BY NATHANIEL CHIN, M.D.
Medical Director and Clinical Core Co-lead of the Wisconsin Alzheimer’s Disease Center
Member of the AFA Medical, Scientific & Memory Screening Advisory Board
All of us, whether we are adults or children, benefit from keeping to a schedule. People with Alzheimer’s are no exception. Daily routines help reduce the stress and anxiety someone with mild
cognitive impairment or dementia might experience. Regular activities create structure and add purpose to daily life. These pleasant activities reduce agitation and lead to balanced emotions and contentment.
The brain, through entrainment, has the ability to cement
routines into the cerebral cortex. This happens by strengthen-ing neural networks so that the same neurons fire together
with less effort each time. Repeated behaviors, even those
that don’t require conscious thought, like eating and drinking, walking, singing, brushing teeth and using the toilet on a schedule, can continue to be performed with modifications
as the disease advances.
When creating routines, consider your loved one’s interests and strengths, the time of day he’s at his best and how he once organized his day. Here are some categories for habit formation that might spark ideas: meals (helping with preparation), creative activities (painting or making music),
physical movement (going for walks), chores (helping around the house or yard), spiritual practices (going to church or daily mass), shopping and socializing with neighbors. Caring for a pet or plant or helping someone else in a manageable way can also provide daily structure. People benefit from having a sense of purpose and often take joy in being helpful to others — even in small ways.
I recommend waking up and going to bed at consistent times for everyone, especially caregivers. As toy inventor E. Joseph Cossman said, “The best bridge between despair and hope is a good night’s sleep.”
On average, it takes 66 days for a new behavior to
become a habit, but the range is wide — from 18 to 254 days —
depending on the circumstances and person. Some people have a head start on consistent bedtimes or a morning routine. The key is regularity. Habits should not be arbitrarily applied to how you are feeling in the moment. The longer you persist, the more deeply it becomes ingrained in long-term memory, even in the face of Alzheimer’s.
Of course, setting routines is only part of the equation.
Just as important is coming to terms with your diagnosis and
learning to live with confidence and follow-through. Even when
the reality feels daunting, recognizing what’s happening can
make it easier to live with greater consistency and stability.
In some families, a parent with Alzheimer’s may live with
one child for a few weeks and then stay with another family
member for a few more. While well intentioned, this is not ideal
because it interferes with the formation of habits. The parent is
going to forget important details or become confused. Houses
and families are different. Transitioning from one home to
another is going to be a hard adjustment. Anytime a routine
or environment changes, it creates anxiety for someone with
Alzheimer’s. They feel on edge and become more forgetful or
disoriented. They might lash out in frustration. It’s not unusual
for an adult child in this situation to call my practice and say,
“Mom’s so confused.” That’s because the family keeps moving
her every two weeks. Of course she’s going to feel uneasy and less
secure. Habits and routines ground us, making all of us feel safe.
They’re comforting.
If you’re not walking or exercising every day, you’re failing
to support your brain. If you’re eating ultra-processed meals
instead of whole foods, your brain is not getting the nutrients it
needs. It is never too late to make progress. Go slowly.
Some people with Alzheimer’s are sedentary. They lounge
in front of a computer or watch TV all day. This isn’t surprising
given that the Centers for Disease Control and Prevention (CDC)
reported 25 percent of U.S. adults are physically inactive. That’s
true of many caregivers as well. Stress is tiring and habitual, and
that is a recipe for the formation and continuation of bad habits.
But even for someone who’s been inactive for most of their
life — a “lifetime couch potato” — movement is still possible.
We can create new habits one small step at a time.
For people who don’t like to move, start with something
that feels natural or necessary. Ask them to help with light
household chores. Get them to go up and down stairs by
asking for help bringing items to the kitchen, laundry or
dining table. Encourage errands that involve walking — like
returning library books, grabbing the groceries from the car,
or browsing a big-box store. A pet can be a helpful motivator,
especially if the person feels responsible for its care. Others
may respond better if movement is connected to something
they enjoy: going to a favorite place, socializing or getting a
(hopefully healthy) treat.
You can also turn movement into moments of purpose:
watering plants, setting the table, folding towels or checking
the weather outside. For some, music can be a powerful tool —
try turning on a favorite song and inviting them to sway, tap or
dance. Even sitting exercises, like marching in place from a chair
or stretching to a rhythm, can help build momentum.
For motivated individuals, make a plan, schedule your
week in advance and say to yourself, I’m going to walk this far,
even if it’s just going to the mailbox or around the block. Write down
what you do each day. When walking around the block becomes
too easy, challenge yourself to go farther. Other tricks to building
good habits include doing them at the same time every day and
associating them with special clothes such as dazzling yellow
running shoes only used for exercise. The key is to keep it simple,
relevant and repetitive — and to celebrate small wins. Motivation
may not come first; often, it follows action.
What about existing bad habits like drinking and
smoking, both of which can harm brain health and can
worsen Alzheimer’s? In the best circumstances, everyone in the
household who smokes stops, and everyone who drinks either
quits or limits their use of alcohol. The same is true of eating
excessive amounts of candy, other sweets and junk food. Use the
diagnosis of Alzheimer’s or cognitive impairment as a motivator
to improve the health of everyone in the household.
From When Memory Fades: What to Expect at Every Stage, from Early Signs to Full Support for Alzheimer’s and Dementia by Nathaniel Chin, M.D. Copyright © 2026 by the author and reprinted by permission of St. Martin’s Publishing Group.