UA Awarded Grant to Study Ways of Reducing Agitation Among Nursing Home Residents

TUSCALOOSA, Ala. – The U.S. Department of Health and Human Services has awarded a University of Alabama aging expert a $550,000 grant to study a method of reducing agitation among nursing home residents suffering from dementia. The study is a collaborative project with the Center for Aging at UAB.

Dr. Louis Burgio, professor of psychology and director of UA’s Applied Gerontology Program, will use the grant to study the benefits of additional training for certified nursing assistants who frequently interact with nursing home residents exhibiting behavior problems associated with dementia. His study will focus on residents and staff in eight Birmingham-area nursing homes.

Dementia can result in nursing home residents frequently displaying verbal outbursts, repetitive demands and even physically aggressive acts. Such displays are among the most stressful problems for other nursing home residents and nursing home staff and are also disturbing to residents’ families, said Burgio.

“In an earlier study, we taught CNAs (certified nursing assistants) how to identify factors in the residents’ environment that could result in disruptive behavior and instructed them in specific behavior management and communication techniques,” said Burgio. “We found that this training reduced residents’ agitation during the care interactions with the nursing assistants.

“Perhaps, most significantly, we also found that CNAs who participated in additional training sessions designed by us and monitored by nursing home staff maintained improved interactions with the residents for a longer time than those not receiving this additional type of training.”

Burgio co-authored an article detailing the earlier study that was published in the academic journal, The Gerontologist, in Sept. 2002. The new study, funded for a five-year period, will refine the training methods, including using a greater reliance on nursing home staff, rather than the researchers, as CNA trainers.

For years, nursing home staff frequently dealt with repeated behavior problems among residents by using physical restraints or prescription drugs, Burgio said.

Both measures came under criticism following questions of effectiveness and worries about restraint injuries and medicinal side effects, Burgio said. In the early 1990s alternative forms of treatment began to be explored and select studies of the problem are ongoing, he said.

Teaching nursing assistants behavior management skills, including such things as making appropriate eye contact with residents, announcing each care task individually prior to administering it and then pausing to see if the resident will do it for themselves, using distraction and diversion techniques and refraining from arguing with residents, reduced agitation among residents in the earlier study, Burgio said.

Burgio also co-directs UA’s new Center for Mental Health and Aging, an interdisciplinary center established earlier this year with a $500,000 grant from the Substance Abuse and Mental Health Services Administration, a public health agency within the U.S. Department of Health and Human Services.

That UA center is designed to assist in coordinating and expanding the University’s efforts to assist the soaring elderly population, and those who care for them, with their mental health needs.