Does Dementia Change Personality?

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How situations and perceptions may affect those with dementia

You are who you are.

People certainly change with dementia. People become more forgetful, they don’t make new memories well, they don’t remember things they knew well, they don’t process information as well, eventually their brains no longer know how to perform functions like walking, or even eating and drinking.

But in spite of all of these changes, people’s personalities stay largely the same it seems to me. Their personalities manifest themselves differently, but people don’t usually have wholesale personality changes.

But who are you with dementia?

A generally easy-going person who is usually happy is still an easy-going person who is generally happy with dementia. A person who is busy, always needing to do something, continues to be this way with dementia. Sometimes people with memory loss can become anxious, as they don’t always know what to do, but their mind is still telling them to do something. People like this often enjoy clearing tables or doing light housekeeping at our houses. Maybe they fold towels or do puzzles or arrange papers. People with a great deal of worry tend to worry still. People with unhappiness tend to still be unhappy.

Short-term changes, confusion and anxiety 

Sometimes there is a short-term change in personality. People can go through tough stretches of dementia. A person who was not generally fearful or anxious prior to dementia may become fearful or anxious due to their confusion. Many of these people can be calmed and be more content through engagement in appropriate activities or through some medication. Unfortunately, sometimes they do not become consistently less worried or anxious until their dementia progresses. At this point, a person may believe that they are thinking clearly, but their mind has slowed enough that they do not recognize their decline, or the progression of dementia causes the loss of ability to worry.

Losing the ability to filter, and unseen sides of ourselves

Often, it can appear to people that personality changes much more than I think it does. Many people lose their filter with dementia. If they were a boisterous and strong personality prior to dementia, they will likely become even more boisterous with dementia and they may be this way at less appropriate times.

Losing your filter can unleash darker, less desirable behaviors in people. I think about a man who I knew back in college when I was a nurse’s aide in a nursing home. This man would make inappropriate comments to female staff sometimes, especially younger female staff. This man never would have said these things to a 20-year-old woman prior to dementia. He would have, prior to dementia, made comments like this to some of his close male friends. Not an ideal behavior to begin with, but very different from saying these things to a young woman. But with his dementia, he lost much of his filter.  He now could come across as being inappropriate, but really, he was the same generally very nice man who he always was, just without a filter. I also have known a woman who would comment on people’s bodies in a joking manner to her close friends. Now with dementia, she would do this in a louder voice, when the targets of her joke were within earshot. Same woman, just less filter and less awareness of her setting.

Confusion and frustration can amplify reactions

People also can have greater tempers or frustration than prior to dementia. People with dementia often react differently to their confusion, their inability to remember, or their inability to accomplish tasks easily. This can be frustrating and angering. People will think they had money in their wallet or purse and then they can’t find it – then they worry that something has been lost or stolen. These people act very much as they always would have, had they lost a significant amount of money or had been robbed.  Again, not that the personality changes, but the dementia has caused them to have a skewed sense of reality, so they may react with greater frustration or anger. 

Uncertainty, perception and aggression

I’ve often seen someone who thinks they are going into their bedroom at their house and someone stops them and tells them this is not their room, that these are not their things and they cannot go in there. Can you imagine how you would feel if, while in your own home, someone stopped you from entering your own bedroom and said it wasn’t yours? This would be a real reason to get angry for anyone. With dementia, this is the reality that people sometimes face. 

Similarly, I think about some people, men especially it seems, who are more prone to aggression and violence and are not people who were this way prior to dementia. I know a situation that happened a while ago where two men both thought that another resident was their wife. Neither of them was this woman’s husband, but they would get into disputes about this. Both thought that the other was trying to ‘steal’ their wife. If this was to happen prior to dementia, these men may well have gotten aggressive or even violent about such a situation involving their actual wives. This situation is not so much a change in their personalities, as a change in their perception of reality causing them extreme duress. 

Our public and private selves

And then there are people who can be quite mean with their dementia. In talking with the families of some of these people, that had always been a facet of their personalities. It was often a more private part that the public did not always see, but with their dementia their private self has become their more public self. Some people have always had an unhappiness with themselves, and with their dementia they no longer are able to ‘put on a good face’ or do the things that propped themselves up, so they turn to lashing out at others. Again, not as much a change in personality as a change in circumstances in which parts of personality become more visible to others.

Awareness and facets of personality

Of course, there are exceptions. Certainly, there are people who have changes in personality that were never there prior to memory loss. If you are someone who sees a great personality change in a loved one with dementia, just think about this person and all the aspects of their personality throughout their lives. I think that quite often you might discover that such a difference is less of a change and more just a different manifestation of their same personality. Or perhaps, this was always a part of their personality, just a part you were not aware of until now.

Change, growth, and perception

With or without dementia, people can and do change. We grow and learn and change somewhat throughout our lives. In general, we learn to curb some of our less-desirable traits and hopefully surround ourselves with people, work, and lives that maximize our best and minimize our worst. Wholesale personality change, however, seems unlikely. We are who we are.

Blessings to you all on your journey through life. 

Reverend Arlen Solem

Chaplain and Campus Pastor

For questions about our spiritual care program, or if you would like spiritual care and support for you or your loved one, contact Chaplain Arlen Solem at 612-554-6379 or apsolem@augustanacare.org.

At Emerald Crest, we offer a deep knowledge of memory care in a specialized assisted living setting for seniors with Alzheimer’s and dementia-related conditions. We encourage you to contact us directly with any questions or request a tour. 

Emerald Crest provides memory care in a unique environment, specifically designed to support those with cognitive issues. Utilizing this exceptional model of care, individuals with dementia, Alzheimer’s and related conditions can flourish in positive relationships and participation in meaningful activities. Memory care is offered in the Minneapolis – Saint Paul area with communities in four convenient locations: Shakopee, Burnsville, Minnetonka and Victoria, MN.