Is Making Noises Part of Dementia? A Comprehensive Guide

According to studies, vocalizations, as part of behavioral and psychological symptoms of dementia (BPSD), affect a significant number of individuals. Understanding why these sounds occur is the first step toward effective management and compassionate care, directly answering the question: is making noises part of dementia?

Quick Summary

Yes, vocalizations like moaning, groaning, or repetitive sounds are a common symptom of dementia, often indicating unmet needs, discomfort, or confusion as a person loses verbal communication skills. They are not intentional but a manifestation of the disease.

Key Points

• Brain Changes Cause Noises: Vocalizations in dementia result from neurological changes affecting communication and behavior, not from a patient being difficult or intentionally loud.

• Noise as a Form of Communication: As verbal skills decline, moans, grunts, or repetitive sounds become a patient’s way of communicating needs like pain, hunger, or discomfort.

• Look for Hidden Triggers: A sudden increase in vocalizations can signal underlying issues such as physical pain, a urinary tract infection, or environmental stress.

• Gentle Redirection Works Best: Instead of correcting the person, use distraction and gentle redirection toward a calming, meaningful activity to break the cycle of repetitive noise.

• Environment is Key: Creating a calm, quiet, and predictable daily routine can help minimize anxiety and the vocalizations that are often a response to it.

• Patience is Paramount: Caregivers must respond with patience and empathy, as the behavior is a symptom of the disease and not intentional defiance.

• Seek Medical Advice for Changes: Any significant or sudden change in vocalizations warrants a medical evaluation to rule out treatable health problems.

Why Vocalizations Occur in Dementia

For caregivers, hearing a loved one with dementia make unusual or repetitive noises can be confusing and distressing. These vocalizations are not a deliberate act but are often a symptom of the progressive brain changes caused by the disease. As dementia advances, it impacts the regions of the brain responsible for communication, emotion, and memory, fundamentally altering how a person expresses themselves.

Communication: When Verbal Skills Fade

As verbal language skills decline, individuals with dementia increasingly rely on non-verbal cues to express their needs and feelings. When they can no longer find the right words, sounds and noises can become a substitute. A grunt might signify discomfort, a moan could indicate pain, and a repetitive phrase might be a search for reassurance or familiarity. This shift in communication is a key reason behind the increase in vocalizations.

Emotional and Neurological Factors

Vocalizations are often an expression of internal states that the person cannot articulate, such as anxiety, fear, loneliness, or frustration. For some, repetitive vocalizations can serve as a form of self-soothing, a response to a heightened sense of anxiety or agitation. Neurologically, damage to the brain’s frontal and temporal lobes can also cause disinhibition or alter the circuits that control vocal behavior, leading to abnormal or inappropriate sounds.

Common Types of Dementia-Related Noises

The noises made by individuals with dementia can vary widely in form and meaning. Identifying the type of vocalization can provide clues about the person's needs.

• Grunting or Moaning: Often associated with physical pain, discomfort, or a feeling of helplessness. This can indicate issues like ill-fitting dentures, joint pain, or the need to reposition in a chair.
• Repetitive Words or Phrases: This can be a form of echolalia or perseveration, where the person repeats words, phrases, or questions they've heard. It is often linked to memory loss, confusion, or a need for reassurance.
• Humming or Chanting: Sometimes, continuous humming or chanting can be a self-soothing behavior, a response to anxiety or overstimulation. It may also occur when the person is calm and content.
• Screaming or Shrieking: This is often a sign of distress, fear, or pain. The cause could be anything from a urinary tract infection to feeling startled or overwhelmed by a loud noise.
• Nonsensical Sounds: As the disease progresses, vocalizations may lose any semblance of language, becoming a series of nonsensical sounds. This reflects the severe breakdown of verbal communication pathways in the brain.

Responding to Vocalizations with Compassion

Reacting with patience and empathy is crucial. The following strategies can help caregivers manage these challenging behaviors.

Non-Pharmacological Management Strategies

1. Observation and Identification: Keep a journal to track when noises occur. Use the ABC method: document the Antecedent (what happened just before), the Behavior (the vocalization itself), and the Consequence (what happened right after). This can reveal patterns and triggers, such as mealtimes or specific sounds.
2. Environmental Modifications: Reduce background noise and create a calm, predictable environment. A familiar and uncluttered space can lower anxiety and confusion.
3. Redirection and Distraction: Gently shift the person’s focus away from the behavior. Use familiar and meaningful activities, such as looking at a photo album, listening to music they enjoy, or folding towels.
4. Reassurance and Touch: Offer a calm, gentle response. A soothing tone of voice, eye contact, and a gentle touch on the arm can provide comfort and security, especially during moments of anxiety or fear.
5. Sensory Stimulation: Utilize sensory items like a soft blanket, a lightly scented item, or a fidget object to provide a sense of comfort and grounding.

