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Reframing Challenging Situations: A Workbook Approach for Caregivers in Adult Day Programs

This article helps you shift from seeing the person with dementia as the problem to finding creative, solution-based approaches. It explains why your thoughts and reactions can escalate or calm situations, and offers concrete steps to reframe your mindset using a workbook-style method. You'll learn practical tools, phrases to use, and how to adapt these strategies for early to moderate stages in an adult day program setting. Remember, you are not alone, and small changes can make a big difference for both of you.

Key points

  • You have control over your thoughts, not the person's behavior. Changing your thought changes the situation.
  • Use 'both/and' thinking to hold two truths at once and reduce stress.
  • Stop trying to fix or correct; instead, support and enter their world.
  • Track one positive contribution you made each day to build resilience.
  • In an adult day program, share successes with colleagues to build a positive team culture.
  • Personalize your approach based on the stage of dementia and the setting.

Why Your Thoughts Shape the Situation

When you see the person with dementia as deliberately difficult or frustrating, your emotions and reactions naturally become defensive or resentful. This thought pattern actually makes the situation worse because it negatively impacts your loved one, who may sense your frustration and become more agitated or withdrawn. As one expert notes, 'as long as that's what you're thinking, you're never going to find the solution' (source 11). You have 100% control over your own thoughts, not over the person's behavior or the disease. Changing your thought is the first step to changing the entire dynamic.

The Power of 'Both/And' Thinking

Instead of thinking in absolutes—'he is either here or gone,' 'she is either present or absent'—try 'both/and' thinking. For example, 'He is both here and sometimes gone' or 'I am both a good caregiver and sometimes I could do better.' This approach, described by researcher Pauline Boss, lowers your stress and helps you stay resilient (source 3). It allows you to hold two truths at once: the person is still the same person you love, even as the disease changes them. This shift reduces the pressure to 'fix' everything and opens space for creative solutions.

From Fixing to Supporting

Many new caregivers fall into the trap of trying to correct or fix the person with dementia—pointing out when they're wrong, reminding them of facts, or arguing about what's real. However, correcting often makes the situation worse because the person's brain can no longer process that information. Your job is not to fix the problem but to stand alongside them and guide them through the experience as best you can (source 12). This means entering their world instead of expecting them to enter yours. For example, if they think a red gown has blood on it, don't argue—validate their feeling and redirect.

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

Step-by-step

  1. Pause and name your thought: 'I am thinking that she is doing this on purpose.' This distinguishes thought from fact and enables change.

  2. Ask: 'What is the need behind this behavior?' Shift from blame to problem-solving by considering unmet needs such as boredom, pain, or fatigue.

  3. Use 'both/and' reframing: Say aloud, 'He is both here and sometimes gone. I am both frustrated and loving.' This avoids absolute thinking.

  4. Enter their world instead of correcting theirs. If they believe it is 1985, respond, 'Let’s get ready together.' This reduces resistance and builds trust.

  5. Plan ahead for common triggers: before bathing, include a calming activity (e.g., music) and prepare all supplies. Use a consistent routine to minimize confusion.

  6. Track patterns daily: log challenges, what you tried, and what worked. End each day with one sentence: 'What did I do today that made a situation better?'

What not to do

  • Do not argue, correct, or use logic with delusions. Validate feelings instead and redirect: 'I hear you’re worried. Let’s look at this photo.'

  • Do not take behaviors personally. Remind yourself: 'This is the disease, not them.' This fosters compassion over resentment.

  • Do not ignore your own emotions. Acknowledge them in a journal or support group—suppressing grief leads to burnout.

  • Do not expect the person to adapt to your reality. Adapt to theirs; this reduces stress for both of you.

Practical tools

  • Both/And Phrase Card

    Write three 'both/and' statements (e.g., 'She is both present and sometimes absent') on a card. Read it aloud when stuck.

  • One-Positive Journal

    Each evening write: 'What did I do today that made a situation better?' Shifts focus to solutions and builds resilience.

  • Validation & Redirection Script

    Use: 'I see you’re feeling [emotion]. Let’s [activity] together.' Then join their reality without correcting. Example: 'I see you’re worried. Let’s look at this clock and have a snack.'

  • Workbook Chapter Guide

    For each challenge (bathing, eating, wandering), list: (1) triggers, (2) unmet need, (3) what worked, (4) what to try next. Use alone or in a group.

  • Calm-Down Kit

    Prepare a bag with soothing items (photo, soft blanket, favorite song, scented lotion). When agitation rises, offer it silently—just hand or place nearby.

Discuss with your clinician

If the person's behaviors become dangerous (e.g., hitting, throwing objects), discuss with a doctor whether medication or a referral to a specialist is appropriate.

If you experience persistent caregiver burnout or depression, talk to your healthcare provider about counseling, support groups, or respite care options.

If the person has sudden changes in behavior (e.g., new aggression, hallucinations), rule out medical causes like infection or pain—discuss with a clinician immediately.

Related guides

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