Shouting, Screaming and Calling Out in Dementia: Causes and What Helps

Repeated shouting, screaming or calling out is one of the hardest dementia behaviors to live with. Here's why it often happens, how to look for the hidden cause, calming approaches that help, and when to call the doctor.

By Jim Pavlish, Editor · Last updated: October 30, 2026 · Editorial policy

Short answer: repeated shouting or calling out in dementia is usually a sign of distress or an unmet need the person can't put into words, such as pain, thirst, needing the toilet, fear or boredom, according to the Alzheimer's Society and Dementia UK. Have the doctor check for pain, infection or constipation, keep a diary to spot triggers, and respond calmly. Medicines are a last resort.

"Help me! Help me!" over and over. Shouting for a mother who died decades ago. Screaming during a shower or every evening around dinnertime. If you're caring for someone with dementia who calls out or screams, you know how exhausting and upsetting it can be, for you, for the person, and for everyone nearby.

The good news is that there's often a reason behind it, and finding that reason can make a real difference. This page is general information, not medical advice. Talk to the person's doctor about any new or worsening behavior.

If the person is in sudden severe pain, has a fall or injury, or seems very unwell, get medical help right away. Call 911 in an emergency.

Why does it happen?

The Alzheimer's Society lists shouting out or screaming among the behavior changes that can come with dementia, and explains that these behaviors often happen because the person has a need that isn't being met and they can't communicate it. They may be thirsty, hungry or in pain, may have misunderstood something and feel threatened, or may be frustrated or bored.

Dementia UK, whose Admiral Nurses specialize in dementia, lists shouting, crying, groaning and calling out for someone as common signs of distress. It describes several possible causes:

• Pain or discomfort. The person may not be able to say what hurts, or may no longer recognize that they need a painkiller. See Recognizing Pain in Dementia.
• Unmet needs. Being hungry, thirsty, too hot or cold, needing the toilet, wanting to stretch their legs, or being bored.
• Sensory overload. Loud noise, strong smells or uncomfortable sensations on the skin.
• Unfamiliar or confusing surroundings. A hospital stay, or not recognizing their own home or belongings.
• Emotions. People with dementia can feel anxiety and depression but may not be able to express them. See Anxiety in Dementia: Signs, Causes and How to Help.
• Sundowning. Feeling more anxious, confused and distressed in the late afternoon or evening. See Sundowning.
• Painful memories. Some people relive traumatic events, such as war or a serious accident, as dementia progresses.

When it starts suddenly, think health first

The NHS says that if a change in behavior comes on suddenly, the cause may be a health problem, such as pain or discomfort from constipation or an infection. It advises asking a doctor to rule out or treat any underlying cause.

For more severe behavior, the NHS lists uncontrolled pain, untreated depression, infections such as a urinary tract infection (UTI), and side effects of medicines as causes the doctor should look for. A UTI can cause sudden confusion and agitation in older adults. See UTIs and Sudden Confusion in Older Adults and Delirium vs. Dementia.

Become a detective: keep a diary

The NHS suggests keeping a diary for one to two weeks to spot triggers. Note when the calling out happens and what was going on:

• What time of day was it?
• Was the room noisy, busy or cluttered?
• Were they being asked to do something, like bathe or dress?
• When did they last eat, drink, use the toilet or have a bowel movement?
• Did anything seem to help?

Patterns often jump out. Calling out every afternoon may point to sundowning or tiredness; screaming at bath time may point to fear, cold or pain. Bring the diary to the doctor.

Calming approaches that help

These suggestions come from Dementia UK, the NHS and the Alzheimer's Society:

• Check the basics first. Pain, hunger, thirst, the toilet and temperature.
• Ask, and really listen. If they can answer, listen closely even if what they say is confused. Look for clues in body language: holding part of the body may mean pain there; covering the face may mean they're overwhelmed.
• Use a soft, steady, low voice. Dementia UK advises not mirroring the person's emotion: if they're shouting, speak low and calm. Get on their level and make gentle eye contact.
• Validate the feeling. Try "I can see you're upset" rather than arguing about facts. Dementia UK advises against challenging the person's reality, which can increase distress.
• Offer comfort. Holding a hand, rubbing their back, or simply sitting with them can help some people feel safe.
• Try music they love, or a favorite film, a simple task, or a short walk. See Music and Art Therapy and Activities for People with Dementia.
• Change the scene, or for some people, move to a quieter familiar room instead.
• Reduce noise and clutter. Turn off the TV or radio and soften the lighting.
• Keep routines predictable, and give information in small pieces at the right moment.

If the person calls out for someone who has died, the NHS suggests avoiding telling them the person died years ago and talking instead about that time in their life. See Should You Tell Someone With Dementia That a Loved One Has Died?.

What about medicine?

Dementia UK says medicines are sometimes used to ease distress, but antipsychotics in particular should be a last resort, considered only after other approaches have been tried, because they can cause drowsiness, falls and a higher risk of stroke, and may worsen some types of dementia. The NHS says that if other strategies don't work, an antipsychotic may be prescribed as a short-term treatment by a specialist. Any decision about medicine belongs with the doctor. Don't start, stop or change medicines on your own. See Antipsychotics and Dementia: Risks and Treating Behavioral Symptoms.

Look after yourself

Hearing someone you love scream or call out for hours is draining. Dementia UK suggests a quick breathing exercise: breathe in, tense your jaw, shoulders and arms, hold for a few seconds, then let go as you breathe out. If you need a minute, step into another room if it's safe to leave them. If you ever feel unsafe, go to a safe room and call for help, or 911 in an emergency.

Ask family or friends to take turns, consider respite care, and talk to the doctor if you're struggling. See Caregiver Stress and Burnout and Respite Care. In the US, the Alzheimer's Association 24/7 Helpline (800-272-3900) can talk through difficult behaviors.

Common questions

Why does my loved one with dementia keep calling out or screaming?

Often it's a way of communicating a need they can't put into words. The Alzheimer's Society says they may be thirsty, hungry, in pain, frightened, frustrated or bored. Dementia UK adds causes like too much noise, unfamiliar surroundings, anxiety, sundowning and painful memories.

Could screaming be a sign of pain or illness?

Yes. The NHS says a sudden change in behavior may be caused by a health problem such as pain from constipation or an infection, and advises asking a doctor to check for underlying causes, including untreated depression and medicine side effects.

What should I do when someone with dementia is shouting?

Stay calm and speak in a low, steady voice, check for basic needs like pain, the toilet, hunger and temperature, validate their feelings rather than arguing, and try comfort, music or a quieter space. Keep a diary of when it happens to spot triggers.

Is there medication for screaming in dementia?

Sometimes medicines are used, but Dementia UK says antipsychotics should be a last resort because of side effects such as drowsiness, falls and stroke risk. Talk to the doctor, who will look for treatable causes first.

The bottom line

Shouting, screaming and calling out are usually signs of distress or an unmet need, not deliberate behavior. Rule out pain, infection, constipation and other health problems with the doctor, keep a diary to find triggers, respond calmly and kindly, and get support for yourself. Medicines are a last resort.

Sources

1. NHS: Coping with dementia behaviour changes
2. Dementia UK: Managing distress in a person living with dementia
3. Alzheimer's Society (UK): Understanding and supporting a person with dementia

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

Related articles

• Agitation and Aggression
• Recognizing Pain in Dementia
• Sundowning
• Anxiety in Dementia: Signs, Causes and How to Help
• Communicating with Someone with Dementia
• Managing Challenging Behaviors