Typology of disruptive vocalizations in older persons suffering from dementia

Verbal and vocal disruptive behaviors (VDB) are important clinical features in dementia because they frequently signal discomfort experienced by an elderly person and because they are disturbing to caregivers, thereby affecting the care of elderly persons manifesting them. This article describes a typology of VDB, the Typology of Vocalizations-TOV. The conceptual framework underlying the development of this typology includes the assumptions that VDB consist of more than one type of behavior and that interventions should be matched to the etiology of the specific type of VDB. The article reports interrater reliability of the typology and validates it against Ryan's classification of verbal and vocal disruptive behaviors. Critical dimensions of the typology are examined and used for its refinement. Finally, use of the TOV for matching individuals to the most effective intervention is demonstrated.