It’s NOT about the handbag: understanding the signs of ill-being in dementia

Understanding the signs of ill-being in dementia and how you can help

As activity coordinators, we’re trained to bring joy, variety and meaning into residents’ lives. But some days, it feels like something’s not quite right  - a resident is anxious, pacing, fixated on something you can’t see or solve.

And that’s when our real work begins.

When behaviour is a message

Natasha Wilson, Dementia care manager for HC-One, recently posted this example on LinkedIn:

I’ve been to support a team today and as I walked through the door, I met an extremely distressed lady who was so upset and worried about her black handbag. Sometimes it had been stolen, other times it had been lost, but it was clear this handbag was the most important thing to her in that moment. 

We went to look for it, but colleagues told me she had never actually had one with her since moving to the care home at the weekend.

I can’t imagine the worry & sheer panic I would feel in a place I wasn’t familiar with & not having my handbag on me.

£2.50 and one quick 4 minute trip round the corner to the Age UK shop and I left with her proudly walking around with this, packing it, unpacking it and smiling 🥰

She didn’t need a handbag. She needed reassurance. A sense of self. The comfort of familiarity.

Recognising ill-being

People living with dementia often experience ill-being in ways that look like:

• Repetition or fixations - “Where’s my handbag?” “I need to catch the bus.”

• Agitation or restlessness

• Withdrawal or retreating to their room

• Sudden mood changes or uncharacteristic behaviour

  
  

Rather than asking “How do I stop this?”, ask: “What is this person trying to tell me?”

How Activity Coordinators can help

You don’t need to have all the answers - but you do need to be a gentle detective.

Observe

• What times of day does the behaviour show up?

• Is it triggered by noise, transitions, hunger, lighting, or fatigue?

• Are there patterns you can spot?

  
  

Listen

• Not just to the words, but to the need underneath them.

• Is your resident asking for a handbag - or asking for safety?

• Are they talking about “going home” - or feeling homesick for the familiar?

  
  

Respond

• Offer comfort over correction. “Let’s have a look for it together” is more helpful than “You didn’t bring it.”

• Use similar objects (a bag, keys, notebook) as part of a comforting routine

• Build it into activities - for example, discuss what items they like to carry in their handbag.

  
  

Working with families

Often, families clear out belongings thinking it’s “for the best.” You may hear:

“Mum won’t need her handbag now.”

But you can help them understand the emotional importance of these everyday items.

Start the conversation with:

• “We’ve found familiar objects can be really grounding - even if they’re not being used in a practical way.”

• “Sometimes, having something like a handbag or an old diary helps someone feel more like themselves.”

• “Would you be open to bringing in something that’s special to them - even if it’s just to have nearby?”

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You might even offer to:

• Store items safely for staff-supported use

• Incorporate them into 1:1 reminiscence sessions

• Photograph treasured belongings as part of a “This is Me” book

  
  

Final thought

Not every problem behaviour is a problem - often, it’s communication.

By observing quietly, listening deeply, and involving families gently, you can support your residents not just to take part in activities - but to feel safe, seen and whole.

It’s not about the handbag. It’s about what the handbag means.