Agitation in Nursing Home Residents: The Role of Gender and Social Context

Abstract

We investigated the relationship among gender of resident, staff social interaction, and agitation in 46 (31 male and 15 female) nursing home residents with clinically significant agitation. Direct observations were conducted of resident behaviors and environmental contextual events using a computer-assisted, real-time observational system. The system recored frequency, duration, and temporal sequencing of events. Results show that female residents displayed almost three times the amount of agitation as male residents (35% vs. 13% of total observation time, respectively), although men in the study were more likely to receive psychoactive drugs for their agitation. Staff spent similar amounts of time verbally interacting and touching male and female residents. Sequential analyses were conducted to examine the likelihood of staff verbal and touch interactions both preceding and following resident agitation using Bakeman and Quera's (1995) SDIS-GSEQ program. Results suggest that staff touch and verbal interaction elicit agitation in a significant proportion of residents. Once agitation occurs, staff were likely to respond by interacting verbally, but not physically, with the resident.

A Longitudinal Examination of Agitation and Resident Characteristics in the Nursing Home

“…This percentage is well within the range reported in our prior research (Burgio, Allen-Burge et al, 2001;Burgio, Butler et al, 2001;Burgio et al, 2002). We found both significant linear and quadratic effects over the 18-month period, showing that residents' agitation improved through the 12-month observation (Epoch 3) but increased from Epoch 3 (12 months) to Epoch 4 (18 months; see Figure 2).…”

Elderspeak Communication: Impact on Dementia Care

“…Duration of behavior was tabulated by the length of time until a key corresponding to an alternate behavior state was pushed. Based on the sequential analysis systems used by Burgio and colleagues, 8 each second of an interaction was coded for communication state (elderspeak, normal speech, or silence) and resident behavior state (RTC, cooperative, or neutral). Figure 1 presents a sample plot comparing nursing communication with resident behavior.…”

Practice style in the nursing home: dimensions for assessment and quality improvement

“…Verbal and non-verbal communication problems with persons with dementia have been linked to agitated behaviors (Burgio et al, 2000;Bourgeois, 2002) and to caregiver burden and stress (Savundranayagam et al, 2005). Communication barriers also exist with family members and between staff members.…”