Étude préliminaire d'une intervention non-pharmacologique pour réduire l'agitation verbale chez les personnes atteintes de démence

Reducing verbal agitation in people with dementia: evaluation of an intervention based on the satisfaction of basic needs

OBJECTIVES

Positive results have been reported with psychosocial interventions used to reduce verbal agitation (VA) in people with dementia, but there is no clear information regarding the proportion of persons who demonstrate significant behavioural improvement with such treatments. The main objectives of this pilot study are (a) to identify the proportion of persons with dementia who demonstrate significant behavioural improvement with a need-based intervention to reduce VA and (b) to further evaluate the effectiveness of this type of intervention.

METHOD

A single-group repeated measures design was used (N = 26). An individualized multicomponent intervention addressing needs for comfort, social interaction and sensory stimulation was applied by a therapist during 30 min sessions during the time of day when VA was most severe. The frequency and duration of VA were measured through computer-assisted direct observation several times before, during and after the intervention.

RESULTS

A statistically significant reduction of the duration of VA during the intervention phase relative to other phases of the protocol was found. This effect was limited to the period during which the treatment is being applied. Half of the participants (54%) demonstrated considerable behavioural improvement during the intervention (50% reduction of symptoms) and those whose functioning is best preserved showed the best response to the intervention.

CONCLUSION

This need-based intervention appears promising for improving the behaviour of a considerable proportion of patients.

Review: verbal agitation in dementia: the role of discomfort

Verbal agitation (VA) is a disturbing and commonly observed behavioral symptom in people with dementia. Although several different variables contribute to VA, it seems that discomfort plays an important role. The overall objective of this article is to review the relationship between VA and discomfort among people with dementia. Specifically, this article discusses the place of discomfort within the conceptualizations of VA, empirical support for the association between discomfort and VA, and practical implications of this relationship in the assessment and treatment of VA. This article contributes to a better understanding of VA and provides recommendations for prevention and effective intervention.