Behavioral disturbance of dementia are described in the literature as related to brain damage and premorbid personality. This perspective, however, does not consider that a patient with dementia is a human being who feels, thinks, wishes, and behaves. It also does not consider that the dysfunctional behavior may be related to the patient's other behaviors or to the behaviors of the patient's caregivers. Although rating scales are commonly used to assess behavioral disturbances, an assessment that a patient shouts, for example, is meaningless unless the situation in which the patient shouts is considered. What provoked the patient to shout? How does the caregiver react when the patient shouts? Understanding the context in which the behavioral disturbance occurs is important for developing effective care plans. Effective treatment is necessary because behavioral disturbances can negatively affect the quality of care received by institutionalized patients with dementia.