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Brick by Brick Bonding with Duplo: A Hand-Under-Hand Activity for Non-Verbal & Any Stage Dementia

When words fade, touch and play can still connect. The Brick by Brick Bonding technique uses Duplo bricks to restore a moment of agency and joy for your loved one, even when they can no longer speak or remember your name. This is not about building something perfect; it is about sharing a quiet, purposeful activity together, hand under hand, that lets them feel capable and valued. You will find concrete steps, exact words to say, and ways to adapt for any stage, so you can create a calm, connecting experience right now.

Key points

  • Duplo bricks are ideal because they are large, easy to grasp, and safe for any stage of dementia.
  • Use hand-under-hand to guide, not control — this preserves dignity and agency.
  • Focus on the process (touch, sound, sorting) not the product (a finished tower).
  • Keep instructions to one step: 'Stack this,' or 'Sort these.'
  • End the activity before your loved one becomes tired or frustrated — 5-10 minutes is often enough.
  • The joy of the moment can be remembered even if the activity itself is forgotten.

Why Duplo bricks work when words fail

In dementia, the brain’s language centers may be damaged, but the parts that process touch, rhythm, and simple motor actions often remain intact much longer. Duplo bricks are large, easy to grasp, and require no verbal instructions — they invite the hands to do what they remember: push, pull, stack, and sort. This taps into what dementia care experts call 'procedural memory,' the body’s memory for how to do things, which can outlast the memory for names or events. When you place a brick in your loved one’s hand and guide their hand with yours (hand under hand), you are not asking them to think or remember; you are inviting them to participate in a familiar, satisfying motion that feels safe and purposeful.

The 'Brick by Brick' philosophy: restoring agency, not building a model

Patty Sherin, co-author of 'Brick by Brick Bonding Tools for Family Care,' developed this approach after her mother forgot who she was. She found that even when her mother could not remember her name, she remembered the joy of playing with bricks. The technique is not about following instructions or creating a specific structure; it is about giving the person a task — 'Can you help me sort these into two piles?' or 'Let’s stack these together' — and letting them respond with their hands. The goal is to restore a sense of agency, the feeling of 'I can do this,' even for a few minutes. This is deeply rooted in Montessori principles for dementia, which emphasize meaningful, self-directed activity that matches the person’s remaining abilities. When your loved one successfully snaps two bricks together, they experience a moment of competence that can reduce agitation, boost mood, and strengthen your bond.

How hand-under-hand changes the interaction

The hand-under-hand technique is the physical foundation of Brick by Brick Bonding. Instead of doing the activity for your loved one (hand over hand, which can feel controlling) or leaving them to struggle alone, you place your hand gently under theirs, palm up, and let them rest their hand on top of yours. Then you guide the brick together. This gives them the sensation of leading the action while you provide gentle support. It preserves their dignity and independence, because they feel they are doing it themselves. As Teepa Snow’s Positive Approach to Care teaches, hand under hand 'gives that support and doing with, not to.' When your loved one feels your hand under theirs, they are less likely to become frustrated or withdraw, because you are partnering, not directing.

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

Step-by-step

  1. Prepare the space: Sit facing your loved one at a table or on a lap tray. Use a small, clutter-free area. Place a handful of Duplo bricks (6-10) in a shallow bowl or on a cloth in front of them. Choose bright, contrasting colors (red, blue, yellow) that are easy to see. Keep the pile small to avoid overwhelm.

  2. Begin with a warm, simple invitation: Instead of saying 'Let’s build something,' which can feel like a demand, say, 'I need your help with these bricks. Can you help me sort them?' or 'Let’s see what these feel like.' Use a calm, slow tone. If they are non-verbal, hold a brick gently in front of them and wait. Your open palm and soft smile signal safety.

  3. Use hand-under-hand to start: Place your hand under theirs, palm up, and let their hand rest on top of yours. Pick up a single Duplo brick with your combined hands. Slowly bring it to the table. Say, 'Feel that? It’s smooth.' Let them explore the brick with your guidance. Do not rush. The goal is the sensation, not the outcome.

  4. Model the action slowly: With your hand still under theirs, pick up another brick and gently press it onto the first one. Make the 'click' audible. Say, 'Listen — click!' Repeat this a few times, letting them feel the resistance and the sound. If they pull away, stop and wait. Follow their lead. You can simply hold the bricks and let them touch them.

  5. Offer a simple choice: Hold up two bricks of different colors. Say, 'Which one should we use next?' Wait for a gesture, a look, or a hand movement. Even a slight glance counts as a choice. This restores agency. If they are non-verbal, watch their eyes or the direction of their hand. Acknowledge their choice: 'You picked the red one. Good choice.'

