Sample Care Plan: Responsive Behaviors (Intrusive)
Supporting residents who display intrusive behaviors requires patience, understanding, and strategies that promote dignity and engagement.
Case Study
Anna is a 79-year-old lady living with 2nd stage dementia.
She usually understands what staff say, though her responses are often slow. Anna is restless most of the day and can only sit for a few minutes at a time. While wandering, she often enters other residents’ rooms and takes items that catch her attention.
At mealtimes, Anna may reach for food from other residents’ plates and offer it to others. She walks with an unsteady gait, which increases her risk of falling.
Anna generally has a good rapport with staff but can be resistant to requests. Diversion works well, especially when she is invited to “help out” with simple tasks, which often redirects her behavior successfully.
Social & Emotional Care Pan
| Client | Anna May |
| DOB | 02/07/1939 |
| Recorded by | Susan Jones |
| Date of Record | 05/08/2025 |
| Evaluation | Quarterly |
| Ongoing Support | Activities Requires supervision at all times Community Outings Anna requires one-to-one assistance. Staff will request that family accompany her on bus trips or ensure sufficient volunteer support. Appointments Anna will be escorted to the hairdresser, podiatrist and all other medical appointments. Communication Approach calmly with kindness, use short clear sentences, allow extra time to respond, and offer choices or simple tasks to ‘help out’. |
| Issues | * Enters peers’ rooms and collects belongings * Takes food from others’ plates during meals * Can upset peers in shared spaces * Resistant at times to staff requests * Slow verbal responses * Unsteady gait and fall risk |
| Strengths | * Alert and engaged for most of the day * Generally maintains good rapport with staff * Responds positively to kindness and redirection |
| Goals | Support Anna with suitable engagement and distraction to reduce responsive behaviors. Help Anna feel safe, secure, and included at all times. |
| Interventions | Social Encourage participation in cooking sessions, assisting with tasks such as stirring, sorting, preparing vegetables, and measuring. Support Anna to join in activities she enjoys, including balloon games, picture bingo, sing-alongs, concerts, music therapy, pet therapy, children’s visits, and nature/animal movie screenings. One-on-one Provide daily sensory stimulation (puzzles, magazines, serviette folding, watering the garden, short walks). When restless, redirect gently with alternatives such as hand massage with essential oils, hair grooming, manicure, make-up, or garden walks. Invite Anna to “help out” with simple tasks, as this approach effectively redirects her behavior. Emotional * Allow extra time for Anna to process instructions and respond. * Approach her in a sensitive, non-directive way when she becomes upset. * Use kindness and reassurance to reduce resistive behavior. Safety * Orient and guide Anna several times a day while wandering. * Provide supervision at all times. * Escort to appointments (hairdresser, podiatrist, medical). Spiritual Support Anna’s Catholic faith by escorting her to monthly services at the facility. Family * Maintain regular contact with Anna’s family regarding her well-being. * Offer support and encourage their involvement when possible. |
See also: Sample Care Plan: Managing Responsive Behaviors (Resistive)
What strategies have you found helpful in supporting residents with responsive behaviors? Share your experiences in the comments - we’d love to learn from you.
This is very helpful, I have used in our Senior Care meetings to ensure they have more knowledge when writing care plans for our residents. Thank you:)
Thank You so much! I have found this article so much helpfulness for my reports and very so many ideas its help me a great dial with my new position as a Director of Activities.
My residents just have so much fun with the jokes and they have become more creative with your arts and crafts. and their names thank you.
Catalina
I'm so glad y ou found this article helpful Catalina. Thanks so much for your feedback and all the very best to you! x
This scenario has really helped me in writing my care plan on challenging behaviour.
Thank you so very much. You have been a big help to me.
Keep up the good work
Thanks so much for your feedback Hyacinth. All the best!
Activity aprons are useful in keeping individual's hands occupied and offer fine motor work.
Yes I also have issues with our dementia residents especially for sundowners. I would appreciate if you have any more suggestions.
As a male student trying do some research came across with this scenario relly helps with my studies Thank you
Need information on activities for last stages of dementia residents how to designed a fun day for them
Its all about Empowering people findig a niche in every person you focus on.
I red most information from your programme and increase the knowledge of activity plan how it is work for my facility thank for sharing this all ideas
Hi Carol, I couldn't agree more. Much is said about 'person-care' but very often the support is not there, hence the stress.
Wondering why such a big burden is put on the Activities Assistant at all the facilities to cope with such a diverse range of needs, when there is supposed to generally be a reasonable ratio of staff to residents? No wonder there is so much stress and anxiety in such workplaces. Two activities staff and volunteers are a compulsory necessity at all times for a successful outcome, don't you think?
