Engaging adults with Alzheimer's disease in activities can prevent disease related agitation. Finding meaningful and enjoyable activities proves to be a difficult task due to severe damage to explicit memory and executive functioning. Fortunately, many spiritual and religious activities rely on more resilient cognitive features such as procedural memory and limbic system aspects of attachment and motivation. Such spiritual activities, if properly selected, can be used to engage adults with dementia. This approach, called Procedural and Emotional Religious Activity Therapy, can be used by various religious traditions and extended to multiple therapeutic venues. © 2004 Taylor & Francis Group, LLC.