If you’re caring for someone with dementia, you’ve likely had this thought:
“This just doesn’t make any sense.”
Maybe they’re asking the same question over and over.
Maybe they’re refusing care they clearly need.
Maybe they’re upset, pacing, or trying to leave.
And you’re standing there trying to figure out what just happened.
Here’s the shift that can change everything:
Most dementia behaviors do make sense.
Just not from your perspective. Yet.
Where This Started for Me
I didn’t come to this work from a textbook.
I came to it watching my grandfather. There were no community resources. The internet wasn’t a thing. My family had nowhere to go for answers, no one to help us understand what was happening.
All I saw was the man I knew and loved forgetting us.
We weren’t really understanding what was happening. And that lack of understanding made everything harder. Not because we didn’t care. Because we didn’t have the framework.
That experience is what eventually led me to become a physical therapist, a Certified Dementia Practitioner, and a caregiver coach. And ultimately to found A Better Way: Dementia Care Solutions.
Because I believe that when caregivers and care teams understand how the brain is actually changing, everything shifts. Not overnight. But it shifts.
Start Here: What Dementia Actually Is
Before we can talk about behavior, we have to talk about the brain.
Dementia is an umbrella term. We talk about Alzheimer’s and all the different types, but if you really break it down, dementia is damage to multiple parts of the brain, to the severity and to the point that function is impacted.
That’s really what’s going on.
So I pull back and start with function. And because I’m a visual person, I think it’s good for people to have a few anchors in what they’re doing. Something to ground themselves, especially at 3:00 a.m. when things are really upside down.
That’s why I developed the Wheel of Function Framework™.
The Wheel of Function Framework™
Think about a bike tire. The outer rubber part of that tire? That’s Function, the person’s ability to move through daily life.
At the center of the wheel is The Person. Always.
And holding it all together are five spokes:
Sensory – what they’re taking in through sight, sound, touch, taste, and smell
Emotional – how they’re feeling and whether they feel safe
Cognitive – how the brain is processing memory, language, attention, and reasoning
Physical – their body, pain, fatigue, and physical comfort
Environment – the space, noise level, pace, and sensory load around them
When all five spokes are working together, the wheel rolls.
When one or more are bent or broken by the changes dementia brings, the wheel wobbles.
And that wobble? That’s what we call behavior.
Behavior is not random. It is not defiance. It is the output of a system under stress. The person’s way of communicating that something isn’t working in one of those spokes.
That reframe is at the heart of everything I teach.
Behavior Is Communication
When someone is resisting care, repeating questions, or becoming agitated, they are not trying to be difficult.
They are trying to communicate something their brain can no longer process or express clearly.
And sometimes, it’s something we’d never think to check.
Maybe there’s a nagging noise in the background. Maybe the tag in their shirt is driving them crazy and they just can’t get beyond that point. Maybe they have a headache, or their hearing isn’t great that day.
That’s the Sensory spoke of the wheel affecting everything else.
When we only respond to the surface behavior, we miss what’s actually happening underneath. When we check the spokes, when we ask which part of the wheel might be under stress right now, things start to make sense.
The Autonomy We Often Accidentally Take Away
Here’s something that’s hard to hear, but important:
Our tendency, when someone is having trouble, is to jump in and help. Or just do it for them. Because we don’t want them to struggle.
But that actually takes away their autonomy and dignity.
What didn’t work today might work differently tomorrow if the circumstances change. Maybe there was a sensory issue. Maybe the cognitive demand was too high in that moment. Maybe the environment was off.
We have a widespread misconception that because someone has dementia, they can’t do things.
That couldn’t be further from the truth. People have so much skill left, very far into the disease process. We just need to allow them to try, in a safe way, and then adapt. If they can’t do the whole thing the way they used to, they can still partake in something.
The Wheel of Function Framework™ helps you see where to adapt. Not assume.
Why Logic Stops Working
This is one of the hardest adjustments for caregivers.
You can explain something clearly. Repeat it. Show proof.
And it still doesn’t land.
That’s not stubbornness. That’s the Cognitive spoke, specifically the parts of the brain responsible for reasoning and insight. When those are affected by dementia damage, trying to convince or correct doesn’t just fail. It can actually increase distress.
So instead of explaining, try:
- Redirecting
- Simplifying to one step at a time
- Validating the feeling, even when you can’t validate the reality
- Adjusting your approach rather than repeating your argument
This is not giving in. This is skilled care.
The Environment Matters More Than You Think
The Environment spoke is one that often gets overlooked, but it has an enormous impact on behavior.
Noise, lighting, pace, clutter, and too much input can overwhelm a brain that is already working harder than it should have to.
Small shifts can make a real difference:
- Turning off background noise before starting care
- Slowing down your own pace
- Reducing visual clutter in their space
- Using a calm, low tone of voice
- Giving one instruction at a time
These aren’t extras. These are direct interventions on a spoke you can actually control.
Taking a Step Back to See What’s Really Happening
When a moment goes sideways, the instinct is to react. But the more useful move is to pause and ask:
What is going on? What might be falling apart? Where is their brain struggling right now?
That’s the practice. That’s how the Wheel of Function Framework™ becomes a real-time tool instead of just a concept.
It’s not cookie cutter. There’s no one approach that works for everybody. That’s the other part of “a better way.” It has to be person-centered. The framework gives you the structure; the person in front of you tells you where to look.
You’re Not Doing This Wrong
If you’ve been feeling confused or questioning yourself, hear this:
You’re not doing it wrong.
Most caregivers are doing a really good job. They just haven’t been taught how dementia actually works in the brain. Or been given a framework they can use in real time, in the middle of a hard moment.
You’ve been trying to use tools designed for a healthy brain. Dementia changes the rules. And almost no one teaches this in a way that’s practical and usable at 3:00 a.m. when things are falling apart and you just want to scream.
“There’s got to be a better way!”
And there is. It starts with education. And sometimes, it just takes one conversation to shift everything.
A Small Shift You Can Try Today
The next time something happens that feels confusing, pause and ask:
“Which spoke might be under stress right now?”
Is it sensory? Physical? Emotional? Is the cognitive demand too high? Is the environment working against them?
That one question can change how you respond.
And over time, those small shifts make caregiving feel more manageable and more connected.
🎧 Listen to the Full Conversation
I walked through all of this – my path into this work, the Wheel of Function Framework™, why I believe education and coaching are the better way forward for dementia care, and so much more – on the Alzheimer’s Speaks podcast with Lori La Bey.
👉 Listen here: https://alzheimersspeaks.com/why-dementia-behaviors-make-sense-once-you-understand-the-brain/
If you’re in the middle of this right now, this conversation will help you connect the dots.
If You Want More Support
I offer caregiver coaching and staff training where we work through real-life scenarios using the Wheel of Function Framework™, so it becomes something you can actually use, not just something you read about.
You can also grab the FREE Caregiver Quick-Start Guide – 5 days to more confident care – here:
A special thank you to Lori La Bey and the entire Alzheimer’s Speaks community for the opportunity to share this conversation. Alzheimer’s Speaks is dedicated to shifting dementia care culture from crisis to comfort. You can find their podcast, resources, and more at alzheimersspeaks.com.
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