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Reframing the Person as Not the Problem: Creative Solutions at the Adult Day Program

When your loved one behaves in ways that feel frustrating or hurtful at the adult day program, it is easy to slip into seeing them as the problem. This sub-article helps you shift that lens: the person is not the problem; the dementia is driving the behavior, and your role is to become a creative problem-solver. You will find concrete steps to pause, reframe, and try new approaches that honor their dignity and reduce your own stress. You are not failing; you are learning a new skill.

Key points

  • The person is not the problem; the dementia is driving the behavior. Always separate the disease from the person.
  • Your feelings of frustration come from your thoughts, not from the person. Pause and reframe your thinking.
  • Use 'both/and' thinking to stay flexible and reduce stress: they are both here and sometimes gone, both capable and struggling.
  • Create a personal mantra to stop arguments before they start. Keep it private and use it silently.
  • Validate their feelings first, then redirect. Never argue or quiz them on reality.
  • Celebrate small successes and treat failures as feedback. You are learning a new skill, and it takes time.

What Is Really Happening: The Disease, Not the Person

When your loved one refuses help, becomes agitated, or says things that seem hurtful at the adult day program, it is easy to feel personally attacked. But the core truth is this: the behavior is a symptom of the brain change, not a reflection of who they are. As one expert puts it, 'If this person was in their right mind, they would maybe not be doing these behaviors.' The dementia is working on their brain, and they are not fully aware of how they are acting. Your job is to stop judging the person and start asking, 'What is driving this? What unmet need is being communicated?' (Source: Dementia With Grace; Teepa Snow's Positive Approach to Care).

The Emotional Trap: Why You Feel Like the Problem Is the Person

It is human to feel resentment, frustration, or even anger when caregiving is hard. But these feelings are not caused by the person with dementia; they are caused by your thoughts about the situation. For example, thinking 'I shouldn't have to do this' or 'They are doing this on purpose' creates the emotion of resentment. The person's behavior is just the first arrow; the second arrow is your own judgment and blame. Acknowledging that your feelings come from your thoughts, not from the person, is the first step to freeing yourself from the emotional trap (Source: Dementia Careblazers; James L. West Center for Dementia Care).

The Gift of 'Both/And' Thinking

Instead of seeing your loved one as either fully present or fully gone, try 'both/and' thinking: they are both here and sometimes gone, both capable and struggling, both the person you love and someone whose brain is changing. This flexible mindset lowers your stress and opens up creative solutions. It also helps you see that you can be both a good caregiver and someone who sometimes makes mistakes. Let go of absolute thinking—it only creates barriers (Source: AlzheimersSpeaks; Pamela D Wilson).

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

Step-by-step

  1. Step 1: Pause and take three deep breaths before you react. When you feel frustration rising, stop yourself. Say silently in your head, 'This is the disease, not the person. I can handle this.' This pause gives your brain a moment to shift from reactive to creative (Source: Teepa Snow's Positive Approach to Care).

  2. Step 2: Ask yourself, 'What unmet need is my loved one trying to communicate?' The five common needs are: physical discomfort (hunger, thirst, pain, needing the bathroom), emotional distress (fear, loneliness, boredom), overstimulation (too much noise or activity), understimulation (not enough to do), or a need for control. Look for clues in their body language, the time of day, or the environment (Source: Teepa Snow's Positive Approach to Care).

  3. Step 3: Use a mantra to stop arguments before they start. Create a short, private phrase you repeat in your head when you feel an argument coming. Examples: 'I am a dementia strategist. I can do this.' Or 'This is not about me.' Or a funny one: 'Brain change, not blame.' This keeps you from getting pulled into a power struggle (Source: Answers About Alzheimer's).

  4. Step 4: Change the subject or redirect with a pleasant activity. If your loved one is agitated at the day program, try offering a snack, putting on soft music, looking at a photo album, or suggesting a short walk. These simple distractions can shift their focus and calm the situation (Source: UCLA Health).

  5. Step 5: Validate their feelings first, then offer help. Instead of saying 'You need to sit down,' say 'I see you are upset. It is hard when things feel confusing. Let's sit together for a moment.' This acknowledges their experience and builds trust (Source: Dementia Careblazers).

  6. Step 6: Ask about their experience if they seem confused or scared. For example, if they say they see something that isn't there, gently ask 'What do you see? Tell me about it.' This can help you understand if it is a true hallucination, an illusion (misperceiving something real), or a memory. Then you can respond appropriately (Source: Dementia Careblazers).