When to Seek Medical Attention

While some noises are part of the disease, a sudden increase or change in vocalizations can signal an underlying medical issue, such as:

• Pain: Look for physical signs of pain, such as wincing or holding a body part, during vocalizations.
• Infection: A urinary tract infection (UTI) is a common cause of sudden behavioral changes and increased confusion in older adults.
• Discomfort: Physical discomfort from ill-fitting clothing, a seating arrangement, or bedding can trigger vocalizations.

Understanding Different Communication Changes

It is helpful for caregivers to differentiate between typical communication challenges and vocalizations that may require intervention.

Feature	Repetitive Questioning	Involuntary Vocalization (Moaning)	Agitated Vocalizations (Shouting)
Cause	Memory loss; searching for reassurance	Neurological damage; expressing discomfort or need	Fear, anxiety, frustration, or pain
Symptom	Asking the same question repeatedly (e.g., "What time is it?")	Continuous, low-level grunting or moaning noises	Loud, urgent, or distressed sounds like screaming
Response	Give a simple, reassuring answer; redirect attention	Investigate for potential physical causes like pain	Stay calm; identify and remove triggers (noise, etc.)
Triggers	Forgetfulness, anxiety	Pain, hunger, temperature issues, positional discomfort	Overstimulation, sudden changes, perceived threat
Goal	Provide comfort and a sense of security	Address the unmet physical need	De-escalate and soothe

The Role of Professional Support

Caring for a person with dementia who is vocalizing can be emotionally and physically taxing. While the strategies above can help, professional support is often necessary. Therapists can offer specialized communication techniques, while respite care can provide a much-needed break for caregivers. If new or worsening behaviors occur, it is essential to contact a healthcare provider to rule out any treatable medical causes.

By understanding that these noises are a form of communication, caregivers can move from frustration to a place of empathy. For further guidance on coping strategies, consult resources from authoritative organizations like the Alzheimer's Society.

Conclusion: A Shift in Perspective

Loud or repetitive vocalizations, while challenging, are an important, though often misunderstood, part of dementia. Rather than seeing these noises as a problem to be stopped, viewing them as a signal of an unmet need or internal state can completely change the caregiving approach. By combining attentive observation with compassionate and creative interventions, caregivers can significantly improve the quality of life for both themselves and their loved ones, fostering a calmer, more secure environment.

Frequently Asked Questions

How do I know if the noises are due to pain in my loved one with dementia?

Observe for other signs of physical discomfort, such as wincing, a change in posture, holding or rubbing a specific body part, or a sudden change in temperament. If the noises increase during movement or touch, pain may be the cause. Rule out common issues like infection, constipation, or hunger first, and consult a doctor if the behavior is new or worsening.

What is the difference between moaning and screaming in dementia?

Moaning is often a continuous, lower-volume sound that can signal general discomfort, while screaming or shrieking is typically more acute and can indicate fear, acute pain, or feeling startled. A sudden scream might be a response to a loud noise, a bad dream, or a sudden move from a caregiver. The underlying cause and appropriate response can be different for each.

My loved one with dementia keeps repeating the same phrase. What should I do?

Repetitive questioning, known as perseveration, is a common symptom of dementia. Respond with a simple, reassuring answer, and then try to gently redirect their attention to another activity. Avoid getting frustrated or trying to use logic, as this can increase their agitation. Consistency and calm are key.

Is it normal for a person with dementia to start vocalizing in the advanced stages?

Yes, it is very common. As dementia progresses, verbal communication abilities often decline, and individuals rely more on non-verbal cues and sounds. In the advanced stages, the brain's language centers may be significantly damaged, leading to sounds and vocalizations replacing coherent speech.

What if the vocalizations are happening at night?

Nighttime vocalizations could be caused by sundowning syndrome, confusion from being in a dark, unfamiliar environment, or discomfort. Ensure the bedroom is a comfortable and predictable space, use a nightlight, and check for unmet needs like a full bladder or pain. A calming routine before bed can also help.

How can I reduce the noise level and frequency of vocalizations?

Start by investigating the potential triggers, such as environmental noise, specific times of day, or physical needs. Use calming techniques like playing soft, familiar music, offering a gentle massage, or providing a favorite sensory object. Engage the person in a simple, meaningful task to provide distraction and a sense of purpose.

Why do some people with dementia hum or sing to themselves?

Humming or singing is often a self-soothing behavior that can indicate a person is feeling calm and content. It can also be an automatic vocal motor program that emerges when propositional speech is lost. Unless the singing is disruptive or inappropriate, it can be a positive sign of internal peace.