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The effect of natural environments upon agitation and aggression in late stage dementia patients

School of Nursing, University of Michigan, Ann Arbor, Michigan

Margaret E. Black, PhD, RN

School of Nursing, McMaster University, Hamilton, Ontario, Canada

Carla J. Groh, PhD, RN

College of Health Professions, University of Detroit Mercy, Detroit, Michigan

Dawn J. Yankou, PhD, RN

Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada

Barbara J. Kupferschmid, MSN, RN

Norman L. Foster, MD

School of Medicine, University of Michigan, Ann Arbor, Michigan

Agitated aggressive behavior in late stage dementia occurs in 30 to 50 percent of patients. This behavior often results in the use of chemical and physical restraints (which have a high degree of untoward side effects) and caregiver burnout. Interventions for agitated aggressive behavior are needed that do not have these side effects, which are readily available in nursing homes and are effective and acceptable to caregivers. Environmental psychologists have proposed that natural elements within the environment decrease agitation in the nondemented as well as the demented Since the shower bath is often a time of great agitation in dementia patients, natural elements were used to modify care during the shower bath (n = 31). There was a significant decrease in mean difference scores from baseline to treatments one and two, with the treatment group demonstrating an overall decline in agitated aggressive behavior Additional randomized trials of the effects of natural environments upon agitation and aggression in dementia are needed.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 12, No. 5, 216-220 (1997)
DOI: 10.1177/153331759701200506


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