Goal Setting in Occupational Therapy for People with Dementia: A Narrative Review of Evidence and Clinical Implications

Background: Goal setting is a core component of Occupational Therapy (OT), yet its application in people with dementia remains complex due to cognitive impairment and contextual factors. Evidence on how goal setting is implemented in this population is still fragmented. Methods: A narrative review was conducted on 23 March 2026, using PubMed, Scopus, Web of Science, and CINAHL Plus. Studies addressing goal setting in OT for people with dementia were included without time restrictions. Data were synthesised narratively, focusing on barriers and facilitators. Results: Thirteen studies were included. The available evidence suggests that goal setting may be feasible, particularly in individuals with mild to moderate dementia, when supported by structured approaches such as COPM, GAS, and SMART criteria. Key facilitators included caregiver involvement, patient insight, and personalised goal discussion. Major barriers included the severity of cognitive decline, misalignment between patient and caregiver expectations, and a lack of structured goal-setting processes. Conclusions: Based on a limited evidence base of thirteen studies, the available findings suggest that goal setting in dementia may be feasible when implemented through flexible, structured, and collaborative approaches. Caregiver involvement and structured approaches may support person-centred goal-setting processes in OT practice. These findings should be interpreted as indicative rather than conclusive.