[The frequent screams]

Functional analysis is a research process that links problem behavior, its surrounding elements and the resulting consequences. The goal of this study was to decrease repetitive shouting of an elderly patient diagnosed with Alzheimer-like dementia. The analysis provided the following data: BEHAVIORS: Repetitive shouting by the patient lasting 80-115 seconds per 30 minutes during specific times of the day--accompanied by licking of the lips to moisten them. Environmental factors: Constant loud noise in the patient's room; the use of loud voices by staff and visitors; familiar objects out of the patient's reach. Individual factors: Diagnosis of the patient's blindness and auditory hypersensitivity; side-effects of psychotropic medications; a lack of social activities; inactivity because of the patient being bedridden 22 hours per day and the use of restraints when positioned in a chair.

The patients was isolated in a private room; psychotropic medication was increased; staff and other patients were less disrupted and the number of visitors to the patient was decreased.

The above data enabled the formulation of four hypotheses (with specific interventions for each) that assisted staff in planning the patient's care for a 10-day period; a reduction of anxiety; a reduction in discomfort; sensory hypostimulation; verbal hypostimulation. Following the application of these interventions for a 10-day period, a second set of data was gathered and the results showed a decrease in shouting by 40 per cent in the morning and 51 per cent in the afternoon.(ABSTRACT TRUNCATED AT 250 WORDS)