Treatment in Residential Settings

Effective behavioral interventions for decreasing dementia-related challenging behavior in nursing homes

“…Multiple studies and clinical experience suggest that for some individuals, DV may result from a lack or an excess of environmental stimulation (Burgio et al, 1996a;Lawton, 1981). To test this idea, Burgio and colleagues provided a variety of auditory and tactile stimuli to nursing home residents who displayed a clinically signi®cant level of DV .…”

“…Community-caregiver stress may exacerbate con¯ictual family relationships (Davis, 1997;Garwick et al, 1994;Semple, 1992), with the well-being of adult child caregivers more negatively aected by caregiving than that of spousal caregivers (Fisher and Lieberman, 1994;Burgio et al, 1996a). Finally, the behavior problems exhibited by community-dwelling care recipients may result in institutionalization (Aneshensel et al, 1993;O'Donnell et al, 1992).…”

“…Various categorizations of dementia-related challenging behaviors exist Burgio and Bourgeois, 1992;Burgio et al, 1996a;CohenMans®eld et al, 1989;Rubin et al, 1987). Generally, behavior problems can be separated into behavioral excesses, wherein the occurrence of the behavior constitutes the problem (eg disruptive vocalization and physical aggression; Burgio, , 1997Cohen-Mans®eld et al, 1989), and behavioral de®cits, wherein the non-occurrence of the behavior is problematic (eg cessation of selfdressing or social interaction; Burgio and Bourgeois, 1992;Burgio et al, 1996a;Rubin et al, 1987).…”

“…Although therapeutic activity programs have been used to decrease dementia-related problem behaviors by providing engagement in pleasant activities (Teri and Logsdon, 1991) and cognitive and sensorimotor stimulation via music (Millard and Smith, 1989;Pollack and Namazi, 1992;Smith-Marchese, 1994), visual arts (Bright, 1986;Kornreich, 1988;Wald, 1986) and pet therapies (Brickel, 1986;Haughie et al, 1992;McCulloch, 1985), we will not review these interventions here. A comprehensive review of this literature can be found in Burgio et al (1996a). Instead, we will limit this review to studies wherein the behaviors of the resident and/or sta are measured quantitatively, omitting interventions evaluating only an increase in knowledge of dementia-related challenging behavior without speci®c measurement of behavioral outcomes.…”

“…Generally, behavior problems can be separated into behavioral excesses, wherein the occurrence of the behavior constitutes the problem (eg disruptive vocalization and physical aggression; Burgio, , 1997Cohen-Mans®eld et al, 1989), and behavioral de®cits, wherein the non-occurrence of the behavior is problematic (eg cessation of selfdressing or social interaction; Burgio and Bourgeois, 1992;Burgio et al, 1996a;Rubin et al, 1987). Following the behavioral environmental model, behavior problems may be precipitated by internal or external stimuli, their expression may vary diurnally (Cohen-Mans®eld and Werner, 1994), and dierent problem behaviors may manifest at dierent points within the disease process (Bourgeois, 1991;Jackson et al, 1997).…”