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Integrative review: Persistent vocalizations among nursing home residents with dementia

Published online by Cambridge University Press:  10 October 2018

Justine S. Sefcik ,
Mary Ersek ,
Sasha C. Hartnett  and
Pamela Z. Cacchione
Justine S. Sefcik*
Affiliation:
University of Pennsylvania School of Nursing, Philadelphia, PA, USA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
Mary Ersek
Affiliation:
University of Pennsylvania School of Nursing, Philadelphia, PA, USA Department of Veterans Affairs, Philadelphia, PA, USA
Sasha C. Hartnett
Affiliation:
University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Pamela Z. Cacchione
Affiliation:
University of Pennsylvania School of Nursing, Philadelphia, PA, USA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA Penn Presbyterian Medical Center, Philadelphia, PA, USA
*
Correspondence should be addressed to: Justine S. Sefcik, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, U.S.A. Phone: +215-898-2689. Email: [email protected]
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Abstract

Background:

Nursing home (NH) residents with dementia commonly exhibit persistent vocalizations (PVs), otherwise known in the literature as disruptive or problematic vocalizations. Having a better understanding of PVs and the research completed to date on this phenomenon is important to guide further research and clinical practice in NHs. This integrative review examines the current literature on the phenomenon of PVs among NH residents with dementia.

Methods:

We conducted a search in the PubMed, Scopus, Ovid Medline, and CINAHL databases for articles published in English. Articles were included if the focus was specifically on research involving vocal behaviors of older adults with dementia residing in NHs.

Results:

Our literature search revealed eight research articles that met the inclusion criteria. These studies were published in 2011 or earlier and involved small sample sizes. Seven of these studies were descriptive and the eighth was a non-pharmacological intervention study for PVs exhibited by NH residents with dementia. These studies were vastly different in their labeling, definitions, and categorization of the PVs as well as methods of measuring PVs.

Conclusion:

The heterogeneity of the evidence limits the ability to make recommendations for practice. Given the paucity of research on this phenomenon; recommendations for additional research are given.

Keywords

integrative reviewpersistent vocalizationsbehavioral symptom of dementianursing home residentsolder adults
Type
Review Article
Information
International Psychogeriatrics , Volume 31 , Issue 5: Issue Theme: Well-Being in Dementia , May 2019 , pp. 667 - 683
Copyright
© International Psychogeriatric Association 2018 

