A variety of group activities is promoted for nursing home (NH) residents with dementia with the aim to reduce apathy and to increase engagement and social interaction. Investigating behaviors related to these outcomes could produce insights into how the activities work. The aim of this study was to systematically investigate behaviors seen in people with dementia during group activity with the seal robot Paro, differences in behaviors related to severity of dementia, and to explore changes in behaviors.

Thirty participants from five NHs formed groups of five to six participants at each NH. Group sessions with Paro lasted for 30 minutes twice a week during 12 weeks of intervention. Video recordings were conducted in the second and tenth week. An ethogram, containing 18 accurately defined and described behaviors, mapped the participants’ behaviors. Duration of behaviors, such as “Observing Paro,” “Conversation with Paro on the lap,” “Smile/laughter toward other participants,” were converted to percentage of total session time and analyzed statistically.

“Observing Paro” was observed more often in participants with mild to moderate dementia (p = 0.019), while the variable “Observing other things” occurred more in the group of severe dementia (p = 0.042). “Smile/laughter toward other participants” showed an increase (p = 0.011), and “Conversations with Paro on the lap” showed a decrease (p = 0.014) during the intervention period.

Participants with severe dementia seemed to have difficulty in maintaining attention toward Paro during the group session. In the group as a whole, Paro seemed to be a mediator for increased social interactions and created engagement.