The present study examined the use of manipulating activity presentation formats and the use of interactions to increase activity engagement in eight older adults with Alzheimer’s disease (AD) living in a special care unit of a nursing home. Three experiments, each using an alternating treatments design, were conducted. Experiment 1 compared two sets of activities (i.e., standard and novel) on engagement. The set of activities that produced the highest mean percentage of engagement (novel activities) was used throughout the subsequent two experiments. Experiment 2 evaluated the effects of three different activity presentation formats—providing single activities, providing activity choices, and providing multiple activities—on engagement. Results showed that providing multiple activities to participants produced the highest mean percentage of engagement when compared to providing a single activity or a choice of two activities. Experiment 3 assessed the effects of various levels of interactions on engagement. Minimal and typical amounts of interaction were provided to participants. Results from Experiment 3 revealed that engagement was higher when minimal interactions were provided for all participants than when a typical amount of interactions was provided. Results from these three experiments extended the literature on use of choice interventions and the amount of interactions to provide to nursing home residents in order to increase activity engagement. A behavior analytic account of the results is presented, implications are discussed, and future research in the area is recommended.