title: Engaging nursing home residents with dementia in activities: the effects of modeling, presentation order, time of day, and setting characteristics.
abstract: We examined the impact of setting characteristics and presentation effects on engagement with stimuli in a group of 193 nursing home residents with dementia (recruited from a total of seven nursing homes). Engagement was assessed through systematic observations using the Observational Measurement of Engagement (OME), and data pertaining to setting characteristics (background noise, light, and number of persons in proximity) were recorded via the environmental portion of the Agitation Behavior Mapping Inventory (ABMI; Cohen-Mansfield, Werner, & Marx, (1989). An observational study of agitation in agitated nursing home residents. International Psychogeriatrics, 1, 153-165). Results revealed that study participants were engaged more often with moderate levels of sound and in the presence of a small group of people (from four to nine people). As to the presentation effects, multiple presentations of the same stimulus were found to be appropriate for the severely impaired as well as the moderately cognitively impaired. Moreover, modeling of the appropriate behavior significantly increased engagement, with the severely cognitively impaired residents receiving the greatest benefit from modeling. These findings have direct implications for the way in which caregivers could structure the environment in the nursing home and how they could present stimuli to residents in order to optimize engagement in persons with dementia.
authors.affiliation: Research Institute on Aging, Charles E. Smith Life Communities, Rockville, MD 20852, USA. cohen-mansfield@hebrew-home.org
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.forename: Khin
authors.initials: K
authors.lastname: Thein
authors.forename: Maha
authors.initials: M
authors.lastname: Dakheel-Ali
authors.forename: Marcia S
authors.initials: MS
authors.lastname: Marx
mesh_terms: D003704:Dementia; D004779:Environment Design; D006801:Humans; D007899:Leisure Activities; D008396:Maryland; D009735:Nursing Homes; D019370:Observation; D010358:Patient Participation; D012720:Severity of Illness Index
references.citation: Healthc Manage Forum. 1992 Summer;5(2):23-9
references.pmid: 10171068
references.citation: J Gerontol Nurs. 1996 Sep;22(9):33-8
references.pmid: 8975028
references.citation: Int Psychogeriatr. 1989 Fall;1(2):153-65
references.pmid: 2491142
references.citation: Aging Ment Health. 2010 Jan;14(1):67-73
references.pmid: 20155522
references.citation: Gerontologist. 2000 Feb;40(1):107-11
references.pmid: 10750318
references.citation: J Gerontol A Biol Sci Med Sci. 1997 Nov;52(6):M369-77
references.pmid: 9402944
references.citation: Int J Geriatr Psychiatry. 2001 Apr;16(4):378-86
references.pmid: 11333425
references.citation: Gerontologist. 1995 Feb;35(1):44-51
references.pmid: 7890202
references.citation: Alzheimer Dis Assoc Disord. 1997 Dec;11(4):228-38
references.pmid: 9437440
references.citation: Gerontologist. 1994 Jun;34(3):316-23
references.pmid: 8076872
references.citation: J Gerontol Nurs. 1998 Jul;24(7):10-7
references.pmid: 9801526
references.citation: J Gerontol B Psychol Sci Soc Sci. 1997 May;52(3):S135-44
references.pmid: 9158570
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Am Geriatr Soc. 1992 Oct;40(10):1018-20
references.pmid: 1401674
references.citation: Gerontologist. 1998 Apr;38(2):199-208
references.pmid: 9573664
references.citation: Int J Geriatr Psychiatry. 2009 Jul;24(7):755-63
references.pmid: 19156701
references.citation: Gerontologist. 1988 Jun;28(3):355-9
references.pmid: 3396916
references.citation: Am J Alzheimers Dis Other Demen. 2003 Jul-Aug;18(4):215-26
references.pmid: 12955786
references.citation: Am J Alzheimers Dis Other Demen. 2002 Jul-Aug;17(4):237-44
references.pmid: 12184513
references.citation: Aging Ment Health. 2005 Mar;9(2):129-34
references.pmid: 15804629
references.citation: Gerontologist. 2003 Oct;43(5):697-711
references.pmid: 14570966
references.citation: J Gerontol. 1994 Sep;49(5):P230-9
references.pmid: 8056948
references.citation: J Appl Gerontol. 1992 Mar;11(1):111-21
references.pmid: 10116942
references.citation: Psychol Aging. 2004 Jun;19(2):336-45
references.pmid: 15222827
references.citation: Am J Geriatr Psychiatry. 2009 Apr;17(4):299-307
references.pmid: 19307858
references.citation: Psychol Aging. 2005 Dec;20(4):589-600
references.pmid: 16420134
references.citation: Gerontologist. 2008 Dec;48(6):711-20
references.pmid: 19139245
references.citation: Soc Sci Med. 2008 Jun;66(11):2366-77
references.pmid: 18325650
references.citation: Int J Geriatr Psychiatry. 1999 Jul;14(7):520-5
references.pmid: 10440971
references.citation: Am J Geriatr Psychiatry. 2007 May;15(5):395-405
references.pmid: 17463190
references.citation: J Am Med Dir Assoc. 2004 Sep-Oct;5(5):283-8
references.pmid: 15357885
references.citation: Neuropsychology. 2003 Jan;17(1):69-81
references.pmid: 12597075
references.citation: Br J Clin Psychol. 2001 Mar;40(1):81-96
references.pmid: 11317951
references.citation: Am J Geriatr Psychiatry. 2010 Apr;18(4):351-62
references.pmid: 20306565
references.citation: Exp Aging Res. 2001 Jul-Sep;27(3):215-28
references.pmid: 11441644
references.citation: Psychiatry Res. 1995 Jun 29;57(1):7-12
references.pmid: 7568561
references.citation: Gerontologist. 1989 Jun;29(3):359-65
references.pmid: 2788109
references.citation: J Am Geriatr Soc. 1995 Dec;43(12):1356-62
references.pmid: 7490386
references.citation: Gerontologist. 2001 Jun;41(3):374-82
references.pmid: 11405435
references.citation: Percept Mot Skills. 1996 Dec;83(3 Pt 1):987-95
references.pmid: 8961335
references.citation: Am J Alzheimers Dis Other Demen. 2001 Jan-Feb;16(1):43-50
references.pmid: 11416947
references.citation: J Clin Psychiatry. 2011 Apr;72(4):480-6
references.pmid: 21527124
references.citation: Am J Alzheimers Dis Other Demen. 2006 Jan-Feb;21(1):15-22
references.pmid: 16526585