In this third installation of the Pool Activity Level (PAL) Series, learn the best way to support your loved one living with dementia at the Exploratory Level using the PAL Tool. Read on to understand the best ways to adapt meaningful and enriching activities for your loved one.
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What is the Exploratory Level
Persons living with dementia at the Exploratory Level, are moving from the mild to moderate stage of dementia. At this Level, persons living with dementia are more reliant on visible and tangible environmental cues to guide action through trial and error. They often engage in hands-on exploration, but need continuous support, as they may not fully understand what to do without demonstration or prompts.
What should Caregivers Do?
The following shares how, as a caregiver, you can support your loved one at the Exploratory Level:
- Offer activities that involve handling and interacting with objects (e.g., picking up, moving, stacking, or manipulating items).
- Keep tasks simple, familiar, and action-focused—emphasise doing rather than understanding or planning the task.
- Use the environment to guide behaviour (e.g., placing items within reach, demonstrating the first step).
- Examples: sorting objects, rolling dough, stacking cups, or placing items into containers.
- Show the action rather than relying on verbal instructions alone.
- Use short, repeated verbal cues to guide the next step (e.g., “put here,” “try this”).
- Allow space for trial and error—step back once they begin engaging.
- Provide brief prompts or gestures if they pause or lose focus.
- Examples: demonstrating how to place a puzzle piece, then prompting with “your turn” or “put it here.”
- Offer short, achievable activities (counting) that involve handling and manipulating objects.
- Structure the task through the environment (e.g., limited number of items, clear placement) rather than relying on instructions.
- Provide immediate, simple encouragement to keep your loved ones engaged (e.g., “yes,” “that’s it,” “keep going”).
- Use tone, facial expressions, and gestures to reinforce participation.
- Focus on sustaining engagement in the activity, rather than correcting mistakes or achieving a perfect outcome.
- Create a safe, clutter-free space, with a few clearly presented items.
- Offer objects that can be handled, moved, or used (e.g., items to sort, stack, place, or transfer).
- Reduce risks by removing unsafe items such as knives and scissors, as judgement and problem solving are limited.
- Allow them to initiate and repeat actions at their own pace.
- Expect repetition and variation as part of exploration.
- Step in with brief cues or demonstrations only when they disengage or get stuck.
- Provide familiar, everyday items that suggest an action (e.g., cups to stack, towels to fold).
- Choose objects that are recognisable and invite use, even if the task is not completed conventionally.
Goal at the Exploratory Level:
To support persons living with dementia to actively engage with objects and their environment through trial and error, using clear cues and simple setups.
Activities for Exploratory Level
At the Exploratory Level, individuals living with dementia engage with their environment through hands-on interaction, movement.
They can initiate actions when objects are visible and accessible, but rely on demonstration, simple cues, and environmental setup to stay engaged. Constant hand-over-hand assistance is typically not required, though close supervision and occasional prompting are important.
Here are some appropriate activities tailored to this Level:
Focus on handling, moving, and using objects:
- Sorting everyday items (e.g., by colour, size, or type)
- Placing objects into containers or transferring items from one place to another
- Stacking cups, blocks, or simple items
- Rolling dough or shaping soft materials
- Simple matching tasks using familiar objects
Encourage repetition and rhythm through action:
- Wiping tables or surfaces
- Folding towels or cloths
- Sweeping with a lightweight broom
- Rolling or passing a ball back and forth
- Repetitive placing or arranging tasks
Use music to support movement and participation, not just passive listening:
- Clapping, tapping, or stepping along to rhythm
- Playing simple instruments (e.g., shaker, drum)
- Moving or swaying while holding or using an object
- Participating in simple action-based songs
Emphasise doing rather than creating a final product:
- Painting with brushes or sponges through guided demonstration
- Placing stickers or objects onto a surface
- Arranging or assembling simple craft materials
- Water painting or repetitive brush strokes
Tap into preserved long-term memory by:
- Looking at photo books with large, familiar pictures, such as photos taken during school days.
- Holding and exploring familiar objects (e.g. a baby doll, an old scarf)
- Reminiscence cards with large images of food, holidays, or vintage items
Use recognisable objects that suggest an action:
- Folding laundry items
- Setting or clearing simple table items
- Handling familiar household objects (e.g., cups, containers)
- Participating in parts of daily routines with support
Support engagement through doing them together:
- Completing simple tasks side by side
- Taking turns in a repetitive activity
- Using short, shared prompts that indicate shared actions (e.g., “your turn,” “put here”)
- Participating in small group activities with clear structure
Tips for Activity Success at the Exploratory Level:
- Keep activities simple, visible, and action oriented
- Use demonstration and short, verbal cues (not lengthy instructions)
- Set up the environment to guide what to do next
- Allow trial and error and repetition
- Focus on engagement in action, not accuracy or outcome
Conclusion
These activities support persons living with dementia at the Exploratory Level to remain actively engaged through simple, hands-on tasks, enabling meaningful participation through interaction with objects and their environment.
- Pool, J. (2022, February 9). How to support people living with dementia at an exploratory level. Caring Times. https://caring-times.co.uk/feature/how-to-support-people-living-with-dementia-at-an-exploratory-level/
