Dementia and Behaviour Changes in Grand Rapids, MI

Dementia can cause significant changes in the behaviour of friends and loved ones. These changes are very common and can place enormous stress on families and caregivers throughout Grand Rapids and West Michigan. Understanding why someone with dementia is behaving in a particular way can make it easier to cope and to know when to seek local medical help.

In Grand Rapids, many families receive support through primary care providers and specialists at Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health, as well as community resources like the Kent County Health Department and local memory clinics.

Why Dementia Causes Behaviour Changes

Dementia is caused by physical changes in the brain. These changes can affect:

• Memory
• Mood
• Behaviour
• Ability to understand and respond to the environment

Sometimes behaviour changes are directly related to the brain changes of dementia. Other times, they are triggered by:

• Changes in the person’s environment (for example, moving from home to a facility)
• Health problems (pain, infections, chronic conditions like heart disease or diabetes)
• Side effects or interactions of medications

In Michigan, seasonal factors can also play a role. Long, dark winters and reduced daylight in Grand Rapids can worsen confusion, sleep problems, and mood changes, especially in older adults.

Keeping Track of Behaviour Changes

Understanding the cause of behaviour change helps you choose the right strategies. Many Grand Rapids caregivers find it helpful to:

• Keep a log or diary of behaviours
• Note the time of day, what was happening, and any recent changes (medications, illness, weather, routine)
• Look for patterns over several days or weeks

Always discuss new or worsening behaviour changes with your family doctor or primary care provider. They can:

• Check for physical illness or pain (for example, urinary tract infections, arthritis, heart or lung problems common in older Michiganders)
• Review medications for side effects or interactions
• Screen for underlying psychiatric conditions such as depression or anxiety

If needed, your doctor may refer you to a neurologist, geriatrician, or memory clinic at a Grand Rapids health system for more specialized dementia care.

Sleep Problems in Dementia

Sleep problems are very common in people with dementia and can be especially challenging for caregivers. In Grand Rapids, long winter nights, early sunsets, and irregular daylight can further disrupt sleep–wake cycles in older adults.

Common dementia-related sleep problems include:

• Sleeping during the day and being awake or restless at night
• Confusing night and day
• Needing less sleep due to reduced daytime activity
• Late-evening agitation or restlessness (“sundowning”)

Sleep problems are often a phase in dementia that may change over time. Many people with dementia sleep more in the later stages of the illness.

Why Sleep Problems Are So Hard for Caregivers

Sleep problems are among the most difficult dementia symptoms for caregivers to manage because:

• Caregivers also need adequate sleep to stay healthy and safe
• Night-time wandering or agitation can increase the risk of falls, injuries, or getting lost
• Chronic sleep disruption can lead to caregiver burnout, depression, and health problems

In West Michigan, where winter conditions can be icy and dangerous, night-time wandering can be especially risky.

Medical Causes of Sleep Problems in Dementia

Several medical issues can disturb sleep in people with dementia:

• Heart disease (such as angina or congestive heart failure)
• Diabetes
• Stomach ulcers or reflux
• Pain (for example, from arthritis, which is common in older adults)
• Urinary tract infections or overactive bladder (frequent need to urinate)
• Leg cramps or “restless legs,” which may indicate metabolic or nerve problems
• Depression (often causing early morning waking and difficulty returning to sleep)
• Side effects of medications (antidepressants, diuretics, stimulants, some pain medications)
• Snoring and sleep apnea (brief pauses in breathing during sleep)

What to Discuss With a Grand Rapids Doctor

Talk with your doctor or a local memory care specialist about:

• Recent changes in sleep patterns
• Pain or discomfort at night
• All medications (including over-the-counter and herbal products)

Questions to ask:

• Could any medications be causing or worsening sleep problems?
• Should diuretics (“water pills”) be taken earlier in the day to reduce nighttime bathroom trips?
• Is an assessment for depression or anxiety needed?
• Are sedatives, tranquilizers, or sleeping pills appropriate, and what are the risks?

Short-term use of sleeping medication may help reset sleep cycles, but these drugs can:

• Increase confusion
• Raise the risk of falls
• Worsen breathing problems, especially in people with sleep apnea

Always use these medications only under close medical supervision from a qualified Grand Rapids provider.

