Social Interaction, Premorbid Personality, and Agitation in Nursing Home Residents With Dementia

Kolanowski, Ann; Litaker, Mark S.

doi:10.1016/j.apnu.2005.08.006

Cited by 54 publications

(41 citation statements)

References 34 publications

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“…In another study (Stabell, Eide, Solheim, Solberg, & Rustøen, 2004), staff members rarely engaged in social engagement-supporting responses to residents, and primarily were engaged in dependence-supporting responses. Kolanowski and Litaker (2006) found that, for cognitively impaired residents, social interactions were associated with increased agitation, perhaps due to the fact that often these social interactions were occurring with other residents and were brief and therefore not of high quality. Based on these findings, it seems reasonable to hypothesize that the success of behavioral interventions in nursing homes may be related at least to some extent to increasing positive staff-resident interactions.…”

Section: Depressed Nursing Home Residents’ Activity Participation Andmentioning

confidence: 99%

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Depressed Nursing Home Residents' Activity Participation and Affect as a Function of Staff Engagement

Meeks

Looney

2011

Behavior Therapy

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Behavioral interventions for depression target activity engagement and increased positive reinforcement, particularly from social interaction. Nursing homes provide limited opportunity for meaningful social engagement, and have a high prevalence of depression. Often residents obtain most of their social contacts from staff members. We present intra-individual correlations among positive staff engagement, resident affect, and resident activity participation from behavior stream observations of residents who were participants in an ongoing trial of an intervention for depression. Sixteen residents were observed 6 times weekly for 8-45 weeks, five minutes per observation. Positive staff engagement during the observations was significantly correlated with resident interest and pleasure. Positive staff engagement was related to resident participation in organized group activity, however, residents tended to be more engaged and show more pleasure when in informal group activities, especially those residents receiving the behavioral treatment. Positive staff engagement was not related to time in activities of daily living. Results have implications for understanding mechanisms and potential targets of interventions for depression. Depressed Nursing Home Residents' Activity Participation and Positive Affect as a Function of Staff Positive EngagementDepression is a major focus of mental health care in nursing homes because of its high prevalence among the frail elders who reside in them (e.g., Katz & Parmelee, 1997; Teresi, Abrams, Holmes, Ramirez, & Eimicke, 2001). Although there is relatively little empirical evaluation of interventions for depression in nursing home residents, behavioral interventions have received some attention and appear to be promising (e.g., Lichtenberg, Kimbarow, Wall, Roth, & MacNeill, 1998;Meeks & Depp, 2002;Meeks, Looney, Van Haitsma, & Teri, 2008). Behavioral interventions for depression derive primarily from the work of Peter Lewinsohn, whose model emphasized the importance of response-contingent positive reinforcement, or increasing pleasant events that result in positive affect (Lewinsohn, 1975;Lewinsohn, Hoberman, Teri, & Hautzinger, 1985). Lewinsohn's original formulation privileged social interaction as a critical aspect of behavior that can lead to necessary positive reinforcement (Lewinsohn, 1975;Lewinsohn & Graf, 1973). Depressed individuals have been found to engage in fewer interpersonal interactions that can lead to positive reinforcement from others (Achterberg et al., 2003;Libet & Lewinsohn, 1973), and lack of positive social interaction might be particularly problematic among older adults with physical and cognitive impairments. Nursing homes are unique social environments; nursing home residents may have fewer contacts with friends and family members in their natural social networks, and traditional nursing home rooms offer limited privacy in a medicalized environment. Social interactions and activity are relatively infrequent (e.g., Kolanowski & Litaker, 2006;Logsdo...

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Section: Depressed Nursing Home Residents’ Activity Participation Andmentioning

confidence: 99%

“…Social interactions and activity are relatively infrequent (e.g., Kolanowski & Litaker, 2006; Logsdon, 2000). Nursing home staff members have special importance in this environment as the most likely providers of social reinforcement.…”

Section: Depressed Nursing Home Residents’ Activity Participation Andmentioning

confidence: 99%

Depressed Nursing Home Residents' Activity Participation and Affect as a Function of Staff Engagement

Meeks

Looney

2011

Behavior Therapy

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“…A Swedish study among persons aged 85 and older showed a 27% prevalence of depression in community-dwelling elderly persons and a 42% prevalence among those living in institutions [10]. In spite of this, nursing home residents spend up to 94% of their daytime sitting or lying down, even if many are capable of independent or assisted activity [11,12]. Individuals with dementia, common in nursing home settings, have higher levels of functional dependence than others and are more likely to require assistance in task-specific ADL domains such as mobility and personal care [13,14].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents: A Randomized Controlled Trial

et al. 2016

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Background: The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject to a decline in health, mobility, autonomy and social contacts and are also at risk of suffering a decline in mental well-being. In a previous study, we demonstrated that transfers, balance and physical activity level improved after 3 months of individually tailored intervention in nursing home residents. Objective: To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls-related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents. Methods: The study was a multicenter randomized, controlled clinical trial with a parallel-group design. It was conducted in nursing homes in Sweden, Norway and Denmark, with an intervention period lasting 3 months and a follow-up at 6 months. Initially, 322 nursing home residents with a mean age of 85 years were included; 85 from Sweden, 171 from Norway and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were assessed with reliable and valid instruments at baseline, immediately after 3 months of intervention and 3 months later at the 6-month follow-up. Results: After 3 months of intervention and an additional period of 3 months without intervention, only the following 2 variables demonstrated significant group differences: social and cognitive function, measured by the Functional Independence Measure n-r, where the IG deteriorated while the CG was almost stable. However, regarding transfers, the IG deteriorated significantly less than the CG. Conclusion: Without supervised physical exercise that challenged the individuals' capability, gains in ADL function, balance and transfer ability deteriorated during the 3 months following the intervention period. Thus, continuous, individually adjusted and supported physical activity seems crucial for the maintenance of physical functions in these vulnerable elderly persons.

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“…Despite this, Kolanowski & Litaker (2006) explore the relationship between high or low social interaction and the appearance of agitation in persons with dementia. Neither too high or too low a level of social interaction prove to be desirable and too high a level may lead to increased agitation.…”

Section: Introductionmentioning

confidence: 99%

Sliding interactions: An ethnography about how persons with dementia interact in housing with care for the elderly

2011

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This ethnography describes how persons with dementia interact with cognitively intact persons in housing with care for the elderly. The results, drawing upon 31 observation sessions and nine interviews, are described under the following themes, which were interpreted from the standpoint of social interaction theory: interaction with expression of satisfaction, disorientation, and dissociation. Interaction provided satisfaction, but did not always reflect a positive experience. Awareness in persons with dementia seemed to be greater than others perceived and, as a result, interaction was adversely affected by frequent well-intentioned corrections and comments. Participation in interaction can be encouraged and feelings of indignation avoided by assuming that persons with dementia are aware of their situation and how others behave toward them. Sensitivity is required to interpret individuals' expressions of desire not to participate, while simultaneously it is important to try to interpret why they want to refrain.

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Social Interaction, Premorbid Personality, and Agitation in Nursing Home Residents With Dementia

Cited by 54 publications

References 34 publications

Depressed Nursing Home Residents' Activity Participation and Affect as a Function of Staff Engagement

Depressed Nursing Home Residents' Activity Participation and Affect as a Function of Staff Engagement

Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents: A Randomized Controlled Trial

Sliding interactions: An ethnography about how persons with dementia interact in housing with care for the elderly

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