Managing Dementia Challenges in Group Activities

Group activities can be incredibly meaningful for people living with dementia, but they also come with unique challenges.

Whether you work in memory care or a traditional long-term care community, understanding how dementia affects participation can help you create more successful, inclusive programs.

Cognitive Challenges Caused by Dementia

Alzheimer's disease and other forms of dementia can affect memory, communication, judgment, attention, and problem-solving. Residents may have difficulty following conversations, understanding instructions, expressing their needs, or making sense of their surroundings.

These changes can sometimes lead to actions that are difficult for others to understand. While they're often called "behaviors," they're usually a person's way of communicating an unmet need. A resident who is wandering, calling out, crying, or becoming physically or verbally aggressive is often trying to tell us something.

Running a successful group activity can be challenging when these situations arise, but a person-centered approach can help everyone participate with dignity and respect.

How to Overcome Common Dementia Challenges

Every resident is unique, so no single strategy works every time. The key is to have a variety of approaches available and adjust them based on the individual's needs and preferences.

Wandering in and out of activities

First, decide whether the wandering is actually disrupting the activity. During a lively social event, it may not be an issue. During a presentation or discussion, however, it can distract both the speaker and other residents.

If you have a resident who regularly wanders, try these approaches:

• Walk alongside them for a while if they enjoy companionship.
• Invite them to stay near the back of the room where their movement is less disruptive.
• Give them a simple role, such as handing out supplies or collecting materials.

Not understanding instructions or asking repetitive questions

Residents with dementia may need instructions presented differently rather than repeatedly.

Helpful interventions include:

• Have a volunteer or staff member sit beside the resident and guide them one step at a time.
• Break tasks into simple, manageable steps.
• Provide written or picture-based reminders when appropriate.
• Pair the resident with a supportive peer who can offer gentle guidance.
• Invite the resident to help you lead the activity so they can follow your cues one step at a time.

Being verbally or physically aggressive during an activity

Dementia can make it more difficult for someone to cope with stress, communicate their needs, or tolerate overstimulation.

If a resident becomes verbally or physically aggressive, consider these strategies:

• Work with nursing and social services to identify patterns, triggers, and successful interventions.
• Reduce overstimulation by moving the resident to a quieter area away from loud noises or crowded tables.
• Check for unmet needs such as pain, hunger, thirst, fatigue, or the need to use the restroom.
• Speak calmly, validate the person's feelings, and avoid arguing or correcting them.
• Redirect them to another activity if it better matches their current mood or abilities.

Other residents being unkind to a resident living with dementia

Sometimes the challenge comes from other residents who don't understand dementia. They may become impatient or make insensitive comments.

If this happens:

• Speak privately with the resident who made the comment.
• Explain that respectful communication is expected and that everyone deserves kindness.
• Offer simple education about dementia when appropriate.
• Involve social services if the issue continues.

5 Truths About Working with Adults with Dementia

1. It's never about the finished product - it's about the experience.
If a resident doesn't complete a craft as intended, that's okay. The real value comes from the enjoyment, creativity, and social connection.

2. Look for the message behind the behavior.
Many actions are a form of communication. Before reacting, consider whether the resident is overwhelmed, uncomfortable, tired, in pain, or trying to meet another need.

3. Everyone deserves to participate in activities.
Our job is to adapt activities so every resident feels included and successful.

4. Your interventions matter.
Creative activity adaptations don't just improve one program - they often help the entire care team better understand and support a resident's needs.

5. Keep learning and keep adapting.
Dementia is progressive, so strategies that worked yesterday may not work today. Stay flexible, keep trying new approaches, and celebrate the small successes.

Have a tip that's worked well for you? Share it in the comments - we'd love to learn from your experience.