Reducing verbal agitation in people with dementia: Evaluation of an intervention based on the satisfaction of basic needs

Abstract

Objectives: Positive results have been reported with psychosocial interventions used to reduce verbal agitation (VA) in people with dementia, but there is no clear information regarding the proportion of persons who demonstrate significant behavioural improvement with such treatments. The main objectives of this pilot study are (a) to identify the proportion of persons with dementia who demonstrate significant behavioural improvement with a need-based intervention to reduce VA and (b) to further evaluate the effectiveness of this type of intervention.

Method: A single-group repeated measures design was used (N = 26). An individualized multicomponent intervention addressing needs for comfort, social interaction and sensory stimulation was applied by a therapist during 30 min sessions during the time of day when VA was most severe. The frequency and duration of VA were measured through computer-assisted direct observation several times before, during and after the intervention.

Results: A statistically significant reduction of the duration of VA during the intervention phase relative to other phases of the protocol was found. This effect was limited to the period during which the treatment is being applied. Half of the participants (54%) demonstrated considerable behavioural improvement during the intervention (50% reduction of symptoms) and those whose functioning is best preserved showed the best response to the intervention.

Conclusion: This need-based intervention appears promising for improving the behaviour of a considerable proportion of patients.

Keywords:

• Alzheimer's disease and related disorders
• behavioural and psychological symptoms of dementia
• psychosocial intervention
• long-term care

Acknowledgements

The authors thank Mariette Audet Prave, Anne-Marie Adam, Raquel Luis, Jean Brin, Marie-Pier Coll, Marie-Pier Madé, Geneviève Dumont, Marie-Ève Bélanger, Isabelle Côté and Pierre-Hugues Carmichael. The authors also thank the administrations of the Unité de recherche sur la santé des populations du centre de recherche du Centre hospitalier affilié universitaire de Québec, and of the Centre de santé et de services sociaux de Québec-Nord et de la Vieille-Capitale, as well as the administrations and nursing staff of the nursing homes who collaborated with them on this study. The authors also wish to thank all the participants and their families.

A. Bédard and P. Landreville developed the research protocol. A. Bédard coordinated the data collection, performed the statistical analyses and drafted the manuscript. P. Landreville oversaw the data collection and statistical analyses and contributed to drafting the manuscript. P. Voyer participated in the development of the protocol and supervision of the project and contributed to drafting the manuscript. R. Verreault and J. Vézina participated in the development of the protocol and contributed to drafting the manuscript.