Factors Associated with Problematic Vocalizations in Nursing Home Residents With Dementia
Open Access
- 3 February 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in The Gerontologist
- Vol. 51 (3), 389-405
- https://doi.org/10.1093/geront/gnq129
Abstract
Purpose of the Study: Problematic vocalizations (PVs) are the most frequent and persistent disruptive behaviors exhibited by nursing home residents with dementia. Understanding factors associated with these behaviors are important to prevent or reduce them. We used the Need-Driven Dementia-Compromised Behavior model to identify the characteristics of persons with dementia who are likely to display nonaggressive and aggressive PVs and the conditions under which these behaviors are likely to occur and persist. Design and Methods: This multisite descriptive study included 138 residents of 17 nursing homes, and approximately half had a history of PVs. Background data were gathered through interviews, chart reviews, and administration of physical and neuropsychological assessments. Proximal data were obtained from observations and videotapes. Results: When the 2 subscales of the Verbal Behavior Scale were used as the dependent variables, agreeableness and conscientiousness, positive affect, and discomfort were associated with nonaggressive vocalizations, and general health state (GHS), age, and negative and positive affect were associated with aggressive vocalizations. When the verbally agitated (nonaggressive) section of the Cohen-Mansfield Agitation Inventory was the dependent variable, the background factors of gender, agreeableness, GHS, and age remained predictors, as did the proximal factors of affect and discomfort. Implications: We identified 5 background factors and 3 proximal factors as risk factors for PVs in persons with dementia, with variation between nonaggressive or aggressive PVs. These data provide direction for caregiving for persons with dementia and design of interventions to prevent or reduce PVs.Keywords
This publication has 57 references indexed in Scilit:
- Vocally disruptive behavior in the elderly: a systematic reviewInternational Psychogeriatrics, 2008
- A survey of the frequency and impact of Behaviours of Concern in dementia on residential aged care staffAustralasian Journal on Ageing, 2007
- The NEO-FFI is a reliable measure of premorbid personality in patients with probable Alzheimer's diseaseInternational Journal of Geriatric Psychiatry, 2006
- Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromesJournal of Psychiatric Research, 2005
- Ethnic Differences in the Prevalence and Pattern of Dementia‐Related BehaviorsJournal of the American Geriatrics Society, 2004
- Acoustic Properties of Vocally Disruptive Behaviors in the Nursing HomeGerontology, 2003
- Pain Assessment for the Dementing Elderly (PADE): Reliability and Validity of a New MeasureJournal of the American Medical Directors Association, 2003
- Verbal aggression in Alzheimer's disease. Clinical, functional and neuropsychological correlatesInternational Journal of Geriatric Psychiatry, 2001
- Environmental "White Noise": An Intervention for Verbally Agitated Nursing Home ResidentsThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1996
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975