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The Art of Saying Yes: Allowing Harmless Unusual Behaviors in Dementia Care

When your loved one starts hoarding objects or wearing multiple layers of clothing, your instinct may be to correct them. But many of these behaviors are harmless expressions of a need for control, comfort, or purpose. By learning to say 'yes' to what doesn't pose a safety risk, you reduce conflict, preserve dignity, and create a calmer environment for both of you. This article gives you concrete steps, phrases, and tools to decide when to allow and when to gently redirect.

Key points

  • Saying 'yes' to harmless behaviors reduces conflict and preserves dignity.
  • Hoarding and layering are often expressions of a need for control, comfort, or identity.
  • Use the 'yes, and' technique to redirect without confrontation.
  • Create a designated 'yes space' for collected items to keep the home safe and organized.
  • Always check for safety hazards first, then allow what is harmless.
  • Personalize your approach based on the stage of dementia, the setting, and your relationship.

Why They Hoard or Wear Layers: It’s Communication, Not Misbehavior

When a person with dementia hoards items—like stuffing newspapers into drawers or collecting empty containers—or insists on wearing three sweaters in summer, they are not being stubborn or illogical. These actions are their way of communicating an unmet need. The behavior is a form of expression: they may feel insecure, anxious, or bored, and the objects or clothing give them a sense of safety and control. As one expert explains, 'behaviors are a form of communication... we’re the ones with the healthy brain that’s got to sometimes be able to figure it out, decode it' (James L. West Center for Dementia Care). Their brain is coping the best it can with what remains, and focusing on what they can still do—rather than what they can’t—helps us respond with compassion rather than frustration.

The Hidden Purpose: Control, Comfort, and Identity

For someone losing their grip on memory and routine, hoarding or wearing layers can be a way to hold onto a sense of identity. A collection of items—even if it looks like clutter—may represent a cherished hobby, a memory of a loved one, or a feeling of being prepared. Similarly, wearing multiple layers might be a response to feeling cold due to changes in circulation, or it could be a way to feel 'wrapped up' and secure. The key is to ask yourself: 'Is this behavior harmful, or is it just unusual?' If it’s not dangerous, allowing it can prevent a power struggle that drains everyone’s energy. As one caregiver expert notes, 'in the scheme of things, it doesn’t matter that they’ve moved things around' (Dementia With Grace). Your job is to be a detective, not a disciplinarian.

When Saying Yes Becomes a Therapeutic Tool

Saying 'yes' to harmless behaviors is actually a powerful redirection technique. Instead of directly saying 'no' (which often triggers agitation), you can say 'yes, and we’ll do that in a moment' or 'yes, let’s put that here for now.' This interrupts the behavioral loop without confrontation. As one dementia educator explains, 'you are not saying no, you’re saying wait... you’re interrupting that behavioral loop... nine times out of ten you’re gonna get them on to doing something else and they will forget that they were headed' (Dementia With Grace). This approach preserves their dignity and your relationship, while still allowing you to guide them toward safer or more appropriate activities.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Pause and ask yourself: 'Is this behavior harmful or just unusual?' Check for safety risks: tripping hazards, fire danger, spoiled food, or extreme temperature discomfort. If none exist, take a deep breath and allow it. Your calm response sets the tone.

  2. Use the 'yes, and' technique. If they want to keep a pile of magazines, say: 'Yes, those are interesting. Let’s put them in this basket so we can look at them later.' This validates their choice while gently organizing the space. Avoid arguing or insisting on discarding.

  3. Offer a limited choice that respects their need. For layering: 'Would you like to wear the blue sweater or the red one today?' This gives them control over a safe option. If they insist on three shirts, let them—as long as they aren’t overheating or in danger of falling.

  4. Create a designated 'yes' space. Set up a drawer, box, or shelf where they can keep collected items—keys, papers, small objects—without judgment. Check it periodically for safety (no sharp objects or expired food), but otherwise let it be their domain.

  5. Use distraction to shift focus when the behavior becomes risky. If they are hoarding food that spoils, say: 'Let’s put these in the fridge together, and then we can have a snack.' Then guide them to a different activity like folding towels or looking at a photo album.

