Table 2. General Nonpharmacologic Strategies for Managing Behavioral Symptoms.

Domain	Key Strategies
Communication	Allow patient sufficient time to respond to a question Provide one to two step simple verbal commands Use calm, reassuring tone Offer simple choices (no more than 2 at a time) Avoid negative words and tone Use a light touch to reassure, calm, or redirect Identify self and others if patient does not remember names Help patient find words to express him/hers
Simplify environment	Remove clutter or unnecessary objects Use labeling or other visual cues Eliminate noise and distractions while you are communicating or when patient is engaging in an activity Use simple visual reminders (arrows pointing to bathroom)
Caregiver education and support	Understand that behaviors are not intentional Learn how to relax the rules (e.g., no right or wrong in performing activities/tasks as long as patient and caregiver is safe) With disease progression, patient may have difficulty initiating, sequencing, organizing and completing tasks without guidance and cueing Go along with patient's view of what is true and avoid arguing or trying to reason or convince Take care of self; find opportunities for respite; practice healthy behaviors and preventive doctor visits Identify and draw upon a support network
Simplify tasks	Break each task into very simple steps Use verbal or tactile prompt for each step Provide structured daily routines that are predictable
Activities	Introduce activities that tap into preserved capabilities and previous interests Introduce activities involving repetitive motion (washing windows, folding towels, putting coins in container) Set up of the activity and helping patient initiate may be necessary

Note: Domains and strategies listed are potential approaches used in randomized clinical trials but are not exhaustive. A suggested strategy may be effective for one patient but not another. Any one strategy may not have been evaluated for effectiveness for use with all dementia patients with the same presenting behavior. Strategies listed above should only be considered once thorough assessment (description and decoding – Figure 1, steps 2 and 3) has been completed.