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References

Algase, D. L., et al. (1996). Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer’s Disease and Other Dementias, 11, 10–19.CrossRefGoogle Scholar
Alzheimer’s Association (2016). 2016 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 12, 459–509. doi: 10.1016/j.jalz.2016.03.001.CrossRefGoogle Scholar
American Geriatrics Society and American Association for Geriatric Psychiatry (2003). Consensus statement on improving the quality of mental health care in US nursing homes: management of depression and behavioral symptoms associated with dementia. Journal of the American Geriatrics Society, 51, 1287–1298. doi: 10.1046/j.1532-5415.2003.51415.x.CrossRefGoogle Scholar
Barton, S., Findlay, D. and Blake, R. A. (2005). The management of inappropriate vocalisation in dementia: A hierarchical approach. International Journal of Geriatric Psychiatry, 20, 1180–1186. doi: 10.1002/gps.1416.CrossRefGoogle ScholarPubMed
Beck, C., et al. (1998). Correlates of disruptive behavior in severely cognitively impaired nursing home residents. The Gerontologist, 38, 189–198. doi: 10.1093/geront/38.2.189.CrossRefGoogle ScholarPubMed
Beck, C., Heithoff, K., Baldwin, B., Cuffel, B., O’sullivan, P. and Chumbler, N. (1997). Assessing disruptive behavior in older adults: The disruptive behavior scale. Aging & Mental Health, 1, 71–80. doi: 10.1080/13607869757407.CrossRefGoogle Scholar
Beck, C., et al. (2011). Factors associated with problematic vocalizations in nursing home residents with dementia. The Gerontologist, 51, 389–405. doi: 10.1093/geront/gnq129.CrossRefGoogle ScholarPubMed
Beck, C. K. and Vogelpohl, T. S. (1999). Problematic vocalizations in institutionalized individuals with dementia. Journal of Gerontological Nursing, 25, 17–26. doi: 10.3928/0098-9134-19990901-07.CrossRefGoogle ScholarPubMed
Bédard, A., Landreville, P., Voyer, P., Verreault, R. and Vézina, J. (2011). Reducing verbal agitation in people with dementia: Evaluation of an intervention based on the satisfaction of basic needs. Aging & Mental Health, 15, 855–865. doi: 10.1080/13607863.2011.569480.CrossRefGoogle ScholarPubMed
Bourbonnais, A. and Ducharme, F. (2010). The meanings of screams in older people living with dementia in a nursing home. International Psychogeriatrics, 22, 1172–1184. doi: 10.1017/S1041610209991670.CrossRefGoogle Scholar
Buhr, G. T. and White, H. K. (2006). Difficult behaviors in long-term care patients with dementia. Journal of the American Medical Directors Association, 7, 180–192. doi: 10.1016/j.jamda.2005.12.003.CrossRefGoogle ScholarPubMed
Clavel, D. S. (1999). Vocalizations among cognitively impaired elders: what is your patient trying to tell you? Geriatric Nursing, 20, 90–93. doi: 10.1053/gn.1999.v20.97008.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J. (2000). Nonpharmacological management of behavioral problems in persons with dementia: the TREA model. Alzheimer’s Care Today, 1, 22–34.Google Scholar
Cohen-Mansfield, J., Marx, M. S. and Werner, P. (1998). A description of agitation in a nursing home. Journal of Gerontology, 44, M77–M84. doi: 10.1093/geronj/44.3.M77.Google Scholar
Cohen-Mansfield, J. and Werner, P. (1994). Verbally disruptive behaviors in elderly persons: a review. In Vellas, B., Albarede, J., and Garry, P. (Eds.) Facts and Research in Gerontology: Dementia and Cognitive Impairments. New York: Springer.Google Scholar
Cohen-Mansfield, J. and Werner, P. (1997). Typology of verbally disruptive behaviors in the nursing home. International Journal of Geriatric Psychiatry, 12, 1079–1091.Google Scholar
Cohen-Mansfield, J. and Werner, P. (1997a). Management of verbally disruptive behaviors in nursing home residents. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 52, M369–M377. doi: 10.1093/gerona/52A.6.M369.CrossRefGoogle Scholar
Cohen-Mansfield, J. and Werner, P. (1997b). Typology of disruptive vocalizations in older persons suffering from dementia. International Journal of Geriatric Psychiatry, 12, 1079–1091. doi: 10.1002/(SICI)1099-1166(199711)12:11<1079::AID-GPS689>3.0.CO;2-P.3.0.CO;2-P>CrossRefGoogle Scholar
Cohen-Mansfield, J., Werner, P., Hammerschmidt, K. and Newman, J. D. (2003). Acoustic properties of vocally disruptive behaviors in the nursing home. Gerontology, 49, 161–167. doi: 10.1159/000069173.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Werner, P., Watson, V. and Pasis, S. (1995). Agitation among elderly persons at adult day-care centers: The experiences of relatives and staff members. International Psychogeriatrics, 7, 447–458. doi: 10.1017/S1041610295002195.CrossRefGoogle ScholarPubMed
