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A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia

Published online by Cambridge University Press:  14 December 2012

Eva S. van der Ploeg*
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Barbara Eppingstall
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Cameron J. Camp
Affiliation:
Center for Applied Research in Dementia, Solon, Ohio, USA
Susannah J. Runci
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
John Taffe
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Daniel W. O'Connor
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
*
Correspondence should be addressed to: Eva S. van der Ploeg, Aged Mental Health Research Unit, Kingston Centre, School of Psychology and Psychiatry, Monash University, Warrigal Road, Cheltenham VIC 3192, Melbourne, Australia. Phone: 0061 3 9265 1700, Fax: 0061 3 9265 1711. Email: Eva.vanderPloeg@monash.edu.

Abstract

Background: Increasingly more attention has been paid to non-pharmacological interventions as treatment of agitated behaviors that accompany dementia. The aim of the current study is to test if personalized one-to-one interaction activities based on Montessori principles will improve agitation, affect, and engagement more than a relevant control condition.

Methods: We conducted a randomized crossover trial in nine residential facilities in metropolitan Melbourne, Australia (n = 44). Personalized one-to-one activities that were delivered using Montessori principles were compared with a non-personalized activity to control for the non-specific benefits of one-to-one interaction. Participants were observed 30 minutes before, during, and after the sessions. The presence or absence of a selected physically non-aggressive behavior was noted in every minute, together with the predominant type of affect and engagement.

Results: Behavior counts fell considerably during both the Montessori and control sessions relative to beforehand. During Montessori activities, the amount of time spend actively engaged was double compared to during the control condition and participants displayed more positive affect and interest as well. Participants with no fluency in English (all from non-English speaking backgrounds) showed a significantly larger reduction in agitation during the Montessori than control sessions.

Conclusion: Our results show that even non-personalized social contact can assist in settling agitated residents. Tailoring activities to residents’ needs and capabilities elicit more positive interactions and are especially suitable for people who have lost fluency in the language spoken predominantly in their residential facility. Future studies could explore implementation by family members and volunteers to avoid demands on facilities’ resources.

Trial Registration: Australian New Zealand Clinical Trials Registry – ACTRN12609000564257.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia
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