The Influence of Everyday Acoustic Environments on the Challenging Behavior in Dementia: A Participatory Observation Study in Nursing Homes

Int J Environ Res Public Health. 2023 Feb 26;20(5):4191. doi: 10.3390/ijerph20054191.

Abstract

Challenging behavior (CB) is a group of behaviors, reactions and symptoms due to dementia, which can be challenging for the caregivers. The study aims to research the influence of acoustics on CB in people with dementia (PwD). An ethnographic method was used to study the daily life of PwD in their nursing homes with a specific focus on how people react to everyday environmental sounds. Thirty-five residents were included in the sample based on purposeful, homogeneous group characteristics and sampling. Empirical data were collected using 24/7 participatory observations. The collected data were analyzed using a phenomenological-hermeneutical method: a naïve understanding, a structural analysis and a comprehensive understanding. The result shows that the onset of CB depends on whether the resident feels safe and is triggered by an excess or lack of stimuli. The excess or shortage of stimuli and whether and when it affects a person is personal. It depends on various factors, the person's state and the time of day, the nature of the stimuli, familiarity, or strangeness is also a determining factor for the onset and progression of CB. The results can form an essential basis for developing soundscapes to make the PwD feel safe and reduce CB.

Keywords: Alzheimer; acoustical triggers; acoustics; auditory stimuli; behavioral and psychological symptoms of dementia (BPSD); challenging behavior (CB); dementia; sound environment; soundscape.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustics
  • Dementia*
  • Emotions
  • Humans
  • Nursing Homes
  • Psychotherapy

Grants and funding

The AcustiCare project is supported by the Flemish Agency for Innovation and Entrepreneurship (VLAIO) under the TETRA program for applied research (grant no. HBC.2016.0089).