Kim J. curyTo, KElly m. TrEvino, suzann ogland-hand, and PETEr lichTEnBErg 6 currently, 4.5 million persons in the united states have alzheimer's disease, with an estimated increase to 11 million to 16 million persons by the year 2050 (hebert, scherr, Bienias, Bennett, & Evans, 2003). a hallmark issue when caring for persons with dementia is addressing challenging or disruptive behavior. approximately 66% of community-dwelling older adults with dementia and 77% of older adults in nursing homes with dementia demonstrate disruptive behaviors (Bartels et al., 2003;chan, Kasper, Black, & rabins, 2003). untreated, these behaviors can lead to decreased quality of life, increased family and staff caregiver burden, staff burnout and turnover, use of restraints, and institutionalization or psychiatric hospitalization. as a result, disruptive behavior can also increase the cost of care (Brotons & Pickettcooper, 1996;Burgio, Jones, Butler, & Engler, 1988;conely & campbell, 1991; daniel, 2000).disruptive behaviors in dementia have been categorized into three types (Beck et al., 1998; cohen-mansfield & deutsch, 1996): (a) verbal agitationrepetitive sentences or questions, calling out, constant unwarranted requests, complaining, and negativism; (b) physically nonaggressive behavior-repetitious mannerisms, inappropriate robing-disrobing, eating or handling things inappropriately, pacing, aimless wandering, trying to get to a different place, general