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A descriptive study of physically aggressive behavior in dementia by direct observation
S Bridges-Parlet1, D Knopman, T Thompson
1University of Minnesota Institute for Disability Studies, Minneapolis.
Journal of the American Geriatrics Society
|February 1, 1994
Summary
Physically aggressive behavior (PAB) in dementia patients is rarely spontaneous. Most PAB in older adults is a defensive reaction to personal space intrusion, not anger.
Area of Science:
- Gerontology
- Neuroscience
- Psychiatry
Background:
- Physically aggressive behavior (PAB) is a challenging aspect of dementia care.
- Understanding the triggers and nature of PAB is crucial for effective management.
Purpose of the Study:
- To directly observe and analyze physically aggressive behavior (PAB) in older adults with dementia.
- To identify the antecedents and consequences of PAB in a nursing home setting.
Main Methods:
- A cross-sectional survey design was employed.
- Direct observation using bar-code readers and daily diaries documented PAB frequency, antecedents, and consequences.
- The study included twenty male and female participants with a history of PAB in specialized Alzheimer's and general skilled nursing units.
Main Results:
- PAB was most frequently directed towards staff (23/28 episodes), often during personal care (15/23 episodes).
- Verbal aggression or non-compliance typically preceded PAB.
- Following PAB, participants usually returned to non-aggressive behavior quickly.
Conclusions:
- PAB in this cohort was seldom spontaneous or indicative of the participant's usual behavior.
- The majority of PAB incidents were triggered by staff or resident intrusion into personal space.
- PAB is best characterized as a defensive response rather than an expression of anger.