The DICE Approach™

What is the DICE Approach?

The DICE Approach is a process that aims to help caregivers manage the behavioral and psychological symptoms of dementia (BPSD). Many caregivers experience difficulties managing BPSD which can include aggression, wandering, and refusing needed care. The DICE Approach guides caregivers through a process to give context to and identify the possible causes of BPSD. With this better understanding of why behaviors are occurring, the DICE Approach assists caregivers to target the underlying causes of the behaviors and use evidence-based behavioral and environmental strategies to create a custom plan for managing BPSD.

Heart with hands graphicThe DICE Approach Training Program

The Program for Positive Aging is offering training sessions on the DICE Approach for family and professional dementia caregivers. These interactive trainings are free of charge and will give caregivers a better understanding of the causes of BPSD and how to apply the DICE Approach when behaviors occur. Caregivers will learn simple strategies to improve communication, create meaningful activities, and ensure a safe yet engaging environment to help reduce behaviors.

See below for training dates and locations.


Upcoming DICE Approach Trainings


November 20, 2017 – 9:00 am – 4:00 pm
Weber’s Inn, 3050 Jackson Ave, Ann Arbor, MI 48103
*This training is for those who are caring for family members or friends with dementia, stay tuned for more information for professional caregivers

Lunch will be provided at all training sessions.
Join our email list to be notified about future trainings!


Contact the DICE Team

Helen Kales, MD
PPA Director
Lynn Etters, DNP
Lynn Etters, DNP
Lead DICE Trainer

Mary Blazek, MD, MEHP
DICE Trainer

Leslie Dubin, LMSW
DICE Trainer
Laura Struble, NP, PhD
Laura Struble, NP, PhD
DICE Trainer
Molly Turnwald, BA
Molly Turnwald, BA
Project Manager







To register for our current training session, please use the form below.
You can also get in touch with The DICE Approach Team at or 734-232-0393.

This course is approved by the Michigan Social Work Continuing Education Collaborative.
Course approval #: 071217-10

This continuing nursing education activity was approved by American Association of Neuroscience Nurses, an accredited approver by the American Nurses Credentialing Center’s commission on Accreditation. AANN Approval Code: 0814/6/02

Michigan’s Aging & Adult Services Agency and the Area Agency on Aging have endorsed the DICE Training Program.
This training is sponsored by the Michigan Health Endowment Fund which works to improve the health and wellness of Michigan residents and reduce the cost of healthcare, with a special focus on children and seniors. More information about the Health Fund can be found at


Creating the DICE Approach


Detailed DICE ApproachDr. Kales and the Program for Positive Aging have led the psychiatric field in understanding the risks of using antipsychotic and other psychiatric medication in people with dementia. As a result, Dr. Kales recognized it was not enough to simply tell providers, staff and family caregivers to avoid the use of these medications. Instead, it is imperative to help caregivers better understand, identify and treat the underlying causes of BPSD rather than resorting to the knee-jerk use of medication.

To address this need, in collaboration with Constantine Lyketsos, MD and Laura Gitlin, PhD, from Johns Hopkins University, Dr. Kales organized an interdisciplinary expert panel. The panel included members with expertise in geriatric medicine, geriatric psychiatry, geriatric psychology, nursing, social work, pharmacy and behavioral science. This group created an algorithmic approach toward assessment and management of BPSD called DICE (Describe, Investigate, Create, Evaluate). The DICE Approach is an adaptation of the clinical reasoning process used by geriatric psychiatrists to assess and manage BPSD.

Since its publication in 2014, the DICE Approach has received national and international adoption and acclaim including. San Diego county adopted DICE as its evidence based approach and it has been put to use in Canadian nursing homes and UK care homes.