A Comparison of Two Treatments of Agitated Behavior in Nursing Home Residents With Dementia: Simulated Family Presence and Preferred Music
Abstract
Objective The objective of this study was to compare the effectiveness of two individualized psychosocial treatments in reducing the frequency of physically and verbally agitated behaviors in nursing home residents whose dementia was complicated by marked behavioral disturbance.Methods Thirty nursing home residents with frequent, severe behavioral disturbances were observed by research staff before, during, and after multiple, randomized, single-blind exposures to 15-minute audiotapes of simulated family presence (a conversation prepared by a family member about positive experiences from the past), music preferred by the resident in earlier life, and a placebo condition of a reading from a horticultural text. Selected (usually multiple) physical and verbal behaviors were counted as present or absent at regular intervals. All three treatment conditions were compared with usual care.Results Simulated presence and preferred music both proved effective in reducing counts of physically agitated behaviors. Simulated presence, but not music, resulted in significantly reduced counts of verbally agitated behaviors. The placebo tape proved more effective than expected. Participants' responses to simulated presence and music varied widely. Behavior counts fell by one-half or more in many cases. Other residents became more agitated.Conclusion Participants' better-than-expected responses to the placebo tape suggest that even the simplest technology can improve the lives of confused, disturbed nursing home residents. Of the two psychosocial treatments, preferred music tapes were easier to make and were clearly helpful in many instances. By contrast, family members often struggled to recall enough happy memories to compile a simulated presence tape. Simulated presence might prove just as effective if relatives speak on topics of their own choosing. Although not all residents were helped by these treatments, adverse effects were mild and shortlived.
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Garland et al. reported that audiotapes containing a family member's voice were more effective than audiotapes with songs to reduce agitation in patients with BPSD.
“Garland et al. [26] reported that audiotapes containing a family member's voice were more effective than audiotapes with songs to reduce agitation in patients with BPSD.”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [26]
Both simulated family presence and preferred music interventions proved to be effective in reducing agitation.
“Both interventions proved to be effective in reducing agitation [26].”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [26]
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- Authors
- Garland, K., Beer, E., Eppingstall, B., & O'Connor, D. W.
- Affiliations
- Monash University (AU)
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 15
- Issue
- 6
- Pages
- 514-521
- ISSN
- 1064-7481 (ISSN-L)
- OpenAlex
- W2074227168
- Cited by
- 157
- References
- 19
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 8 · 2018: 13 · 2017: 16 · 2016: 11 · 2015: 10 · 2014: 11 · 2013: 12 · 2012: 8
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Keywords
- dementia, behavioral problems, agitation, nursing home residents, musical taste, psychosocial interventions, verbal aggression, physical aggression, placebo effect, reminiscence
- MeSH terms
- Aged, Aged, 80 and over, Choice Behavior, Dementia, Family, Female, Humans, Male, Music Therapy, Nursing Homes, Psychological Theory, Psychomotor Agitation, Social Environment, Verbal Behavior
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