Recent psychology research* showed reduced levels of agitation in nursing home residents with dementia, some to the point of not being considered agitated at all.
This promising study used a structured yes/no list to find the types of activities the residents found pleasurable either now or in the past, such as listening to jazz music or spending time with family members. The researchers presented participants with paired choices of desirable objects, such as different colored balloons or fabric. They also examined the times and reasons the residents appeared to be agitated, such as an apparent need to “escape” during the busy change of shift.
One resident wandered and jiggled the doorknobs of the rooms of other residents when he was left alone. Giving him his preferred objects (jazz music on a CD walkman, purple fabric, etc) significantly reduced his agitation. The resident who became agitated during busy times needed to be presented with her preferred objects (a family photo album, a felt flower, etc) before she became agitated and difficult to engage, but she also showed a dramatic improvement in behavior.
While readers might not use all the elements of this study simultaneously, there are many aspects that can be incorporated into our daily routines.
For further information:
*Based on the research study, Applications of Preference Assessment Procedures in Depression and Agitation Management in Elders with Dementia, by Leilani Feliciano, PhD, Mary E. Steers, MA, Alexandra Elite-Marcandonatou, LCSW, Maura McLane, MA, and Patricia A. Areán, PhD, Clinical Gerontologist, 32:239-259, 2009.
What I’ll want to look at.
Dr. El,
Two of the most valuable assessment questions that I have my staff ask residents/family members are:
– What leisure activity is the most meaningful to you? (and why?)
– What was your usual daily routine?
Sue, I'd imagine most recreation therapists use some of these techniques as yours do, and I found it hopeful to read about the dramatic improvement by using them at the same time.
While tailoring residents' daily routine to their past habits is likely reduce agitation (following a lifelong morning shower routine, for example), in this case the researchers looked at when residents were likely to get agitated during the regular nursing home schedule. In my observation, one or two agitated residents can raise the agitation level of the whole unit. Addressing the needs of just one or two people can positively affect a whole group.