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Quick reference

Why Is This Happening? A Quick Reference

Behavior is communication. Here is where to look when you can't tell what a hard moment is about, and what it is most often saying.

Start here · Before anything else

Their body, first

CheckNeeding the bathroom. Pain. Hunger. Thirst. Tiredness. Constipation. A new medication, or an old one working differently than it used to.
Especially whenThe change is new, sudden, or different from how they usually are.
Rule this out before you reach for any other explanation. When the body is the answer, every day spent on the wrong story is a day they're hurting and can't tell you.
Then look wider

Three more places to look

Who they've always beenTheir history, what they valued, the work they did, the routines that shaped their days before dementia.
What the disease may be changingMemory, language, and judgment shift in ways that reshape how they act right now.
What's happening around themNoise, the time of day, how many people are in the room, something that just happened, who just walked in.
These aren't a sequence. They're three angles on the same moment, and most hard moments have something from each.
Keep reading

What the behavior is often saying

Pain or an unmet needThe body speaks first, and it speaks loudest when nobody has listened yet.
FearNot knowing where you are, who someone is, or what is about to happen to you.
BoredomLong empty stretches with nothing to do and no role to play.
OverstimulationToo much noise, too many people, too many questions at once.
Pacing, refusing a bath, sundowning, asking the same question forty times. None of it is random and none of it is misbehavior.
Field card · Read

When you can't tell what's going on

What's happeningThe behavior is the message, and the body speaks first. Something is difficult for them, and this is how it's coming out.
DoCheck the body before you settle on a story. Then look wider, and ask what this is telling you before you ask how to stop it.
Say instead"He's not being difficult. Something is difficult for him. What changed, and did I check the body first?"
More information should raise your understanding, not hand you certainty. Stay curious after you land on a theory.
If the change came on suddenly

A sharp change over hours or days isn't dementia progressing. It's usually delirium sitting on top of the dementia, and it's often treatable. Start here instead, and call the doctor today.

Go deeper

This is the Read skill from The Steadier Ground Method. Section 3 of the free guide, "Diagnosed With Dementia: Now What?", covers it in full.