It's as if you're watching a loved one live with dementia through the slow motion of turning the pages of a challenging book—one that hurts, is unpredictable, and intimate. You may anticipate forgetfulness, some confusion, or the periodic retelling of a tale. But occasionally, the shifts are much more than you can cope with. Someone who was once gentle may now rage in fury, get lost from home, or have frightening hallucinations.

These aren't all indications that the disease is advancing. Occasionally, they're red flags—obvious signs it's time to get help.

If you're a family member or caregiver, recognizing what to look out for can be a lifesaver.

Behavioral Changes Are More Than Mood Swings

Dementia isn't only a memory thing—it reprograms how someone understands the world. But when those changes contribute to fear, harm, or misery—for your loved one or for you—it's more than part of the "normal" course. It could be a turning point.

Too many families delay, hoping it's temporary, or that they can get by without help. Some behaviors are not to be dismissed.

Let's discuss what those red flags actually are.

Red Flag #1: Abrupt or Escalating Aggression

A loved one who suddenly becomes verbally or physically aggressive—yelling, throwing objects, pushing, or hitting—is not having "a bad day." This kind of behavior is often due to fear, confusion, physical discomfort, or even medication side effects.

But if aggression occurs more often or more severely, it's time to call in a doctor or dementia specialist. They can rule out reversible causes (such as infection or drug interactions) and discuss interventions for keeping all parties safe.

What to do: Monitor the behaviors—what precedes, what occurs, and what follows. Report that information to a healthcare professional.

Red Flag #2: Hallucinations or Paranoia

If your loved one is experiencing things that don't exist, or they suddenly believe someone is "out to get them," it's more than confusion. These symptoms are frightening—not only for the person experiencing them, but for the people around them.

Paranoia may cause them to accuse others of thievery, dishonesty, or attempting to hurt them. Hallucinations may cause fear responses or dangerous behaviors.

What to do: Reassure them calmly without disputing. Then call their care team. Occasionally a change of medication, place, or routine can help these symptoms lessened considerably.

Red Flag #3: Wandering or Getting Lost

Has your loved one ever wandered out of the house alone and not been able to find their way back? Did they venture out at night, unsure of the time of day?

Wandering is perhaps the most critical dementia behavior, particularly when combined with confusion and poor judgment. A cold night, a busy street, or a mere fall can become deadly.

What to do: Consider GPS tracking devices, door alarms, or signing up for a local alert program such as Project Lifesaver. More importantly, discuss long-term safety measures with a care team.

Red Flag #4: Refusal to Eat, Bathe, or Take Medications

When a person with dementia repeatedly resists minimal care, it can have severe consequences for their health. Refusal sometimes happens because they are afraid or misunderstanding. Other times, they do it as a form of control in a world that is uncoordinated and unknown.

No matter what the reason is, repeated refusal to eat, bathe, or take medication is not a long-term solution.

What to do: Experiment with simplifying routines, providing choices, or incorporating familiar voices and faces. But if these techniques fail, it's time to seek professional advice—particularly if health is an issue.

Red Flag #5: Caregiver Burnout or Safety Issues

Here's a red flag that's easily overlooked: you.

If you're so tired, drained, or scared of your loved one's actions that you dread every day, that's not a normal part of caregiving. That's burnout—and it's unhealthy for both of you.

No human can give from an empty container. And if you're stressed all the time, you might unconsciously overlook critical warning signs or respond in ways that make things worse.

What to do: Discuss things with your doctor, a support group, or a dementia care counselor. It's possible that outside assistance, respite care, or moving to a care facility might be necessary.

When to Take the Next Step

Families sometimes feel guilty for seeking assistance. They feel that they must be able to "get it done." But dementia is not forgetfulness—it's an advanced, complicated disease that infiltrates every area of life.

Getting help is not abandoning your loved one. It's coming in to support them getting the care they require—and to keep yourself strong enough to continue caring for them.

Some interventions may include:

Meeting with a geriatric psychiatrist or neurologist
Medication adjustment
Hiring in-home support
Making home safety changes
Considering a memory care community

Final Thoughts: You're Not Alone

Caring for a person with dementia is one of the toughest, most heartbreaking jobs a human being can have. But you don't have to go about it in the dark. Being aware of the red flags isn't about expecting the worst—it's about being prepared to act when your loved one requires more care than you are capable of delivering on your own.

Intervening isn't failure. Intervening is because you love them enough to ensure that they are actually safe, comfortable, and cared for.

And that's the kind of love that louder than words.

Red Flags: When Dementia Behaviors Signal a Need for Intervention