Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents

Beck, Cornelia; Vogelpohl, Theresa S; Rasin, Joyce; Uriri, Johannah Topps; O’Sullivan, Patricia; Walls, Robert C.; Phillips, Regina M.; Baldwin, Beverly

doi:10.1097/00006199-200207000-00002

Cited by 125 publications

(118 citation statements)

References 34 publications

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“…These issues most likely contributed to the lack of significant findings for negative affect. These findings are similar to Beck et al (2002) who found significantly more positive affect, but no reduction in negative affect or agitation, following implementation of tailored behavioral interventions for NH residents with dementia. They too found little negative affect, and concluded that their nontargeted interventions need to be more precisely designed to improve a broader range of behavioral outcomes.…”

Section: Discussionsupporting

confidence: 82%

Efficacy of Theory-Based Activities for Behavioral Symptoms of Dementia

2005

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Abstract:Background: Agitation and passivity are behavioral symptoms exhibited by 90% of nursing home residents with dementia. They account for many poor health outcomes, caregiver burden, and increased costs of longterm care. Objectives: This study tested the efficacy of recreational activities derived from the Need-driven Dementiacompromised Behavior (NDB) model: activities matched to skill level only; activities matched to style of interest only; and a combination of both (NDB-derived) for responding to the behavioral symptoms of dementia. Methods: Thirty participants were randomly assigned to 1 of 6 possible order-of-condition presentations in this crossover experimental design with repeated measures of dependent variables. Trained research assistants, blind to condition match, implemented each condition for 12 consecutive days. Measures of engagement (time on task and participation), affect, and behavioral symptoms (agitation and passivity) were taken from videotape recordings of each session. Mood was measured with the Dementia Mood Picture Test. The primary analysis method was mixed-model analysis of variance. Results: Significantly more time on task, greater participation, more positive affect, and less passivity were found under NDB-derived and matched to interest only treatments compared with the matched to skill level only treatment or baseline. Agitation and negative affect improved under all treatments compared with baseline. There was no significant change in mood. Discussion: The NDB-derived activities are tailored to meet individual needs and improve behavioral symptoms associated with dementia. These findings help to explain factors that produce behavioral symptoms and the mechanisms that underlie their successful treatment.

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Section: Discussionsupporting

confidence: 82%

Efficacy of Theory-Based Activities for Behavioral Symptoms of Dementia

2005

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“…However, we are unable to discriminate between the treatment and placebo effect given this sample size. All individuals providing the placebo TT used a calm approach, and were using touch in a non-custodial context, which may have been interpreted by the participant as compassionate touch, or one-to-one social interaction known to have positive effects [52,53].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Therapeutic Touch on Behavioral Symptoms and Cortisol in Persons with Dementia

Woods

Beck

Sinha

2009

Forsch Komplementmed

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Background: Between 75–90% of nursing home (NH) residents with dementia develop behavioral symptoms (BSD) which may be associated with a stress response. Therapeutic touch has been shown to decrease restlessness in NH residents, however the mechanism is unknown. The purpose of this randomized controlled trial (RCT) was to examine the effect of therapeutic touch on BSD and basal cortisol levels among NH residents with dementia. Participants and Methods: Using a double blind experimental interrupted time series ABAB design, 65 participants were assigned to one of three groups. The experimental group received therapeutic touch with contact on the neck and shoulders delivered twice daily for 3 days (administered over 2 separate treatment periods); the placebo group received a mimic treatment identical in appearance, and the control group received routine care. Study outcomes were BSD, measured by the modified Agitated Behavior Rating Scale (mABRS), and salivary cortisol levels, measured by enzyme-linked immunosorbent assay (ELISA). Results: 64 residents, aged 67–93 years (M = 85.5, SD = 5.50), completed the study. Restlessness was significantly reduced in the experimental group compared to the control group (p = 0.03). There was a significant difference in morning cortisol variability among groups across time periods (<0.0001). Findings suggest that therapeutic touch may be effective for management of symptoms like restlessness coupled with stress reduction. At a time when cost containment is a consideration in health care, therapeutic touch is an intervention that is non-invasive, readily learned, and can provide a non-pharmacologic alternative for selected persons with BSD.

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“…Thirty-one RCTs met the inclusion criteria [40][41][42][43][44] and five main intervention categories emerged (Table 1): psychoeducational [13][14][15][16][17][18][19][20][21], physical activity [22][23][24][25], sensorial [26][27][28][29][30][31][32][33][34], staff-focused [35,36,37,38,40] and complex [41][42][43][44] (Table 2). Nineteen studies were two-arm RCTs [14,15,[17][18][19][21][22][23]25,26,[29][30][...…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nineteen studies were two-arm RCTs [14,15,[17][18][19][21][22][23]25,26,[29][30][31][32]35,38,40,41,43] and 12 were three-arm or more [13,16,20,24,27,28,33,34,36,37,42,44].…”

Section: Study Characteristicsmentioning

confidence: 99%