Service Delivery

The effects of rearranging ward routines on communication and eating behaviors of psychogeriatric patients.

Melin et al. (1981) · Journal of applied behavior analysis 1981
★ The Verdict

Group the chairs, give time and choice, and dementia patients talk more and eat better.

✓ Read this if BCBAs running adult day or nursing home dementia programs.
✗ Skip if Clinicians serving only pediatric or non-dementia populations.

01Research in Context

01

What this study did

James et al. (1981) moved chairs into small circles, gave dementia patients more mealtime, and let them pick foods.

They compared this new routine to a no-change control ward.

The study used a quasi-experimental design in a psychogeriatric unit.

02

What they found

Patients talked more and ate better after the furniture and meal changes.

The control ward showed no such gains.

Positive results held across the study period.

03

How this fits with other research

Sharp et al. (2019) repeated the idea 38 years later. They also saw more talk when lounge chairs faced each other instead of lining the walls.

AYLLON et al. (1959) started the line. Nurses in that study first showed that small ward tweaks could shape patient behavior without drugs or talk therapy.

Pomerleau et al. (1973) took a different path. They paid staff for patient gains and saw progress, proving both money and furniture can move the needle.

04

Why it matters

You can boost social interaction and nutrition in dementia units tomorrow. Push tables together, extend mealtime, and offer simple food choice. No extra staff or cost needed. Start with one dining room, measure talk and food intake, and expand if you see the same lift L et al. found.

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→ Action — try this Monday

Re-arrange one dining table into a tight square, add ten minutes to lunch, and tally patient verbal responses for a week.

02At a glance

Intervention
other
Design
quasi experimental
Sample size
21
Population
dementia
Finding
positive

03Original abstract

Several aspects of ward routine were changed to study the effects of environmental manipulation on the behavior of 21 psychogeriatric patients. Furniture was rearranged to be more conductive to conversation (i.e., grouped around tables instead of along corridor walls), and mealtime routines were changed to allow patients more time to eat, more freedom in choosing the composition of the meal, and more pleasant surroundings. Patients were divided into experimental and control groups, and data were collected on the frequency of verbal and tactile communication and degree of skill in eating behavior. Following baseline, environmental changes were introduced across behaviors. Results show that the frequency of communication increased for the experimental group, as compared to both baseline and the control group. Eating behavior also improved significantly for the experimental group. The study shows that minor changes in the physical environment can promote therapeutic change in the behavior of patients diagnosed as senile dementia.

Journal of applied behavior analysis, 1981 · doi:10.1901/jaba.1981.14-47