What if some dementia behaviors are attempts to express preserved abilities rather than simply symptoms to manage?
What if some of the behaviors we work so hard to stop aren’t simply symptoms to manage—but attempts to express preserved abilities?
At first glance, that may sound like an unusual question.
For decades, dementia care has taught us to view behaviors like interrupting, wandering, refusing activities, or repetitive talking primarily as problems to manage. We ask questions like:
- How do we stop it?
- How do we redirect it?
- How do we reduce it?
Those are understandable questions.
But what if, at least sometimes, they’re not the first questions we should be asking?
This way of thinking didn’t happen by accident.
Over the past 15 years, I’ve worked with hundreds of people living with dementia. Time and again, I found myself questioning whether some of the behaviors we were trying to stop were actually attempts to express preserved abilities. That observation eventually led me to develop the Preserved Abilities Method™, an ability-based approach to dementia care inspired by Dr. Howard Gardner’s Theory of Multiple Intelligences.
Rather than beginning with what’s been lost, the method begins by asking a different question:
What abilities might still be there?
Because if that’s the case, then our goal isn’t simply to stop the behavior. Our goal is to understand what the behavior might be communicating.
Interrupting Other Residents or Visitors
I once worked with a woman living with dementia who repeatedly interrupted conversations between other residents, visitors, and staff.
Her behavior frustrated nearly everyone around her.
Staff redirected her.
Visitors became uncomfortable.
Some assumed she simply had poor boundaries because of dementia.
But when we looked more closely, something else became apparent.
Throughout her life, she had always been deeply social. She loved conversation. She loved connecting with people. Her survey revealed strong preserved interpersonal abilities.
She wasn’t trying to be disruptive.
She was trying to participate.
Once staff understood this, their response changed completely. Rather than repeatedly redirecting her away from conversations, they intentionally invited her into appropriate social interactions throughout the day.
The “behavior” became much less of a problem because the underlying need was finally being recognized.
Ask Yourself…
Could this behavior be an attempt to connect rather than simply a symptom to eliminate?
“They Just Won’t Participate.”
One of the most common frustrations caregivers express is that someone refuses activities.
“They just sit there.”
“They won’t participate.”
“They’re not interested.”
But sometimes the activity itself isn’t the issue.
Many traditional dementia activities emphasize verbal communication, crafts, or group participation.
What if those simply aren’t the person’s strongest preserved abilities anymore?
Someone with strong bodily-kinesthetic abilities may thrive during movement-based activities.
Someone with strong musical abilities may become highly engaged through rhythm or familiar songs.
Someone with strong naturalistic abilities may light up while gardening or spending time outdoors.
Refusing one activity doesn’t necessarily mean the person has lost the ability to engage.
It may simply mean we’ve offered the wrong kind of engagement.
Ask Yourself…
Are we asking this person to use an ability that has declined instead of one that has been preserved?
Constant Talking
Many caregivers describe someone who “talks nonstop.”
The instinct is often to redirect, quiet the conversation, or view it as another challenging behavior.
But what if constant talking reflects a preserved verbal-linguistic ability?
Some people have spent a lifetime processing the world through words.
Even as dementia progresses, that desire to communicate may remain surprisingly strong.
The words themselves may become disorganized.
The stories may repeat.
But the underlying ability—the drive to express thoughts verbally—may still be there.
Instead of trying to stop the talking, we might ask how we can channel it into meaningful conversation.
Ask Yourself…
Could this person still be expressing a preserved ability, even if the conversation no longer makes perfect sense?
Wandering
Wandering is often viewed solely as a safety concern.
And safety absolutely matters.
But wandering may also represent something more.
For some individuals, movement has always been part of how they think, regulate emotions, reduce stress, or interact with the world.
I’ve worked with people whose restlessness decreased dramatically after they were given structured opportunities for movement during the day.
The goal wasn’t to eliminate movement.
It was to better understand it.
When movement itself is viewed as a preserved ability rather than only as a problem, different interventions become possible.
Ask Yourself…
Is this person trying to go somewhere…
Or are they trying to move?
Changing the Question
None of this means every dementia behavior represents a preserved ability.
Pain.
Fear.
Confusion.
Medical conditions.
Medication side effects.
Environmental stress.
All can contribute to behaviors.
But I believe we’ve spent decades asking one question first:
“How do we stop the behavior?”
Perhaps another question deserves equal attention.
“Could this behavior be expressing a preserved ability?”
Sometimes the answer will be no.
But sometimes that single question changes everything.
Because when we begin by understanding the person—not just managing the behavior—we often discover opportunities for connection that were there all along.
Learn More About the Preserved Abilities Method™
The Preserved Abilities Method™ is an ability-based approach to dementia care that helps families and professionals identify retained cognitive abilities and use them to guide communication, activities, environments, and everyday care.
Instead of focusing exclusively on decline, the method helps answer a different question:
What can this person still do—and how can we build from there?
If you’d like to learn more about the Preserved Abilities Method™, visit PreservedAbilities.com.
You may also enjoy:
- Why Dementia Communication Strategies Often Miss the Mark
- Before We Ask “Can We Get Them Something?” Should We Ask “Why?”
- The Dementia Care System Doesn’t Just Fail People. It May Be Setting the Stage for Abuse and Neglect.
About the Author
Matthew Call is the creator of the Preserved Abilities Method™, an ability-based approach to dementia care grounded in Dr. Howard Gardner’s Theory of Multiple Intelligences. Over the past 15 years, he has worked with families and professionals to help identify and build upon the preserved abilities of people living with dementia. His work has been recognized by Harvard-affiliated cognitive scientists and featured by CBS and Newsweek.