can understandably become exhausting for families.
But often repetition is rooted in worry rather than memory alone.
Someone may ask repeatedly because:
they are anxious about forgetting
they need reassurance
something feels unresolved
they are uncertain about what happens next
How we respond matters enormously.
If someone is met with frustration or exasperation, confidence can quickly reduce further.
But warmth, reassurance and calm responses help someone feel emotionally safe.
Fear of getting things wrong
One of the things I often notice is how worried many people living with dementia become about upsetting the people helping them.
There can be huge fear around:
getting things wrong
being a burden
saying the wrong thing
forgetting names or information
losing independence
When we understand this, we naturally become gentler in how we respond.
Instead of:
“Stop pacing.”
“You’ve already asked me.”
“You don’t need to move things.”
We might instead say:
“You seem unsettled.”
“Shall we walk together?”
“You’re safe.”
“There’s nothing you need to get right right now.”
Behaviour is communication
One of the most important principles in person-centred dementia care is recognising that behaviour is communication.
Very often, people are showing us what they need:
reassurance
familiarity
connection
comfort
emotional safety
reduced overwhelm
The goal is not controlling behaviour.
The goal is understanding what sits underneath it.
And when people feel understood, distress often reduces naturally.
If you would like support around dementia communication, anxiety or person-centred approaches, I offer dementia education and consultancy for families, community groups and care providers.
Find out more here:
Fran Hamilton Dementia Support and Education