When we think of dementia, memory loss often takes centre stage. But there’s another deeply personal side to this condition that’s just as important and that’s the way it affects how people feel, express emotions, and connect with those around them. Emotions don’t simply disappear when dementia is diagnosed. In many ways, they become even more central to how people with dementia relate to the world. Let’s explore how emotional expression and mood change over time, and how we can continue to support emotional wellbeing throughout the journey.
Emotions are often still felt, even in the later stages
One of the most comforting things to know is that people with dementia can still feel a full range of emotions including joy, love, sadness, fear, contentment. In fact, the parts of the brain responsible for emotional expression are often preserved until much later in the disease. Even when someone has lost the ability to speak or remember names, they may still smile when they see a familiar face, become teary during a moving song, or light up at the sight of a beloved pet. These moments remind us that the emotional self is still very much alive.
Caregivers and loved ones can tap into this by paying attention to non-verbal cues. Facial expressions, tone of voice, posture, and even subtle changes in breathing often speak louder than words. This is something the specialised dementia caregivers at Livewell Estates are trained to do and recognise.
Recognising emotions in others becomes more difficult
While emotional expression often remains, the ability to read other people’s emotions can slowly fade. This happens because dementia affects the parts of the brain that help us interpret facial expressions and emotional cues. This means that someone with dementia might misread your mood. A gentle nudge might be seen as irritation. A neutral face could be perceived as anger. As a result, confusion or anxiety may increase, even if no harm was intended.
Being warm, expressive, and clear in your body language can go a long way in helping a loved one feel safe and understood. Sometimes, simply smiling while you speak or maintaining a calm tone can make a world of difference and we have seen firsthand how well this works.
Mood swings and emotional sensitivity can increase
As the disease progresses, emotional regulation becomes more difficult. You might notice that someone becomes more irritable, anxious, or teary than they once were. This isn’t because they’re being difficult, it’s because their brain is struggling to process and regulate emotions in the way it used to.
You might also find that emotional responses seem more intense. A small frustration could lead to an angry outburst. A sad memory might trigger prolonged crying. These heightened reactions are often a sign of inner distress or unmet needs. Try to look beyond the behaviour to what might be causing it. Is the person hungry, tired, overstimulated, or in pain? Addressing these basic needs can often reduce emotional overwhelm. We also understand that not everyone is able to recognise these behavioural signs and it’s one of the reasons why so many families opt for placing their loved one in a specialised dementia care facility such as Livewell. Our carers are trained to look after your loved ones with dementia and know the signs to look out for and how to manage it.
Depression and anxiety are common and often overlooked
People with dementia are at a higher risk of experiencing depression and anxiety, especially in the early and middle stages when they are still aware of what they’re losing. These feelings are valid and real, but they’re not always easy to recognise.
Unlike typical depression, someone with dementia might not say “I feel sad.” Instead, they may become withdrawn, lose interest in activities, or grow more irritable or restless. The same goes for anxiety, it might appear as pacing, fidgeting, or a general sense of agitation. Supportive environments, structured routines, and meaningful activities can all help ease these feelings. In some cases, professional support or medication may also be necessary. What’s most important is not to dismiss these emotional changes as “just part of dementia.” They deserve care and attention, too.
Emotional connection through music, art, and memory
Even when language becomes limited, emotions can still be expressed through other channels. Music, for instance, can tap into deep emotional memories and bring someone back to moments they thought were lost. A familiar melody might prompt a smile, a tap of the foot, or even a few whispered lyrics.
Art, touch, and reminiscence therapy (using photos, scents, or stories from the past) are also powerful ways to connect. These activities don’t just fill time. They give people with dementia a sense of purpose, joy, and identity. When words fail, emotional expression often finds a new path.
What to expect as dementia progresses
In the early stages of dementia, people are often aware of their diagnosis and may experience sadness, frustration, or grief. They may feel anxious about losing independence or forgetting loved ones. Offering reassurance and listening without judgment is vital during this time.
In the middle stages of dementia, as verbal communication becomes more difficult, mood swings and emotional outbursts may become more common. Patience and structure are key. Gentle redirection, calm surroundings, and soothing activities can help reduce distress.
In the later stages of dementia, the person may appear more withdrawn or less reactive. But this doesn’t mean they’ve stopped feeling. They may still respond to touch, familiar voices, and expressions of love. Emotions become more internal, and your ability to read subtle cues becomes even more important.
Caring with compassion
- Observe closely. Emotions are often communicated through tone of voice, facial expressions, and body language.
- Validate feelings. If someone is upset, don’t try to reason them out of it. Acknowledge how they feel and offer comfort.
- Create calm spaces. Soft lighting, familiar objects, and gentle music can help ease anxiety.
- Encourage emotional activities. Music, art, storytelling, and nature walks offer outlets for emotional expression.
- Ask for support. If you notice ongoing signs of depression, anxiety, or distress, reach out to a healthcare professional.
Emotional expression may shift, but it does not disappear. In fact, as memory fades, emotions often become the primary language through which people with dementia engage with the world. Recognising and responding to these emotional cues, with empathy, respect, and care, can profoundly improve the daily lives of those living with dementia. It can also deepen the connection between caregiver and loved one, reminding us all that emotional presence is more powerful than words.