Cummings, J., et al. (2015). Agitation in cognitive disorders: international psychogeriatric association provisional consensus clinical and research definition. International Psychogeriatrics, 27, 7–17. doi: 10.1017/S1041610214001963.CrossRefGoogle ScholarPubMed
Draper, B., et al. (2000). Case-controlled study of nursing home residents referred for treatment of vocally disruptive behavior. International Psychogeriatrics, 12, 333–344. doi: 10.1017/S1041610200006438.CrossRefGoogle ScholarPubMed
Dwyer, M. and Byrne, G. J. (2000). Disruptive vocalization and depression in older nursing home residents. International Psychogeriatrics, 12, 463–471. doi: 10.1017/S104161020000658X.CrossRefGoogle ScholarPubMed
Edberg, A. K., Sandgren, Å. N. and Hallberg, I. (1995). Initiating and terminating verbal interaction between nurses and severely demented patients regarded as vocally disruptive. Journal of Psychiatric and Mental Health Nursing, 2, 159–167. doi: 10.1111/j.1365-2850.1995.tb00051.x.CrossRefGoogle ScholarPubMed
Hall, G. R. and Buckwalter, K. C. (1987). Progressively lowered stress threshold: A conceptual model for care of adults with Alzheimer’s disease. Archives of Psychiatric Nursing, 1, 399–406.Google ScholarPubMed
Harding, R. and Peel, E. (2013). ‘He was like a zombie’: off-label prescription of antipsychotic drugs in dementia. Medical Law Review, 21, 243–277. doi: 10.1093/medlaw/fws029.CrossRefGoogle Scholar
Harris-Kojetin, L., et al. (2016). Long-term care providers and services users in the United States: data from the National Study of Long-Term Care Providers, 2013–2014. Vital & Health Statistics. Series 3, Analytical and epidemiological studies/[US Dept. of Health and Human Services, Public Health Service, National Center for Health Statistics], 38, 1–105.Google Scholar
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2015). State of the art review: Assessment and management of behavioral and psychological symptoms of dementia. BMJ, 350, h369.CrossRefGoogle ScholarPubMed
Khan, S. S., Ye, B., Taati, B. and Mihailidis, A. (2018). Detecting agitation and aggression in people with dementia using sensors—A systematic review. Alzheimer’s & Dementia. 14, 824–832. doi: 10.1016/j.jalz.2018.02.004.CrossRefGoogle ScholarPubMed
Kolanowski, A., et al. (2017). Determinants of behavioral and psychological symptoms of dementia: a scoping review of the evidence. Nursing Outlook, 65, 515–529. doi: 10.1016/j.outlook.2017.06.006.CrossRefGoogle Scholar
Kolanowski, A., Fick, D., Frazer, C., and Penrod, J. (2010). It’s about time: Use of nonpharmacological interventions in the nursing home. Journal of Nursing Scholarship, 42, 213–222. doi: 10.1111/j.1547-5069.2010.01338.x.CrossRefGoogle ScholarPubMed
Kuhlmei, A., Walther, B., Becker, T., Müller, U. and Nikolaus, T. (2013). Actigraphic daytime activity is reduced in patients with cognitive impairment and apathy. European Psychiatry, 28, 94–97. doi: 10.1016/j.eurpsy.2011.04.006.CrossRefGoogle ScholarPubMed
Lai, C. K. (1999). Vocally disruptive behaviors in people with cognitive impairment: Current knowledge and future research directions. American Journal of Alzheimer’s Disease, 14, 172–180. doi: 10.1177/153331759901400304.CrossRefGoogle Scholar
Livingston, G., et al. (2014). A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technology Assessment (Winchester, England), 18, 1–242. doi: 10.3310/hta18610.CrossRefGoogle ScholarPubMed
Maher, A. R., et al. (2011). Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis. JAMA, 306, 1359–1369. doi: 10.1001/jama.2011.1360.CrossRefGoogle ScholarPubMed
Matteau, E., Landreville, P., Laplante, L. and Laplante, C. (2003). Disruptive vocalizations: A means to communicate in dementia? American Journal of Alzheimer’s Disease and Other Dementias, 18, 147–153. doi: 10.1177/153331750301800307.CrossRefGoogle ScholarPubMed
McMinn, B. and Draper, B. (2005). Vocally disruptive behaviour in dementia: development of an evidence based practice guideline. Aging & Mental Health, 9, 16–24. doi: 10.1080/13607860512331334068.CrossRefGoogle ScholarPubMed
