title: A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia.
abstract: BACKGROUND
  Increasingly more attention has been paid to non-pharmacological interventions as treatment of agitated behaviors that accompany dementia. The aim of the current study is to test if personalized one-to-one interaction activities based on Montessori principles will improve agitation, affect, and engagement more than a relevant control condition.
  
  
  METHODS
  We conducted a randomized crossover trial in nine residential facilities in metropolitan Melbourne, Australia (n = 44). Personalized one-to-one activities that were delivered using Montessori principles were compared with a non-personalized activity to control for the non-specific benefits of one-to-one interaction. Participants were observed 30 minutes before, during, and after the sessions. The presence or absence of a selected physically non-aggressive behavior was noted in every minute, together with the predominant type of affect and engagement.
  
  
  RESULTS
  Behavior counts fell considerably during both the Montessori and control sessions relative to beforehand. During Montessori activities, the amount of time spend actively engaged was double compared to during the control condition and participants displayed more positive affect and interest as well. Participants with no fluency in English (all from non-English speaking backgrounds) showed a significantly larger reduction in agitation during the Montessori than control sessions.
  
  
  CONCLUSIONS
  Our results show that even non-personalized social contact can assist in settling agitated residents. Tailoring activities to residents' needs and capabilities elicit more positive interactions and are especially suitable for people who have lost fluency in the language spoken predominantly in their residential facility. Future studies could explore implementation by family members and volunteers to avoid demands on facilities' resources.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry - ACTRN12609000564257.
authors.affiliation: Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia. Eva.vanderPloeg@monash.edu
authors.forename: Eva S
authors.initials: ES
authors.lastname: van der Ploeg
authors.forename: Barbara
authors.initials: B
authors.lastname: Eppingstall
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Camp
authors.forename: Susannah J
authors.initials: SJ
authors.lastname: Runci
authors.forename: John
authors.initials: J
authors.lastname: Taffe
authors.forename: Daniel W
authors.initials: DW
authors.lastname: O'Connor
mesh_terms: D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D032763:Behavior Control / Q000379:methods*; D001526:Behavioral Symptoms / Q000523:psychology / Q000628:therapy*; D018592:Cross-Over Studies; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009735:Nursing Homes; D010043:Outcome and Process Assessment, Health Care; D018802:Patient-Centered Care / Q000379:methods*; D011595:Psychomotor Agitation / Q000150:complications / Q000523:psychology / Q000628:therapy*