When Dementia Looks Like Aggression: What Behaviour Is Really Saying & How to Respond

If you’ve ever supported someone living with dementia and been faced with shouting, swearing, hitting, or refusal of care, this episode is for you. In this solo episode, Andy Baker unpacks one of the most misunderstood areas of dementia care: behaviour that looks aggressive but is almost always communication driven by distress. Drawing on years of experience in behaviour support, Andy helps caregivers, teachers, and parents move away from labels like “challenging” or “difficult” and instead understand what the behaviour is trying to say. You’ll learn why dementia affects far more than memory, how fear, pain, confusion, trauma, overstimulation, and even poor care practice can drive behaviour — and most importantly, what to do in the moment. Andy shares a simple, practical three‑step response framework and language you can use immediately to de‑escalate situations while protecting your own wellbeing. This episode is especially valuable for anyone feeling exhausted, overwhelmed, or unsure whether they’re “handling things right”. ⏱️ Episode Chapters (Timestamps) 00:00 – Aggression or communication? Reframing behaviour in dementia 00:49 – Why dementia affects personality, perception, and processing 01:10 – Why behaviour becomes the fastest communication channel 02:22 – Fight, flight, and the safety of saying “no” 03:30 – From “challenging behaviour” to “distress behaviour” 04:19 – Hidden drivers: pain, fear, trauma, overstimulation, under‑stimulation 05:12 – When behaviour isn’t dementia — it’s poor care 06:07 – A simple 3‑step response framework 06:29 – Step 1: Pause, protect, and regulate yourself 06:58 – Step 2: Scan for unmet needs (HELP model) 07:31 – Step 3: Adjust, connect, and reduce distress 08:13 – What to say when someone is frightened or overwhelmed 09:05 – The HEART approach: Hear, Empathise, Align, Reassure, Transition 10:26 – Why “calm down” doesn’t work 10:51 – Caregiver regulation and burnout 11:52 – The core message: behaviour is communication 12:22 – Resource: Targeting the Positive 🧩 Three Key Takeaways Aggression in dementia is rarely intentional What looks like defiance or hostility is often a terrified brain trying to cope with confusion, pain, or fear. Behaviour makes sense when you understand the context Distress behaviours are often driven by unmet physical, emotional, cognitive, or environmental needs — not the diagnosis itself. You can’t calm someone else if you’re dysregulated Supporting distress starts with your own regulation. Compassionate care requires supported carers. 🛠️ Resources Mentioned Targeting the Positive with Behaviours That Challenge by Andy Baker A practical, person‑centred guide to understanding and responding to distressed and dysregulated behaviour across dementia, trauma, neurodiversity, and mental health. Click here to find out more 🎯 Why Listen to This Episode? You’re supporting someone with dementia and struggling with aggression, refusal, or distress You want practical language and tools, not theory You’re tired of feeling blamed, judged, or unsure You want to support others without losing yourself You believe behaviour has meaning — and want to understand it better This episode offers reassurance, clarity, and immediately usable strategies grounded in empathy and realism. 🔗 Connect with Able 📲 Instagram: @AbleTraining 📲 LinkedIn: Able Training 📲 TikTok: @AbleToCarePodcast 🌐 Website: Able Training