A decision model for guiding the management of disruptive behaviors in demented residents of institutionalized settings

Abstract

Nursing personnel contend with disruptive behavior in persons with dementing disorders on a daily basis. This article presents a practical decision model consistent with industry-wide efforts to reduce chemical and physical restraints. The model screens behavior having medical or somatic causes to ensure appropriate assessment and intervention. Four approaches taken from the literature address functionallydriven behavior: appropriate levels of stimulation, iatrogenic caregiving effects, stimulus control, and applied behavior analysis. Paraprofessional nursing personnel are able to learn and use this model with relatively little professional support.