Nursing home residents with advanced dementia and persistent vocalisations: Observations of surrounding context.
Justine S Sefcik, Mary Ersek, Pamela Z Cacchione
PMID 32383798WHAT IT FOUND
Residents with advanced dementia who vocalised repeatedly were often kept alone in rooms.
Staff sometimes moved or cared for them without speaking first, and residents appeared startled or vocalised more. This describes context, not a tested treatment.
Key findings
01Five of the nine participants spent all or most of their day in their room, and they were observed to vocalise more than participants who spent more time outside their rooms.
02Staff sometimes completed tasks such as moving a resident without speaking first, and residents appeared startled and vocalised.
03Staff reported daily fluctuations for seven participants, and for six of the nine participants at least one staff member said the resident was unusually quiet during the observed shift.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only nine residents were observed, so the findings cannot show what happens for all residents with advanced dementia. The investigator inferred distress from behaviour because the residents could not clearly tell her what they needed. Staff may have acted differently because an investigator was present. The data were not analysed by facility, so differences between nursing homes may have shaped what was observed. Only residents who understood and spoke English were included. Staff dementia or communication training was not known. One investigator wrote all field notes, so the record reflects her filtered observations. The study did not test whether moving residents to common areas, giving verbal cues, or adding activity changed persistent vocalisations.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read the room isolation as a treatment that works. The study only observed that residents kept in rooms were more disruptive and often vocalised more; it did not test whether isolation reduced persistent vocalisations.