Skip to main
Information about the author of this post.
tlwe223's picture Terri Weber, MSW, CSW
Elder Care Specialist
College or Department
Work-Life and Well-Being
Phone Number
(859) 218-0457
Email Address

Have you ever completely blanked on a name or couldn’t find the right words to say? It’s embarrassing, frustrating and a bit scary. These are everyday occurrences for someone living with dementia. Over time, those with dementia lose their words and can’t tell others what they want or need.

Why meeting unmet needs is important

There are normal changes in the brain as we age. These changes can impact a person’s behavior, making it more challenging and frustrating for them to express themselves, and more difficult for their caregiver to care for them. When dementia is involved, those changes become even more severe.  

Dementia interferes with a person’s daily functioning and behavior in many ways:

  • Memory loss: unable to immediately recall new memories, current events and relationships
  • Language and comprehension: loss of ability to express oneself and interpret messages
  • Sensory changes: changes to sight and depth perception; noise reception; information overload; and changes to touch, smell and taste
  • Impulse behavior control: control of emotions diminishes greatly

Unmet wants and needs may aggravate these factors, causing our loved ones to behave unpredictably and become anxious, frustrated and/or aggressive. They lack communication skills. They may wander, use inappropriate language or lash out. When challenging behaviors occur, caregivers need to explore possible causes to explain these behaviors. These causes might just be unmet wants and needs.
What are the unmet needs?
We all have unmet wants and needs. People with dementia express their needs and wants either verbally, nonverbally or behaviorally in ways that are not always understandable. These behaviors are an attempt to communicate that something is missing or wrong, such as hunger, loneliness, pain or the need to rest. These behaviors can be distressing to both the caregiver and their loved one.
Teepa Snow* identifies three areas of unmet wants and needs:

Unmet physical needs

  • Hunger and thirst
  • Tired and/or overstimulated
  • Bowel or urinary distress
  • Discomfort
  • Pain

Unmet emotional needs

  • Anger
  • Sadness
  • Loneliness
  • Fear
  • Boredom

Unmet psycho-social needs

  • Comfort
  • Compassion
  • Occupational
  • Attachment
  • Identity
  • Inclusion

Teepa cites nine behaviors that a person living with dementia may use to express unmet wants and needs:

  • Wandering
  • Repetition
  • Hoarding
  • Inappropriate language
  • Incoherent speech
  • Searching
  • Walking about
  • Fatigue as the day goes on
  • Sleep disturbances         

How do we identify unmet needs?
Do the detective work. Caregivers need to explore the many possible causes for distressing behaviors by looking at unmet physical, emotional and psychosocial needs. By identifying unmet wants and needs, a caregiver can act on and engage in activities to meet these needs.
A good detective keeps a journal, tracking and noting the following:

  • Loved one’s body language and environment: Is it too loud? Is the room too bright or not bright enough?
  • Time of day
  • What room are they in? Where are they exactly?
  • Cues through their sounds and words
  • Behavior when they are not upset: What’s different?
  • Triggers: What actions make the behavior better or worse?      

Being a detective is an important caregiving skill and necessary tool. Patience, persistence, and trial and error can reduce the challenges in your loved one’s behavior and improve the quality of life for both of you. 
Stay well, stay healthy, stay connected,

*Chapin, Marion, PAC and Dementia Certified. 2020. “Dementia Informed Positive Approach to Unmet Needs.” presented at University of Wisconsin -Madison, Division of Continuing Studies – Behavioral Health, January 30.