  7. Step 7: Celebrate small successes and learn from failures. When a strategy works, even a little, say out loud or to yourself, 'That worked. I am one step closer to figuring this out.' When it doesn't work, treat it as feedback, not failure. The most successful caregivers are those who are willing to try, fail, and try again (Source: Dementia Careblazers).

  8. Step 8: Use 'both/and' thinking to stay resilient. Remind yourself: 'My loved one is both here and sometimes gone. I am both a good caregiver and someone who can improve.' This reduces the pressure to be perfect and opens up creative options (Source: AlzheimersSpeaks).

  9. Step 9: Write down what happened and what you tried. Keep a small journal or notes on your phone. Writing helps you process your emotions and spot patterns over time. It also gives you a record to share with the day program staff or a doctor (Source: All Home Care Matters).

  10. Step 10: Talk to the day program staff about what works. They see your loved one in a different setting and may have insights you haven't considered. Ask them, 'What have you noticed that helps when they get upset?' Collaboration often reveals new solutions (Source: Teepa Snow's Positive Approach to Care).

What not to do

  • Don't argue or try to reason with them. Arguing about what is real or what they should do only escalates the situation. Instead, validate their feelings and redirect to a calming activity (Source: UCLA Health).

  • Don't take their behavior personally. When they are worse with you than with others, it is actually a sign of trust—they feel safe enough to let their guard down. This is called a 'cruel compliment.' Remind yourself it is not about you (Source: Dr. Camille Sinclair).

  • Don't try to 'fix' everything yourself. You are not responsible for solving problems you didn't create. Ask for help from staff, family, or professionals. Collaboration reduces your burden (Source: Pamela D Wilson).

  • Don't use absolute thinking like 'He is gone' or 'She will never get better.' This closes off possibilities. Instead, practice 'both/and' thinking to stay flexible and hopeful (Source: AlzheimersSpeaks).

  • Don't ignore your own feelings of resentment or guilt. These are normal, but they can grow if unaddressed. Acknowledge them, write them down, and talk to someone you trust. You are human (Source: Dementia Careblazers; James L. West Center for Dementia Care).

  • Don't quiz them on memory or reality. Asking 'What did you have for dinner?' or 'Don't you remember?' only reminds them of their losses and increases their distress. Instead, join them in their reality or gently redirect (Source: TEDx Talks).

Practical tools

  • Mantra Card

    Write 2-3 short mantras on an index card or in your phone. Examples: 'This is the disease, not the person.' 'I am a dementia strategist.' 'Both/and, not either/or.' Read one silently when you feel frustration rising. This helps you pause and reframe (Source: Answers About Alzheimer's).

  • The Five Needs Checklist

    Keep a mental or written checklist of five common unmet needs: physical discomfort, emotional distress, overstimulation, understimulation, need for control. When behavior happens, quickly scan the list. This shifts your focus from blame to problem-solving (Source: Teepa Snow's Positive Approach to Care).

  • Validation Phrases

    Memorize a few phrases to use when your loved one is upset: 'I see you are feeling [emotion]. That is hard.' 'It is okay to feel that way.' 'Let's take a break together.' 'Tell me more about that.' These phrases calm the situation and build connection (Source: Dementia Careblazers).

  • Distraction Toolkit

    Prepare a small bag or box with calming items: a soft blanket, a favorite photo album, a simple puzzle, a stress ball, or a snack. At the day program, you can ask staff to use these items when your loved one becomes agitated. Having a go-to distraction ready saves time and reduces stress (Source: UCLA Health).

  • Journaling Prompt

    After each visit or challenging moment, write three things: (1) What happened? (2) What did I try? (3) What can I try next time? This turns failures into feedback and helps you spot patterns. Use a notebook or a notes app (Source: All Home Care Matters).

  • The 'Both/And' Reframe

    When you catch yourself thinking in absolutes (e.g., 'He is completely gone'), stop and reframe: 'He is both here and sometimes absent. I am both a good caregiver and someone who can learn.' Say it out loud or write it down. This lowers your stress and opens up creative solutions (Source: AlzheimersSpeaks).

Discuss with your clinician

Ask your doctor: 'Could my loved one's agitation be caused by an underlying medical issue like a urinary tract infection, pain, or medication side effect?'

Ask your doctor: 'Are there any non-drug approaches or therapies (like music therapy or occupational therapy) that could help reduce challenging behaviors?'

If your loved one has Lewy body dementia, ask your doctor: 'Are there any medications we should avoid because they can worsen hallucinations or movement problems?'

Ask your doctor: 'What signs of caregiver burnout should I watch for in myself, and what resources are available to support me?'

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