What can it mean if your normally cooperative loved one suddenly becomes surly, or if someone who has always liked to walk refuses to budge? It can be tempting to blame the dementia. But more often, a sudden change in attitude or physical function reflects something else going on that warrants checking.
Look for other behavioral clues: Is the person more withdrawn or agitated than normal? Engaged in any unusual behaviors (more unusual than what's "normal" now)? These could be signs of emotional distress triggered by a previous bad experience the last time the person was in similar circumstances.
Look for other physical clues: Does your loved one seem feverish? Is he or she walking with a limp or favoring one side? Experiencing a loss of appetite? These may be signs of an underlying physical problem that should be checked by a doctor.
Look for other cognitive clues: Is he or she saying strange, disjointed things? Unsure of surroundings or the year? Look for changes from what has been customary for that person. One possible cause: delirium, which can be life threatening and requires immediate medical attention.
Look for environmental cues: Is there a new home health aide? Did the behavior start in connection with a particular activity (a bad experience bathing in too-cold water last week, for example, could make the person skittish when the bathwater is run this week). Is your loved one hospitalized or recovering from a surgery or illness? Delirium is also a common complication among older adults with dementia who have been hospitalized.
Learn the telltale signs of delirium, a possible life-threatening explanation for sudden behavioral changes.