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.

What causes screaming and crying in dementia

Screaming, yelling, and crying in dementia can be caused by a variety of reasons, including:

Typically, the distress or agitation that causes this behavior improves with non-drug methods, medication, or a combination of both.

crying in dementia

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 songs
  • Go outside for some fresh air and a dose of nature – even if it’s just sitting near an open door or window
  • Provide comfort with a beloved pet, favorite stuffed animal, or baby doll
  • Give the comfort of touch by holding hands or giving a gentle hand, shoulder, or back massage
  • Invite 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

8 longer-term ways to handle screaming and crying in dementia

1. Ask their doctor to review all their medications
Sometimes, side effects from a medication or combination of medications can cause disorientation and distress. That includes anything they might be taking, not just prescription drugs.

Ask their doctor or pharmacist to review their full list of prescription medications, vitamins, over-the-counter medications, and supplements.

2. Pain management
Pain that isn’t well managed can cause someone with dementia to frequently scream or cry. Talk with their doctor to find out if their current pain management treatment needs adjustment.

Be especially mindful if someone is still recovering from surgery (seniors can take much longer to heal) or if they have a chronic condition like arthritis that causes pain.

3. Identify possible triggers and test your theories
Review your notes to see if you can find any patterns or triggers to their outbursts.

Think about ways you can avoid these potential triggers and experiment to see if avoiding them reduces your older adult’s need to cry or yell.

4. Evaluate for depression
Many seniors with Alzheimer’s or dementia are also dealing with depression. Frequent crying or calling out could be a sign of depression, along with additional symptoms.

It’s important to have a doctor evaluate your older adult to find out if they could have depression so they can get proper treatment.

5. Establish a regular daily routine
Following a daily routine gives your older adult’s day structure and predictability. This helps reduce stress and anxiety, which can contribute to crying or screaming episodes.

6. Create a calm environment
People with dementia are often highly sensitive to their surroundings. Creating a soothing place to live helps minimize agitation, reduce difficult behaviors, and improve overall quality of life.

7. Reduce daily frustrations
When someone has dementia, their ability to complete everyday tasks declines. Things that we do without thinking, like putting on a sweater when we’re cold or getting a glass of water when we’re thirsty actually involve many steps.

To someone with dementia, it can be difficult to remember all those steps and sequence them properly. And getting frustrated over and over again during the day could provoke an outburst of crying or yelling.

Making everyday life easier helps reduce stress, frustrations, and feelings of failure – factors that can make someone very upset.

8. Speak to the doctor about medication
If non-drug techniques aren’t working and these episodes of screaming or crying are affecting quality of life, it might be time to work with their doctor to carefully experiment with behavioral medications.

When used appropriately, behavioral medication may be able to reduce or eliminate intense outbursts and improve quality of life for both your older adult and yourself.

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