Dementia is characterized by a decline in cognitive abilities that is sufficient to impair functioning in daily living. There are a number of forms of dementia (Alzheimer’s, vascular, Lewy body, etc), each with its own cognitive profile and developmental course. The present paper deals with the progressive dementias, such as Dementia of the Alzheimer Type (DAT). The cognitive deterioration associated with advanced DAT is often accompanied by a decline in emotional control, social behaviour and motivation. The paper focuses particularly on the emotional features of the disorder, because this issue has a profound impact on both the sufferer and carer. A framework for conceptualizing anxiety is presented, and a model of how this conceptualization can be used effectively within a carer’s training programme is discussed.