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Author: Marcia S Marx (27)


Dec
1969

The Sources of Discomfort Scale (SODS) assesses discomfort manifestations based on source of discomfort, thus making it both distinct from and complementary to pain assessments for persons with dementia. Sources were categorized as pertaining to physical discomfort, to body position, and to environmental sources. Body position sources of discomfort were related to poor functional status and to pain.

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Jul
2015

The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents with dementia from six Maryland nursing homes were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools.

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Jul
2014

Research is needed to determine specific factors that contribute to the success of nonpharmacologic interventions. In this study, we examined the influence of personal characteristics (demographic, medical, and functional variables) and possible barriers (eg, staff or family barriers) on the efficacy of nonpharmacological interventions in reducing agitation.
Agitation was systematically observed at baseline and intervention stages using the Agitation Behavior Mapping Instrument (ABMI) in a sample of 89 residents from 6 Maryland nursing homes (mean age = 85.

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Feb
2015

This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest.
Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.

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Sep
2012

A randomized, placebo-controlled clinical trial was undertaken to determine the efficacy of nonpharmacologic individualized interventions (individualized to address unmet needs such as boredom or pain) in decreasing agitation in persons with dementia.
Agitated nursing home residents with advanced dementia (from 9 nursing homes in 5 locations in Maryland, United States) were randomized into an intervention group (n = 89) and a placebo control group (n = 36). On the basis of data from baseline assessment, a systematic methodology for individualizing nonpharmacologic interventions, Treatment Routes for Exploring Agitation (TREA), was used with the intervention group: an unmet need was hypothesized, a corresponding treatment category was identified, and specifics of the treatment were chosen to fit the person's need, past identity, preferences, and abilities.

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May
2012

Affect, behavior, and cognition can be considered as basic constructs that dictate human functioning, with intricate and bi-directional relationships among them. Prior to the present study, relationships among these constructs have not been systematically examined within the context of dementia.
Sample 1 contained 185 nursing home residents with a diagnosis of dementia.

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Mar
2012

We examined the impact of environmental, person, and stimulus characteristics on pleasure in persons with dementia. Study participants were 193 residents of 7 Maryland nursing homes who were presented with 25 stimuli from these categories: live human social stimuli, live pet social stimuli, simulated social stimuli, inanimate social stimuli, a reading stimulus, manipulative stimuli, a music stimulus, task and work-related stimuli, and two different self-identity stimuli. Systematic observations of pleasure in the natural environment were conducted using Lawton's Modified Behavior Stream.

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Mar
2012

To explore the impact of personal attributes, environmental attributes, and the presentation of 9 categories of stimuli on agitation in nursing home residents with dementia.
Participants in this randomized, controlled, observational cross-sectional study were 193 residents of 7 nursing homes, all with a diagnosis of dementia, for whom we obtained data pertaining to cognitive functioning (via the Mini-Mental State Examination), performance of activities of daily living (Minimum Data Set), and role-identity/activities of past interest (Self-Identity Questionnaire). Environmental attributes (eg, noise, lighting) and direct observations of agitation (primary outcome) were recorded via the Agitation Behavior Mapping Inventory.

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Oct
2011

Engagement refers to the act of being occupied or involved with an external stimulus. In dementia, engagement is the antithesis of apathy.
The Comprehensive Process Model of Engagement was examined, in which environmental, personal, and stimulus characteristics impact the level of engagement.

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May
2012

Behavioral symptoms are common in persons with dementia, and nonpharmacological interventions are recommended as the first line of therapy. We describe barriers to conducting nonpharmacological interventions for behavioral symptoms.
A descriptive study of barriers to intervention delivery in a controlled trial.

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Apr
2011

To examine how presentation of different stimuli impacts affect in nursing home residents with dementia.
Participants were 193 residents aged 60 to 101 years from 7 Maryland nursing homes who had a diagnosis of dementia (derived from the medical chart or obtained from the attending physician). Cognitive functioning was assessed via the Mini-Mental State Examination (MMSE), and data pertaining to activities of daily living were obtained through the Minimum Data Set.

