Can agitated behavior of nursing home residents with dementia be prevented with the use of standardized stimuli?

Objectives: To assess the relative effect of different types of stimuli on agitated behaviors of nursing home residents with dementia.

Design: Repeated-measures design with randomized assignment of conditions.

Setting: Seven Maryland nursing homes.

Participants: One hundred eleven nursing home residents with a diagnosis of dementia who exhibited agitation.

Intervention: Different types of stimuli (music, social stimuli, simulated social stimuli, and individualized stimuli based on the person's self-identity) were presented.

Measurements: Agitation was directly observed and recorded using the Agitation Behavior Mapping Instrument.

Results: All stimulus categories were associated with significantly less physical agitation than baseline observations, and all except for manipulative stimuli were associated with significantly less total agitation. Live social stimuli were associated with less agitation than music, self-identity, work, simulated social, and manipulative stimulus categories. Task and reading stimulus categories were each associated with significantly less agitation than work, simulated social, and manipulative stimulus categories. Music and self-identity stimuli were associated with less agitation than simulated social and manipulative stimuli.

Conclusion: Providing stimuli offers a proactive approach to preventing agitation in persons with dementia, with live social stimuli being the most successful.