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using activities to prevent difficult behaviors

Key points

  • Difficult behaviors are communication, not misbehavior. The most effective prevention is to meet the underlying need with a meaningful activity.
  • Become a detective: track triggers, past interests, and what calms them. Use a simple journal to identify patterns like sundowning.
  • Simplify everything: offer only two choices, break tasks into small steps, and use a predictable routine to reduce anxiety.
  • Use distraction proactively: when you see early signs of agitation, redirect to a calming activity like music, a walk, or a simple task.
  • Never confront or argue during a behavior. Stay calm, give space, and try a different activity later.
  • Personalize activities to the person's history and current abilities. What worked last month may need to be simplified today.

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

Step-by-step

  1. Communicate clearly using short, simple sentences and a calm tone, with patient, unhurried pacing and adequate time for response.

  2. Maintain a consistent daily routine for meals, bathing, and activities to reduce confusion and anxiety.

  3. Ensure a safe environment by removing tripping hazards, installing grab bars, and using locks on doors to prevent wandering.

  4. Validate and redirect feelings of distress (e.g., agitation or frustration) by acknowledging emotions and gently shifting focus to a comforting activity.

  5. Provide visual and verbal cues during daily tasks, such as laying out clothes in order or offering step-by-step guidance for bathing.

  6. Monitor for changes in behavior, pain, or physical health, and report these to the healthcare provider promptly.

  7. Use positive language and avoid criticism or arguments; offer choices between two acceptable options to support autonomy.

  8. Engage in simple, familiar activities that match current abilities, such as folding laundry or looking at photo albums.

  9. Encourage adequate hydration and offer small, frequent meals with easy-to-eat foods to maintain nutrition.

  10. Support mobility and physical activity with supervised, safe exercises like short walks or seated stretches.

What not to do

  • Do not argue, correct, or contradict the person with dementia, even if they express a false belief.

  • Do not ask open-ended questions that require complex reasoning or memory; avoid testing memory by asking 'Do you remember...?'

  • Do not introduce new environments, multiple caregivers, or complex tasks without gradual and supported transition.

  • Do not use restraints, chemical or physical, as first response to wandering or agitation.

  • Do not neglect your own self-care and need for respite as a caregiver.

Practical tools

  • Daily Routine Checklist

    A customizable, printed schedule for morning, midday, and evening activities to provide structure and predictability.

  • Safety Home Audit Guide

    A room-by-room checklist to identify and remove fall risks, secure doors/windows, and improve lighting for dementia safety.

  • Communication Cue Cards

    Physical cards with simple pictograms and short phrases (e.g., 'Time to eat', 'Use bathroom') to assist with verbal cues.

  • Pain and Behavior Log

    A daily chart to track episodes of agitation, sleep changes, or new behaviors, alongside possible triggers and responses, for medical reviews.

Discuss with your clinician

If your loved one's agitation or aggression becomes frequent or severe, discuss with their doctor whether a medication evaluation is needed. Antipsychotics or other medications may be considered, but only after non-drug approaches have been tried and documented. Always ask about risks and benefits.

If your loved one has a history of falls or physical limitations, ask their doctor or physical therapist which activities are safe. For example, some exercises may be too strenuous or increase fall risk.

If your loved one has trouble swallowing (dysphagia), discuss safe snack options with their doctor or speech therapist. Avoid hard, small, or sticky foods that could cause choking.

If your loved one is on medications for other conditions (e.g., blood thinners, diabetes), ask how activities might affect their medication schedule or blood sugar levels. For example, physical activity may require adjusting insulin doses.

Related guides

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