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When Dementia Looks Like Aggression: What Behaviour Is Really Saying & How to Respond
If you’ve ever supported someone living with dementia and been faced with shouting, swearing, hitting, or refusal of care, this episode is for you.
In this solo episode, Andy Baker unpacks one of the most misunderstood areas of dementia care: behaviour that looks aggressive but is almost always communication driven by distress. Drawing on years of experience in behaviour support, Andy helps caregivers, teachers, and parents move away from labels like “challenging” or “difficult” and instead understand what the behaviour is trying to say.
You’ll learn why dementia affects far more than memory, how fear, pain, confusion, trauma, overstimulation, and even poor care practice can drive behaviour — and most importantly, what to do in the moment. Andy shares a simple, practical three‑step response framework and language you can use immediately to de‑escalate situations while protecting your own wellbeing.
This episode is especially valuable for anyone feeling exhausted, overwhelmed, or unsure whether they’re “handling things right”.
⏱️ Episode Chapters (Timestamps)
00:00 – Aggression or communication? Reframing behaviour in dementia
00:49 – Why dementia affects personality, perception, and processing
01:10 – Why behaviour becomes the fastest communication channel
02:22 – Fight, flight, and the safety of saying “no”
03:30 – From “challenging behaviour” to “distress behaviour”
04:19 – Hidden drivers: pain, fear, trauma, overstimulation, under‑stimulation
05:12 – When behaviour isn’t dementia — it’s poor care
06:07 – A simple 3‑step response framework
06:29 – Step 1: Pause, protect, and regulate yourself
06:58 – Step 2: Scan for unmet needs (HELP model)
07:31 – Step 3: Adjust, connect, and reduce distress
08:13 – What to say when someone is frightened or overwhelmed
09:05 – The HEART approach: Hear, Empathise, Align, Reassure, Transition
10:26 – Why “calm down” doesn’t work
10:51 – Caregiver regulation and burnout
11:52 – The core message: behaviour is communication
12:22 – Resource: Targeting the Positive
🧩 Three Key Takeaways
Aggression in dementia is rarely intentional
What looks like defiance or hostility is often a terrified brain trying to cope with confusion, pain, or fear.
Behaviour makes sense when you understand the context
Distress behaviours are often driven by unmet physical, emotional, cognitive, or environmental needs — not the diagnosis itself.
You can’t calm someone else if you’re dysregulated
Supporting distress starts with your own regulation. Compassionate care requires supported carers.
🛠️ Resources Mentioned
Targeting the Positive with Behaviours That Challenge by Andy Baker
A practical, person‑centred guide to understanding and responding to distressed and dysregulated behaviour across dementia, trauma, neurodiversity, and mental health.
Click here to find out more
🎯 Why Listen to This Episode?
You’re supporting someone with dementia and struggling with aggression, refusal, or distress
You want practical language and tools, not theory
You’re tired of feeling blamed, judged, or unsure
You want to support others without losing yourself
You believe behaviour has meaning — and want to understand it better
This episode offers reassurance, clarity, and immediately usable strategies grounded in empathy and realism.
🔗 Connect with Able
📲 Instagram: @AbleTraining
📲 LinkedIn: Able Training
📲 TikTok: @AbleToCarePodcast
🌐 Website: Able Training
View all episodes
By Able Training Support LtdIf you’ve ever supported someone living with dementia and been faced with shouting, swearing, hitting, or refusal of care, this episode is for you.
In this solo episode, Andy Baker unpacks one of the most misunderstood areas of dementia care: behaviour that looks aggressive but is almost always communication driven by distress. Drawing on years of experience in behaviour support, Andy helps caregivers, teachers, and parents move away from labels like “challenging” or “difficult” and instead understand what the behaviour is trying to say.
You’ll learn why dementia affects far more than memory, how fear, pain, confusion, trauma, overstimulation, and even poor care practice can drive behaviour — and most importantly, what to do in the moment. Andy shares a simple, practical three‑step response framework and language you can use immediately to de‑escalate situations while protecting your own wellbeing.
This episode is especially valuable for anyone feeling exhausted, overwhelmed, or unsure whether they’re “handling things right”.
⏱️ Episode Chapters (Timestamps)
00:00 – Aggression or communication? Reframing behaviour in dementia
00:49 – Why dementia affects personality, perception, and processing
01:10 – Why behaviour becomes the fastest communication channel
02:22 – Fight, flight, and the safety of saying “no”
03:30 – From “challenging behaviour” to “distress behaviour”
04:19 – Hidden drivers: pain, fear, trauma, overstimulation, under‑stimulation
05:12 – When behaviour isn’t dementia — it’s poor care
06:07 – A simple 3‑step response framework
06:29 – Step 1: Pause, protect, and regulate yourself
06:58 – Step 2: Scan for unmet needs (HELP model)
07:31 – Step 3: Adjust, connect, and reduce distress
08:13 – What to say when someone is frightened or overwhelmed
09:05 – The HEART approach: Hear, Empathise, Align, Reassure, Transition
10:26 – Why “calm down” doesn’t work
10:51 – Caregiver regulation and burnout
11:52 – The core message: behaviour is communication
12:22 – Resource: Targeting the Positive
🧩 Three Key Takeaways
Aggression in dementia is rarely intentional
What looks like defiance or hostility is often a terrified brain trying to cope with confusion, pain, or fear.
Behaviour makes sense when you understand the context
Distress behaviours are often driven by unmet physical, emotional, cognitive, or environmental needs — not the diagnosis itself.
You can’t calm someone else if you’re dysregulated
Supporting distress starts with your own regulation. Compassionate care requires supported carers.
🛠️ Resources Mentioned
Targeting the Positive with Behaviours That Challenge by Andy Baker
A practical, person‑centred guide to understanding and responding to distressed and dysregulated behaviour across dementia, trauma, neurodiversity, and mental health.
Click here to find out more
🎯 Why Listen to This Episode?
You’re supporting someone with dementia and struggling with aggression, refusal, or distress
You want practical language and tools, not theory
You’re tired of feeling blamed, judged, or unsure
You want to support others without losing yourself
You believe behaviour has meaning — and want to understand it better
This episode offers reassurance, clarity, and immediately usable strategies grounded in empathy and realism.
🔗 Connect with Able
📲 Instagram: @AbleTraining
📲 LinkedIn: Able Training
📲 TikTok: @AbleToCarePodcast
🌐 Website: Able Training