Thanks for such pertinent and easily accessible information it will provide evidenced based research for my Bachelors in Health Practice.
thanks for the ideas i would like to add that it sounds like Anna would benefit from the Montessori principals she seems to have a need to help and care , i would put into place a program where she is helping at meal time then invited to sit down and have her own meal i find that the Montessori principals help to reduce many behaviours as you are fulfilling the need to be useful and needed . it is usually the case meet the need and reduce the behaviour .
This has been very helpful as i am doing my Aged Care Course...
Hi, Anne. Tell me ,please, where are I can find The Sonas Session-training in Melbourne? Thanks, Regards, Viktoria
Hello I have found your activities very encouraging and would like to put some in to practice in the home where I work, I find music is the greatest way to promote better moods better people and a sense of peace and well being for the residents. Another thing is not to rush them, nothing worse than a staff member on there own mission, in now we are going to do this this and this it does my head in imagine what it does to them
Hi Sandra,
Can you help me with the following, I look after 25 residents and work 3 days a week for 6hrs struggling to put things in place without preparing things at home, with no help from nursing staff,l am told I do not need to do any documentation only exceptional reporting for accreditation? . I have 9 dementia clients in this and struggle with activities for sundowners do you have any ideas ?
Great information
Great ideas thank you so much.
Hi there,
Great ideas here thank you very much. Similar to your situation Sandra, i too am new to a residential care setting and am in the process of setting up a programme for over 60 patients. I'll check out the sonas programme now havn't heard of it before but any other suggestions or tips are welcome!
Sandra, do you know anything about the sonas programme? This has proved popular/succesful in our facility, it would be great if you had a volunteer to assist you. Rgds, Anne
Desperate for new ideas for my sundowners. I am one therapist for 45 residents and I have no assistance from other staff. i am finding the expectations unbelievable and three weeks feel like three years any ideas? the Programme I am taking over from was non existant and I am having to start from scratch and am working a full day and having to do all planning documentation etc at home. needless to say I am getting exhausted.
Regards Sandra
Hi Sandra.
I feel for you!!! I have been where you are now.
I look after 85 residents, and we have an excellent "sundowning" evening program which runs well and effective and our resdients are participating in meaningful activities.
I will be glad to offer you some help and ideas if you want to email me your details.
My email address is (sent privately).
Regards
Fil :)
Great ideas Nicole, thank you for the feedback.
You might like to try a raised 'weed' garden (with flowering weeds) outside for the resident gardener who likes to pull out plants or perhaps objects at waist or shoulder height for distraction, ie: rainbow flags, wind chimes, washing line etc. We have potted fake flowers/plants in plaster of paris so they can't be pulled out. Good luck.
Love it. I will come back again and again.
Hi. Yes thats a hard one. i have gone outside and put fake flowers in the ground for the residents to pick. just need to keep putting them back when you find them lying around.
Could laminate some nice signs that say
please enjoy the flowers but please dont pick me, Thats if your client can read.
We do flower arranging. we have a large selection of cheap artificial flowers 1St I place a fitted bed sheet on the table then put all the flowers on the table. some men weiil also join in due to the sensory stimulation. Good luck.
You really need to know the persons Life history to work with most behaviours.
Example: We have many R.N's in our Dementia unit who are patients. They are invited to our staff meetings and training sessions if appropriate. Another resident who was also an R.N likes to sort out our linen trolley. The afternoon staff ask her to help give out the linen with them.
Another lady grew up in an orphanage in India. She likes to bring water to the back door so we can have water for the cooking/ cleaning etc. we allow this but will remove this when she is occupied with other things.
I think the main thing is being switched on to where they are currently in their minds with there dementia and how old they think they are.
Doll Therapy works well but there are lots of protocols and guidelines to follow and EVERYONE must treat the dolls as real babies .
Food activities are great for the sundowners, i find this settles most residents
We have a John like this. Loves to torment. Pulls out all the flowers/vege in the garden, much to the sorrow of our plant lovers!!! Any ideas???
great read stragities are very help full, keep up the good work
i have a resident who is in the 2nd stage of demensia, he has worked hard all his life and gets confused when staff wont do as he says. He likes to work with his hands and we have tried all kinds of activities with him( building activities,puzzles,workshopping, ect but he soon losses interest, any help with new activities would be appreciated. ( Ideas ) Kind regards Kelly
Yes, I have found this most helpful. Thank you and look forward to more info regarding our challenging
clients.
Yes, our Ann is very similar in behaviour, have also tried to engage her in helpful activities. Face washer & serviette folding, unwinding knitted garments, watering, washing up etc.... She looks and expresses anxiety often, walks to exhaustion, can't rest.
I have found the golden carers web pages to be very informative and useful - full of great ideas - keep up the good work!
very good.