An Assessment Method for Identifying Acceptable and Effective Ways to Present Demands to an Adult With Dementia

Williams et al. (2020) tested four ways to ask an adult with dementia to do something.

They compared a direct command, a rule, a polite question, and casual chat.

Each format was tried many times and staff watched for refusal or problem behavior.

Plain commands like “Sit down” triggered the most refusal and agitation.

When the same task was framed as “Could you help me by sitting?” compliance rose and problems dropped.

Social chatter before the request had little effect on its own.

Edelstein et al. (2021) saw a similar pattern in students with autism: harder task wording increased echoing and push-back.

Laposa et al. (2017) got detained teens to comply by teaching self-control plus a DRL schedule, showing that both antecedent and consequence tweaks matter.

Together the three studies line up: how you give the demand is as important as what follows it.

If you work with adults who have dementia, drop the blunt orders.

Swap “Take your pills” for “Can you help me with your medicine?” and you may prevent a battle.

Try it at the next med pass or during personal care and track refusals for a week.