Why does dementia make you feel fearful and anxious?

People with dementia can sometimes feel anxious or fearful. There can be all kinds of reasons for this. In this article, we’ll explore what can cause feelings of fear for those who have dementia, and what can be done to help.

Dementia and feeling fearful

Dementia affects the brain, including the parts that help us process information, our environment and what’s going on around us. Living with dementia means you’re constantly living in a moving and changing world that can be hard to understand. It’s understandable that this can be frightening sometimes.

Fears are real 

Things that may seem perfectly logical and normal to someone who doesn’t have dementia can be confusing and even frightening to someone who does. This may cause what can seem like irrational fears, however, to the person with dementia these fears can seem very real.

Hallucinations

Sometimes, people with dementia can experience hallucinations – usually because their brain isn’t processing their environment as it normally would. Shadows, sudden movements in the edge of vision and even patterned surfaces can take on a new dimension. It’s easy for the brain to play tricks sometimes, and more so for those with dementia.

Memory and time-lapses

Dementia can also affect memory, so, it can be hard to recognise people, faces and events from the present and recent past. It’s possible that someone with dementia can slip into another time from their past, and become worried about events that are no longer happening. Or, they may become suspicious and fearful of people they don’t recognise.

Environment

If there is an atmosphere of tension in the home or a change in mood, someone with dementia can be extra sensitive to this. As they may have a limited way of expressing their feelings about this, it can manifest as anxiety or fear.

Not all fears are irrational

All of us have worries, anxieties and fears. This is the same for people living with dementia. It may be that they’re worried about just the same things as you are – such as what’s going on in the world, or their own lives and the people they love.

Medication

It’s also possible that medication could be causing anxiety or fear. It’s always worth checking with a GP for possible side effects of certain medications and if they could be contributing.

It’s likely that you may not always understand why someone feels anxious or fearful. It may also make you feel distressed, especially if you’re not sure how to help. There are things you can do to help ease that fear, even if you’re not sure of the exact cause.

Managing anxiety and fear

There are things you can do to help someone with dementia who’s feeling fearful, to feel better.

1. GENTLE EXPLANATION – provide some simple commentary on what’s going on and who people are, providing reassurance. Even simple things like ‘I’m just going to turn the lights up a little bit so we can see better.’ Or ‘your daughter Alice is here to visit you, she’s brought you some lovely flowers.’ Even if they can’t understand everything you’re saying, you can help calm the atmosphere with your tone of voice, body language and expression.
2. KEEP ROUTINES – providing routines can be reassuring and help calm anxiety and fear. Repeating daily activities at set times can foster a sense of security and order. This can be important for someone with dementia, who may feel disorientated in this new world they’re getting used to.
3. REASSURE – offer reassurance, using calming phrases like ‘You’re safe here’, ‘I’m sorry that you’re upset’ and ‘I’ll stay until you feel better’.
4. LISTEN – try to figure out what the source of the fear is. Be understanding, without being patronizing or contradicting.
5. ACTIVITIES – activities such as art, music, walking or other activities can be relaxing and can help take their mind off anxieties.
6. DON’T REACT – don’t show anger, argue, criticize or ignore. Try to stay calm and collected.

Does a person with dementia know they have it?

This can depend on the person, the type of dementia and the stage of dementia. Not understanding why you’re feeling confused can be a source of anxiety. Likewise, understanding that your brain is declining can also be upsetting and scary.

It’s best not to remind someone they have dementia when you’re dealing with anxiety or fearful behaviour. Saying things like, “oh it’s just your dementia” may not make sense to someone, or could make the situation worse.