Environmental Causes of Sleep Problems

The person’s environment can significantly affect sleep. In Grand Rapids, factors like heating, indoor air dryness in winter, and lighting during long dark evenings can all play a role.

Environmental causes can include:

• Bedroom too hot or too cold
• Poor lighting leading to confusion or fear
• Inability to find the bathroom
• Recent move (for example, to assisted living, rehab, or hospital)
• Noises (furnace, traffic, neighbors, hospital sounds)

Practical Changes You Can Make at Home

Try these strategies to improve sleep:

• Keep the environment consistent

  • Avoid frequent room changes or major rearranging of furniture.

• Check temperature and comfort

  • Make sure the bedroom is not too hot or cold.
  • Remember dementia can affect the body’s internal thermostat.

• Improve lighting

  • Use soft, even lighting to reduce shadows and glare.
  • Consider night-lights in the bedroom and hallway to the bathroom.

• Adjust mirrors

  • Move or cover mirrors if reflections cause confusion or fear.

• Make the bathroom easy to find

  • Install night-lights.
  • Place a commode near the bed if bathroom access is difficult.

• Create a familiar, comforting bedroom

  • Use familiar bedding and personal items.
  • Avoid leaving daytime clothing in view at night, which may signal it’s time to get up.

• Encourage daily activity

  • Aim for one or two short walks each day, weather permitting.
  • In winter, consider indoor walking at malls, community centers, or hospital corridors if allowed.

Other Causes of Sleep Problems and What You Can Try

Other common causes of poor sleep include:

• Disturbing dreams or nightmares
• Going to bed too early
• Too much daytime napping
• Being overtired and tense
• Not enough physical activity
• Too much caffeine or alcohol
• Hunger at night
• Agitation after an upsetting event

Managing Sleep Problems With Food and Drink

Consider:

• Cutting down on caffeine (coffee, cola, tea, chocolate) during the day
• Avoiding caffeine entirely after 5 p.m.
• Reducing alcohol intake and discussing alcohol use with the doctor
• Offering a light snack before bed or if the person wakes hungry at night
• Trying herbal teas (caffeine-free) or warm milk in the evening if tolerated

Managing Sleep Problems Through Daily Routine

A predictable daily routine can improve sleep:

• Keep regular times for waking, meals, and bedtime
• Schedule more stimulating activities (appointments, visitors, outings) in the morning
• Reserve the late afternoon and evening for calming activities
• Avoid upsetting tasks or difficult conversations late in the day
• If the person refuses to go to bed, offer alternatives (for example, resting on the sofa)

If sleep problems remain severe, talk with your Grand Rapids doctor about whether sedative or sleeping medications are appropriate and safe in your loved one’s specific situation.

Hoarding Behaviours in Dementia

People with dementia may seem driven to search for, hide, or hoard items. This can be distressing for families but often has understandable causes.

Common reasons for hoarding include:

• Isolation – being left alone or feeling neglected can cause the person to focus intensely on their own belongings.
• Memories of the past – current events may trigger memories of:
  • Growing up with siblings who took their things
  • Living through the Great Depression or wartime shortages
  • Raising a family with limited resources
• Loss – people with dementia experience ongoing losses:
  • Friends and family
  • A meaningful role or job
  • Financial independence
  • Reliable memory
• Fear – fear of being robbed or losing something precious. The person may hide valuables, forget where they are, and then accuse others of stealing.

Managing Hoarding in Dementia

Strategies that may help:

• Learn the person’s usual hiding places and check these first for missing items.
• Provide a special drawer, box, or basket of safe odds and ends for the person to sort or “organize.”
• Ensure the person can recognize their environment; confusion about where they are can increase hoarding behaviour.
• Avoid arguing about hoarded items; instead, gently redirect attention.

If hoarding becomes unsafe (for example, food spoiling, fire hazards), consult your doctor or a social worker at a Grand Rapids hospital or community health center for guidance.

Repetitive Behaviour in Dementia

People with dementia often:

• Ask the same questions repeatedly
• Repeat stories
• Perform the same action over and over
• Become very clingy and follow the caregiver everywhere, even to the bathroom

These behaviours can be very upsetting and exhausting for families and caregivers.

Managing Repetitive Questions and Actions

Try:

• Distraction

  • If explanations don’t help, gently redirect with a walk, a snack, music, or a favourite activity.