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Aug
2010

The present study examined the impact of different attributes of social stimuli using the stimulus attributes aspect of the Comprehensive Process Model of Engagement ( Am J Geriatr Psychiatry. 17:299-307). Participants were 193 residents of 7 Maryland nursing homes with a diagnosis of dementia.

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Aug
2010

To assess the relative effect of different types of stimuli on agitated behaviors of nursing home residents with dementia.
Repeated-measures design with randomized assignment of conditions.
Seven Maryland nursing homes.

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May
2010

We examined the impact of setting characteristics and presentation effects on engagement with stimuli in a group of 193 nursing home residents with dementia (recruited from a total of seven nursing homes). Engagement was assessed through systematic observations using the Observational Measurement of Engagement (OME), and data pertaining to setting characteristics (background noise, light, and number of persons in proximity) were recorded via the environmental portion of the Agitation Behavior Mapping Inventory (ABMI; Cohen-Mansfield, Werner, & Marx, (1989). An observational study of agitation in agitated nursing home residents.

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May
2010

In a previous article, we discussed a theoretical framework asserting that a combination of stimulus attributes, personal attributes and environmental attributes as well as interactions among these affects engagement with stimuli by persons with dementia [Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M.

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Apr
2010

To determine which stimuli are 1) most engaging 2) most often refused by nursing home residents with dementia, and 3) most appropriate for persons who are more difficult to engage with stimuli.
Participants were 193 residents of seven Maryland nursing homes. All participants had a diagnosis of dementia.

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Jan
2010

We examined engagement with stimuli in 193 nursing home residents with dementia. We hypothesized that activities and stimuli based on a person's past and current preferences would result in more engagement than other activities/stimuli.
The expanded version of the self-identity questionnaire [Cohen-Mansfield, J.

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Apr
2009

The aim of this article is to delineate the underlying premises of the concept of engagement in persons with dementia and present a new theoretical framework of engagement.
The sample included 193 residents of seven Maryland nursing homes. All participants had a diagnosis of dementia.

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Jul
2009

To examine the impact of personal attributes on engagement in persons with dementia.
Participants were 193 residents of seven Maryland nursing homes. All participants had a diagnosis of dementia.

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Feb
2010

To provide further empirical evaluation of the effectiveness of animal-assisted therapy in nursing home residents with dementia.
Participants were 56 residents of 2 suburban Maryland nursing homes and had a diagnosis. Activities of daily living performance was assessed via the minimum data set and cognitive functioning assessed using the Mini-Mental State Examination.

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Feb
2010

We examined the influence of stimulus attributes on the engagement of 69 nursing home residents with dementia. Specifically, we looked at work-related stimuli versus manipulative block stimuli, and whether the color, size, and material of a stimulus affect the duration and quality of engagement. Engagement was assessed using the Observational Measurement of Engagement (OME).

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Aug
2007

The objective of this study was to examine the efficacy of a systematic algorithm for providing individualized, nonpharmacological interventions for reducing agitated behaviors in nursing home residents with dementia.
This placebo-controlled study combined nomothetic and ideographic methodologies. The study was conducted in 12 nursing home buildings in Maryland; 6 were used as treatment facilities, and 6 as control facilities.

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Aug
2006

Two different models of exercise behavior in an older population have been previously published (Schuster et al., 1995 and Resnick et al., 2000).

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Jun
2004

To examine preferences concerning social and environmental aspects of exercise in the elderly population.
Participants were 324 community-dwelling persons aged 74-85 years who completed a health questionnaire that included items on exercise preferences as well as questions on demographic variables, health, and exercise habits. Selected participants then completed a physical performance battery to measure lower body functioning.

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Sep
2003

To determine correlates of hoarding behavior in frail elderly persons.
Information about nursing home residents (n = 408) and community-dwelling senior day-care participants (n = 177) was gathered through interviews with family and professional caregivers, medical chart review, and physician examinations, and included the following areas of assessment: hoarding behavior, demographic and health information, level of cognitive functioning, activities of daily living (ADL) performance, depressed affect, social functioning, manifestations of agitated behaviors, and previous stressful life experiences.
We found that 15% of the nursing home residents and 25% of the community-dwelling senior day-care participants manifested hoarding behavior at a rate of several times a week or higher.

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