People living with dementia (PLWD) attending adult day health programs often experience neuropsychiatric symptoms (NPS) that can interfere with participation in meaningful activities, social engagement, and overall quality of life. This pilot study evaluated the feasibility and preliminary effectiveness of an individualized activity program guided by the Pool Activity Levels (PAL) framework to reduce neuropsychiatric symptoms (NPS) among people living with dementia (PLWD) attending a Northern California adult day health center within a Program of All-Inclusive Care for the Elderly (PACE).