• Acknowledge the feeling behind the question

  • For example, “What am I doing today?” may really mean, “I feel lost and uncertain.”
  • Respond to the feeling: “You’re safe here. I’ll be with you, and we’ll have lunch soon.”

• Avoid pointing out repetition

  • Do not say, “You already asked that.” This can increase frustration and embarrassment.

• Provide something to do with their hands

  • A soft ball to squeeze
  • Clothes or towels to fold
  • Simple sorting tasks

If repetitive behaviours escalate or are accompanied by severe anxiety or aggression, contact your doctor or a dementia specialist in Grand Rapids for further evaluation.

Wandering in Dementia

Wandering is common in dementia and can be very worrying, especially in a city like Grand Rapids where traffic, riverfront areas, and winter conditions increase safety risks.

People with dementia may not be able to explain why they wandered. Possible reasons include:

• Believing they have a job or duty to perform
• Searching for a person or place from the past
• Excess energy or boredom
• Confusing day and night
• Continuing a long-held habit (such as early-morning walks or going to work)
• Feeling anxious, depressed, or frightened
• Pain or physical discomfort

Medical and Psychological Checks

To manage wandering:

• Arrange a physical check-up to identify illness, pain, or discomfort.
• Review medications with the doctor to avoid drugs that increase confusion, drowsiness, or incontinence.
• Consider psychological causes: is the person anxious, depressed, or feeling unsafe?

Safety Strategies for Wandering in Grand Rapids

• Make sure the person carries identification with current address and emergency contacts.
• Consider medical ID bracelets or cards recommended by Alzheimer’s and dementia organizations.
• Inform trusted neighbours and nearby family members about the situation.
• Secure doors and gates in a way that does not cause distress or a feeling of being trapped.
• If night-time wandering occurs, consider allowing safe movement within the home while ensuring hazards are removed.
• In case the person goes missing, have an action plan:
  • Note what they were wearing
  • Immediately search usual routes and favourite places
  • Contact local police and provide a recent photo

In extreme weather (snowstorms, ice, heat waves), wandering can become life-threatening very quickly, so prompt action is essential.

Sundowning in Dementia

Sundowning refers to increased confusion, restlessness, or insecurity in the late afternoon and evening. In Grand Rapids, shorter winter days and early darkness can make sundowning more noticeable.

Signs of sundowning include:

• Becoming more demanding or restless
• Increased suspicion or paranoia
• Seeing, hearing, or believing things that aren’t real (hallucinations or delusions)
• Greater disorientation, especially at night
• Reduced attention span and concentration
• More impulsive or risky behaviour

These behaviours can worsen after:

• A move (for example, to a new home, assisted living, or hospital)
• A change in routine
• A recent illness

Managing Sundowning

Steps to consider:

• Visit the doctor for a full check-up and medication review.
• Restrict stimulating activities to the morning and early afternoon.
• Create a calm, predictable late-afternoon and evening routine.
• Use soft lighting as it gets dark to reduce shadows and confusion.
• Play soothing music or familiar TV shows at a low volume.
• Avoid large gatherings, loud noises, or upsetting conversations in the evening.

Caring for Yourself as a Caregiver in Grand Rapids

Caring for someone with dementia is demanding, especially when behaviour changes, sleep problems, or wandering are involved. Caregivers in Grand Rapids should:

• Plan regular rest periods and breaks
• Ask family, friends, or faith communities for help
• Explore respite care options through local agencies and senior services
• Talk with their own doctor about stress, mood, and sleep

Local resources may include:

• Primary care and memory clinics at Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health
• Kent County Health Department and Grand Rapids Public Health programs
• Local chapters of Alzheimer’s and dementia support organizations
• Caregiver support groups (often available through hospitals, senior centers, and faith-based organizations)

Key Points

• Dementia can cause common but distressing behaviour changes in loved ones.
• Understanding the cause—medical, environmental, emotional, or seasonal—helps guide effective strategies.
• Sleep problems, including night-time wandering and sundowning, are among the most challenging symptoms for caregivers.
• Simple changes in routine, environment, and communication can often improve behaviours.
• Always discuss significant behaviour changes with a doctor or dementia specialist in Grand Rapids.
• Caregivers need rest, support, and local resources to stay healthy while providing care.