Evaluating the influence of time of day on activity engagement in persons with dementia

Boyden et al. (2020) asked a simple question: does the time of day change how much people with dementia join in activities?

They used an alternating-treatments design. Each person did the same activity once in the morning and once in the afternoon.

Three adults with dementia took part. Staff scored how often each person touched, looked at, or used the activity materials.

Morning and afternoon scores were almost identical for every participant. The clock made no difference.

Only one person showed a clear favorite activity. For the other two, liking the task did not change with time either.

Gaily et al. (1998) also found that personal choice beats schedule tricks. Adults with profound disabilities picked either varied or repeated tasks, showing that preference, not structure, drives engagement.

Winett et al. (1972) looked like they disagreed at first. They saw that preschoolers stayed busy during required activities. But their trick was lots of materials and quick exits—still letting kids control the pace. Once you see that, the studies line up: give control to the person, not the clock.

Latham et al. (2014) used the same fast-switch design in dementia care. They compared two ways to teach walking routes and found big differences. Their result shows the design can spot change when it is really there. Boyden’s flat lines are not a fluke.

Stop blocking activities by time slot. If Mrs. Lee likes music, run the group when staff are free, not only at 10 a.m. Track what she prefers, not what the schedule says. This one shift frees you from rigid calendars and puts choice back in the resident’s hands.