Vocally disruptive behaviors, which include screaming, shouting, and other disturbing loud noises, are common in nursing homes. The necessity for managing these behaviors is widely recognized, and represents one of the major challenges in long-term care. The proposed study builds on the findings of our previous studies on the understanding of behavioral problems in the nursing home. These studies showed that screaming is associated with cognitive impairment, depressed affect, and with pain. Additionally, in an in-depth study of highly agitated nursing home residents, we found that verbally agitated behaviors, such as screaming, were manifested less frequently when the residents were exposed to music or to television, and when they were not alone.
The aim of the proposed study is to assess the effectiveness of several interventions for the management of vocally disruptive behaviors. The interventions are: 1) a thorough medical examination aimed at finding and treating any underlying physiological reason for pain; 2) the use of music; 3) the presentation of a videotape of the resident's relatives, and 4) direct social interaction. The effect of these management techniques to control disruptive verbal behaviors will be assessed in 56 nursing home residents. In the first phase of the study all participants will be exposed to the medical intervention. In the second phase, a pretest-posttest cross-over design will be used. All participants will be exposed to all the management interventions, as well as to a """"""""no-intervention"""""""" condition. The specific interventions will last 2 weeks, and will be followed by a week """"""""wash-out"""""""" period. The frequency and duration of vocally disruptive behaviors will be assessed using audiotapes, systematic time-sampling observations, and nurses' assessments. This study is expected to provide data that will help mitigate the suffering of nursing home residents manifesting verbally disruptive behaviors, improve their quality of life, and decrease the burden for caregivers.
| Cohen-Mansfield, Jiska; Werner, Perla; Hammerschmidt, Kurt et al. (2003) Acoustic properties of vocally disruptive behaviors in the nursing home. Gerontology 49:161-7 |
| Cohen-Mansfield, J; Werner, P (1997) Management of verbally disruptive behaviors in nursing home residents. J Gerontol A Biol Sci Med Sci 52:M369-77 |
| Cohen-Mansfield, J; Werner, P (1997) Typology of disruptive vocalizations in older persons suffering from dementia. Int J Geriatr Psychiatry 12:1079-91 |