  6. Observe patterns. Note when the hoarding or layering happens—before meals, after a bath, during quiet times. This can reveal an unmet need (hunger, feeling cold, boredom). Address the root cause: offer a warm drink, a blanket, or a simple task like sorting socks.

  7. For layering that becomes excessive (e.g., wearing a winter coat indoors in summer), check the environment first. Is the room too cold? Are their clothes itchy or uncomfortable? If the environment is fine, offer a lightweight alternative: 'This soft cardigan is so cozy—want to try it instead?'

  8. If the behavior is in a memory care facility, communicate with staff. Ask them to allow the behavior unless it interferes with others’ safety or the person’s health. A simple note in their care plan—'Resident may wear multiple layers; please do not remove without checking temperature'—can prevent daily battles.

What not to do

  • Don’t say 'no' outright or argue about the behavior. This often triggers a fight-or-flight response, making the person more determined to keep the items or layers. Instead, use redirection: 'Let’s put that in the closet for now and come back to it after lunch.'

  • Don’t throw away or hide their hoarded items without their knowledge. This can cause deep distress and erode trust. If you must remove something for safety (like spoiled food), do it when they are not watching, and replace it with a similar safe item (like a clean empty container).

  • Don’t shame or criticize. Avoid phrases like 'Why are you wearing that? It’s too hot!' or 'You don’t need all this junk.' This makes them feel like a failure. Instead, use neutral observations: 'I see you have a lot of things here. Let’s make sure you have room to walk safely.'

  • Don’t force them to change clothes or discard items if they are not ready. This can lead to agitation, aggression, or withdrawal. Use the 'do, delay, delete' approach: do something together, delay the decision, or delegate it to a trusted person later (Dementia Caregiver Support For Christians).

  • Don’t ignore safety hazards. While you want to allow harmless behaviors, you must intervene if there is a fall risk (clutter on stairs), fire risk (papers near a stove), or health risk (rotting food). Frame the intervention as care: 'Let’s move this to a safer spot so you don’t trip.'

  • Don’t assume the behavior is meaningless. Ask yourself: 'What is this person trying to tell me?' They may be expressing anxiety, boredom, or a need for sensory input. Address the underlying need, not just the behavior.

Practical tools

  • The 'Yes, and' Phrase Bank

    Keep these phrases handy: 'Yes, we can keep that. Let’s put it in this special box.' 'Yes, you can wear that. Would you like a sweater over it too?' 'Yes, I see you’re collecting these. Let’s sort them together.' These validate without confrontation.

  • The Safety Checklist for Hoarding

    Before you allow hoarding, run this quick check: Are there clear pathways? Is anything blocking doors or vents? Are there sharp objects, expired food, or medications mixed in? If any answer is yes, remove the hazard while offering a replacement (e.g., a safe empty box).

  • The 'Layer Check' Routine

    If your loved one insists on wearing many layers, check their temperature by feeling their neck or back. If they are sweating, offer a cool drink and a lighter alternative: 'This cotton shirt is so soft—want to try it?' If they are cold, add a safe layer like a fleece vest.

  • The 'Yes Space' Setup

    Designate a drawer, basket, or shelf as their 'collection zone.' Label it with their name or a fun sign like 'Grandma’s Treasures.' This gives them a safe place to keep items without cluttering the whole house. Check it weekly for safety.

  • The Distraction Menu

    Have a list of go-to activities that engage their hands and mind: folding towels, sorting socks, looking at a magazine, or doing a simple puzzle. When they start hoarding or layering excessively, gently guide them to one of these activities.

  • The 'Do, Delay, Delete' Framework

    When you need to address a behavior: Do it together (e.g., 'Let’s put these papers in this box together'), Delay the decision (e.g., 'We’ll decide about these tomorrow'), or Delete the item when they aren’t looking (only for safety hazards). This reduces resistance.

Discuss with your clinician

If hoarding includes medications (old prescriptions, mixing pills), discuss safe disposal with the doctor or pharmacist.

If layering leads to skin breakdown, rashes, or overheating, ask the doctor about temperature regulation and appropriate clothing materials.

If hoarding becomes severe (blocking exits, attracting pests, causing falls), discuss whether a home safety assessment or adult protective services referral is needed.

If the behavior is linked to hallucinations or delusions (e.g., they believe items are being stolen), ask the doctor about medication adjustments or non-pharmacological approaches.

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