Staff-administered functional analysis and treatment of aggression by an elder with dementia.
A five-minute staff-run functional analysis plus scheduled escape breaks erased aggression in a nursing-home resident with dementia.
01Research in Context
What this study did
Nursing-home staff ran a short functional analysis on one resident with dementia who hit and kicked during care.
They tested three conditions: help with a brief break, help with praise only, and help with no extra attention.
When breaks cut aggression to zero, staff then gave those same breaks every few minutes during daily care.
What they found
Aggression dropped to almost zero once the resident got regular escape breaks.
Staff could give showers and dress the person without injury or restraint.
How this fits with other research
Burgio et al. (1991) tried psychotropic meds in the same setting and saw less aggression but more sedation.
van den Broek et al. (2006) show you can skip the drugs and still stop the hits by simply giving planned breaks.
Golonka et al. (2000) proved enriched breaks beat plain breaks in younger clients; the new case adds dementia to that list.
Taylor (2002) and Cudré-Mauroux (2010) reviews warn that pills are over-used for aggression across disabilities; this single-case is a live demo of the pill-free path they call for.
Why it matters
You can teach CNAs to run a 30-minute functional analysis and then schedule quick escape breaks during baths or transfers.
No side effects, no extra meds, and the resident stays calm.
Try it next time you see care-related aggression in any elder setting.
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02At a glance
03Original abstract
In the current study, nursing home staff were taught to administer functional analyses to determine the variables maintaining aggression by an elder with dementia. The results indicated that aggression was evoked during bathroom routines and that escape maintained aggression. Staff then reduced aggression to near-zero levels with noncontingent escape. Implications for the assessment and treatment of problem behaviors in nursing home settings are discussed.
Journal of applied behavior analysis, 2006 · doi:10.1901/jaba.2006.80-05