Palese, A., Menegazzo, E., Baulino, F., Pistrino, R. and Papparotto, C. (2009). The effectiveness of multistrategies on disruptive vocalization of people with dementia in institutions: A multicentered observational study. Journal of Neuroscience Nursing, 41, 191–200. doi: 10.1097/JNN.0b013e3181aaaab2.CrossRefGoogle ScholarPubMed
Preuss, U. W., Wong, J. W. and Koller, G. (2016). Treatment of behavioral and psychological symptoms of dementia: a systematic review. Psychiatria Polska, 50, 679–715. doi: 10.12740/PP/64477.CrossRefGoogle ScholarPubMed
Prince, M., Wimo, A., Guerchet, M., Ali, G., Wu, Y. and Prina, M. (2015). World Alzheimer Report 2015. The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost & Trends. London: Alzheimer’s Disease International.Google Scholar
Randall, E. W. and Clissett, P. C. (2016). What are the relative merits of interventions used to reduce the occurrences of disruptive vocalisation in persons with dementia?–a systematic review. International Journal of Older People Nursing, 11, 4–17. doi: 10.1111/opn.12083.CrossRefGoogle ScholarPubMed
Sefcik, J. S. (2017). A multi-methods observational study of persistent vocalizations in nursing home residents with advanced dementia. ProQuest Dissertations Publishing, 10260882, University of Pennsylvania.Google Scholar
Sefcik, J. S. and Cacchione, P. Z. (2015). Non-Pharmacologic Management of Agitated Behaviors in Persons with Dementia. In Butcher, H. K. (Ed.) University of Iowa College of Nursing Csomay Center for Geriatric Excellence.Google Scholar
Sefcik, J. S. and Cacchione, P. Z. (2014). Non-pharmacologic management of agitated behaviors in persons with Alzheimer’s Disease and other dementias in long term care. In Butcher, H. K. (Series Ed.), Series on Evidence-Based Practice Guidelines, Iowa City, IA: The University of Iowa College of Nursing John A. Hartford Foundation Center of Geriatric Nursing Excellence.Google Scholar
Selbæk, G., Engedal, K., Benth, J. Š. and Bergh, S. (2014). The course of neuropsychiatric symptoms in nursing-home patients with dementia over a 53-month follow-up period. International Psychogeriatrics, 26, 81–91. doi: 10.1017/S1041610213001609.CrossRefGoogle Scholar
Sloane, P. D., Davidson, S., Knight, N., Tangen, C. and Mitchell, C. M. (1999). Severe disruptive vocalizers. Journal of the American Geriatrics Society, 47, 439–445. doi: 10.1111/j.1532-5415.1999.tb07236.x.CrossRefGoogle ScholarPubMed
Smith, M., Gerdner, L. A., Hall, G. R. and Buckwalter, K. C. (2004). History, development, and future of the progressively lowered stress threshold: a conceptual model for dementia care. Journal of the American Geriatrics Society, 52, 1755–1760. doi: 10.1111/j.1532-5415.2004.52473.x.CrossRefGoogle ScholarPubMed
Valembois, L., Oasi, C., Pariel, S., Jarzebowski, W., Lafuente-Lafuente, C. and Belmin, J. (2015). Wrist actigraphy: a simple way to record motor activity in elderly patients with dementia and apathy or aberrant motor behavior. The Journal of Nutrition, Health, & Aging, 19, 759–764. doi: 10.1007/s12603-015-0530-z.CrossRefGoogle ScholarPubMed
van der Geer, E., Vink, A., Schols, J. and Slaets, J. (2009). Music in the nursing home: Hitting the right note! The provision of music to dementia patients with verbal and vocal agitation in Dutch nursing homes. International Psychogeriatrics, 21, 86–93. doi: 10.1017/S104161020800793X.CrossRefGoogle ScholarPubMed
van der Linde, R. M., Dening, T., Matthews, F. E. and Brayne, C. (2014). Grouping of behavioural and psychological symptoms of dementia. International Journal of Geriatric Psychiatry, 29, 562–568. doi: 10.1002/gps.4037.CrossRefGoogle ScholarPubMed
Vink, A. (2000). The problem of agitation in elderly people and the potential benefit of music therapy. In: Aldridge, D. (ed.), Music Therapy in Dementia Care: More New Voices (pp. 102–118). London: Jessica Kingsley Publishers.Google Scholar
Wetzels, R. B., Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2010). Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period. The American Journal of Geriatric Psychiatry, 18, 1054–1065. doi: 10.1097/JGP.0b013e3181f60fa1.CrossRefGoogle ScholarPubMed
Whittemore, R. and Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52, 546–553. doi: 10.1111/j.1365-2648.2005.03621.x.CrossRefGoogle ScholarPubMed
Zuidema, S., Koopmans, R. and Verhey, F. (2007). Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. Journal of Geriatric Psychiatry and Neurology, 20, 41–49. doi: 10.1177/0891988706292762.CrossRefGoogle ScholarPubMed