Top Tips for Identifying Stress and Distress in People with Dementia

April is Stress Awareness Month and Top Tips Tuesday will focus on stress and people with dementia each week.

Here are 20 Top Tips for spotting the signs of stress in people with dementia:

1. Remember the LAW: Listen – Attention – Watch. Observation is your superpower.
2. Notice changes rather than labels — “different from usual” is often a first clue.
3. Look for physical signs: pacing, fidgeting, restlessness.
4. Listen for vocal clues such as calling out, crying or groaning.
5. Pay attention to requests for loved ones (including those long passed away).
6. Notice “I want to go home” — often a need for comfort or safety, not geography.
7. Watch for changes in appetite or eating behaviour.
8. Observe any withdrawal or quietness — silence can communicate distress.
9. Spot new or unusual language, including swearing or racial slurs never used before.
10. Look for object-related behaviours like hiding items or moving belongings.
11. Pay attention to personal care refusals — often about dignity or discomfort.
12. Notice protective postures: crossed arms, flinching, stiffening.
13. Observe “aggression” as communication — frustration, fear or unmet needs.
14. Be aware of sundowning patterns — late-afternoon changes in mood or behaviour.
15. Monitor sleep changes — more, less or disturbed sleep may signal stress.
16. Notice social changes — avoiding groups or becoming overly dependent on one person.
17. Be curious about clothing changes (removing layers, refusing items).
18. Look for self-comforting actions like rubbing, rocking or repetitive movements.
19. Pay attention to sensory triggers — noise, busy spaces, lighting.
20. Always ask yourself: “What feeling might be underneath what I’m seeing?”

Next time, we’ll explore the idea of being a Dementia Behaviour Detective, creating a detective mindset and the 4 Ws before getting to the Why.  

The above Top Tips are taken from my course Dementia: Behaviour – A Challenge of a Gift and its accompanying E-book.

Book a Discovery Call to discuss your learning and development needs.