Ways to Handle Screaming and Crying in Dementia
Dementia can cause intense emotional outbursts
When caring for someone with Alzheimer’s or dementia, there may be times when they yell, scream, or cry.
They might yell “Help! Help!” at the top of their lungs or cry inconsolably for long periods of time. This can be disturbing and upsetting for both of you.
It can also be frustrating because the person with dementia can’t explain what’s causing their distress, they can’t or won’t stop the behavior, and you don’t know how to help.
We explain some common causes of screaming and crying in dementia and share 6 things you can do to immediately calm the situation. We also share 8 longer-term solutions that help reduce the frequency and intensity of these episodes.
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What causes screaming and crying in dementia
Screaming, yelling, and crying in dementia can be caused by a variety of reasons, including:
FearPhysical pain or discomfortBoredomFeeling overwhelmed, frustrated, overtired, or agitatedFeeling sadness or lossHallucinations, delusions, or deliriumSundowning symptomsLoud, busy environmentDepression
Typically, the distress or agitation that causes this behavior improves with non-drug methods, medication, or a combination of both.
6 immediate ways to handle screaming and crying in dementia
1. Stay calm Take a deep breath and stay as calm as possible. If you get upset, that unintentionally causes your older adult to get more upset because their body is subconsciously matching yours.
Breathe deeply and slowly, exhaling fully, to help calm both of you. Speak slowly and keep your voice soft, reassuring, and positive.
If they’ll accept it, use a gentle and calming touch on the arm or shoulder to give comfort and reassurance.
2. Identify the cause or trigger A crying or yelling episode could be triggered by something like pain, fear, frustration, or boredom. Take a moment to think about what happened just before it started and jot down your observations.
At first, these outbursts may seem random. But taking notes and keeping a dementia journal can give you the information you need to find patterns and identify triggers.
3. Observe and listen for clues Listen carefully to anything they might be saying to try to understand why they’re so upset.
For example, someone might say “Help! Help! I’m trapped!” or “No no no no no!” That could tell you that someone really wants to go outside or needs a change of scenery. Or something might be happening that’s making them feel scared or uncomfortable.
They might grab at their clothes or a certain part of their body, indicating that they’re cold or hot, feeling pain, or have a physical need like needing the toilet.
If they jab their finger at something, they could be frustrated trying to reach it or it could be causing agitation. Or they might keep pushing at something because it’s bothering them, like a mirror or something that’s loud or distracting.
Or, they might have hallucinations or paranoia that are making them anxious or scared.
4. Take care of physical needs Sometimes, screaming or crying is the only way the dementia brain knows how to ask for help. If it seems like there could be a physical cause for their distress, take care of it right away.
That could mean giving them a pain reliever (that’s been approved by the doctor), taking them to the bathroom, fixing something that’s causing pain or discomfort, or getting them a snack or drink of water.
Or it could mean changing something in their environment, like turning down loud music, turning off the TV, moving away from bustle or activity, or covering up mirrors or clutter.
5. Use calming techniques Reducing your older adult’s agitation gives you a chance to solve the problem or distract and redirect to a pleasant activity.
If you’ve been able to identify a clue to what’s causing the problem, use that information to calm the situation – take care of pain or a physical need, go outside for some fresh air, find an enjoyable activity, etc.
If you’re not sure what’s the problem is, try different calming techniques. You know your older adult best, so if there are things that often work to soothe them, try those first.
You could also try something like this calming technique from top dementia educator Teepa Snow.
6. Distract and redirect with comforting activities Since logic and reasoning don’t work with someone who has dementia, try “distracting and redirecting” instead.
That’s when you look for a moment when you can introduce a distraction and then gradually transition into an enjoyable activity.
For example, you might offer your hand so they’ll instinctively reach out and take it. That allows you to provide gentle, calming pressure in their palm while you stroke their arm and soothingly say “I think it’s time for a snack. Let’s get some [a food they like].” After eating the snack, suggest an activity you know they enjoy.
Another example is if someone is yelling that they’re trapped and need to get out. You might say “Oh no, that’s not good. Let’s get out of here right now. We just need to get your jacket.” While you both go to collect their jacket, stop and look out the window at a bird or squirrel, get a snack, or visit the toilet. After that distraction, work on redirecting them to an activity they’ll enjoy or if possible, take them outside for a breath of fresh air and change of scenery.
Comforting activity suggestions:
Listen or sing along to their favorite songsGo outside for some fresh air and a dose of nature – even if it’s just sitting near an open door or windowProvide comfort with a beloved pet, favorite stuffed animal, or baby dollGive the comfort of touch by holding hands or giving a gentle hand, shoulder, or back massageInvite them to “help” you with household tasks to give a sense of purpose. Simple, repetitive tasks are calming and make it easy for them to be successful. Examples include: folding hand towels, sorting coins, or “organizing” the kitchen junk drawer.Having a favorite snack or drink – this is especially helpful if your older adult might be thirsty or hungry
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