  6. Introduce a sorting task: Place a mix of red and blue bricks on the table. Say, 'Can you help me put the red ones here and the blue ones here?' Point to two separate areas. If they hesitate, use hand-under-hand to guide one brick to the correct pile. Then let go and see if they continue. Praise any attempt: 'Thank you, that helps so much.'

  7. Build a simple tower together: Stack two bricks with your hand under theirs. Then hand them a third brick and say, 'Your turn to add one.' If they cannot grasp it, gently place the brick in their palm and help guide it. Do not correct if they place it crookedly. The tower may fall — that is fine. Laugh together and say, 'Oops! Let’s try again.'

  8. End gently: After 5-10 minutes, or when you notice signs of fatigue (looking away, sighing, dropping bricks), say, 'We did a great job. Thank you for helping me.' Slowly remove the bricks. Place a soft cloth over them if you plan to return later. Offer a hand rub or a warm drink to transition to the next activity. The memory of the joy lasts longer than the session itself.

What not to do

  • Do not correct or 'fix' their building: If they stack bricks in a way that seems 'wrong' to you, resist the urge to rearrange them. Correcting can feel like criticism and destroy the sense of agency. Instead, admire what they have done: 'Look at that tower — you made it so tall!'

  • Do not use small LEGO bricks: Standard LEGO bricks are too small and can be a choking hazard or cause frustration. Always use Duplo (large bricks) or similar oversized blocks. If your loved one has difficulty gripping, look for bricks with a textured surface or larger knobs.

  • Do not talk too much or give complex instructions: Avoid saying things like, 'First, find a red brick, then put it on top of the blue one, then we’ll add a yellow one.' This overloads the brain. Use one-step phrases: 'Let’s stack.' Or just point and nod. Silence is okay — the hands are doing the talking.

  • Do not force participation if they are agitated: If your loved one pushes the bricks away, turns their head, or seems distressed, stop immediately. The activity should feel like a gift, not a demand. Try again later, or switch to a different sensory activity like folding cloths or sorting spoons. Forcing can create negative associations with the bricks.

  • Do not expect them to remember the activity from session to session: Each time you bring out the Duplo, it may feel new to them. That is normal. Do not say, 'Remember we did this yesterday?' Instead, greet the bricks as if for the first time: 'Look what I found — can you help me with these?' This keeps the interaction fresh and pressure-free.

  • Do not leave them alone with the bricks: Even with Duplo, supervision is important to prevent mouthing or throwing. Stay present, even if you are just sitting quietly nearby. Your calm presence is part of the bonding. If you need to step away, remove the bricks first.

Practical tools

  • The 'Sorting Piles' Invitation

    Exact phrase to say: 'I need your help sorting these bricks. Can you put the red ones here and the blue ones here?' Use two small plates or cloth squares as markers. This turns the activity into a 'job' that feels purposeful, not childish. It works because sorting is a preserved skill for many people with dementia, even in later stages.

  • The 'Click and Listen' Routine

    Each time you snap two bricks together, pause and say, 'Listen — click!' Then smile and nod. This creates a predictable, rhythmic pattern that can be calming. If your loved one is non-verbal, you can hum or tap the bricks together gently. The sound becomes an anchor that signals success and connection.

  • The 'One More' Gentle Prompt

    When your loved one places a brick, say, 'One more?' and hold up a single brick. Wait with an open hand. If they reach for it, great. If not, place it in their hand and guide it. This keeps the activity open-ended without pressure. It also gives them a clear, simple next step.

  • A Calm Environment Checklist

    Before starting: turn off the TV, lower the lights, and sit at eye level. Remove any sharp objects or breakables from the table. Have a soft cloth nearby to wipe hands if needed. Play quiet, familiar music from their youth in the background (e.g., big band or classical). This sets the stage for focus and reduces distractions.

  • The 'Hand-Under-Hand' Physical Setup

    Sit beside them, not across, so your arm can comfortably reach under theirs. Use a pillow to support their elbow if needed. Keep your movements slow and exaggerated. If they have arthritis, warm their hands with a warm towel first. The goal is comfort, not speed.

  • A 'Finished' Signal

    When the activity is over, say, 'We did it. Thank you for your help.' Then gently place your hand over theirs (palm to palm) for a moment of stillness. This signals closure without words. Then slowly remove the bricks and offer a hand lotion massage — the touch continues the bonding.

Discuss with your clinician

If your loved one has a history of swallowing difficulties (dysphagia), ask your clinician whether Duplo bricks are safe to use, even with supervision. Some individuals may attempt to mouth objects, and a clinician can advise on alternatives like soft, textured fabric blocks.

If your loved one has severe arthritis or hand pain, ask your clinician or occupational therapist for recommendations on adaptive grips or larger, softer building blocks that are easier to hold.

If your loved one becomes agitated or aggressive during the activity, discuss with your clinician whether this might be a sign of unmet pain, discomfort, or a need for a medication adjustment. Do not assume the activity itself is the cause.

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