Assessment of Agitation in Older Adults

Jiska Cohen-Mansfield, Lori Schindel Martin

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Accurate and comprehensive assessment of agitation in persons with dementia is critical for clinical, administrative, and research purposes. Clinically, assessment of agitation is relevant to selecting appropriate treatment(s), monitoring treatment effectiveness and making adjustments if necessary, and determining optimal living situations. Administrative issues affected by the assessment of agitation include formulating unit placement plans, staff communication, and quality control of nursing units. Regarding clinical research, the ability to accurately assess agitation is essential to understanding the etiology of agitation and estimating the effectiveness of interventions and prevention programs, and to translating this information into practice. Approaches to assessing agitation include informant ratings, observational methods, and technological devices. Assessment may include identification of the frequency, intensity, and duration of the behavior, as well as determination of a level of risk to oneself and others associated with the behavior. It may involve a behavioral mapping system, which is an observational method that examines the stimulus/response relationship a person has with the environment. Agitation consists of several syndromes, including physically aggressive behaviors, physically non-aggressive behaviors, verbally aggressive behaviors, and verbally non-aggressive behaviors. Because different syndromes are associated with unique etiologies, it is often important to determine the specific syndrome manifested. Some assessments focus only on one type of syndrome or behavior, whereas others identify which syndrome is present, and still others only provide a global score. Given the multitude of assessments available for measuring agitation, the user needs to choose the instrument that will best meet the goal of assessment and will be compatible with the resources available, such as time and cost.

Original languageEnglish
Title of host publicationHandbook of Assessment in Clinical Gerontology
PublisherElsevier Inc.
Pages381-403
Number of pages23
ISBN (Print)9780123749611
DOIs
StatePublished - 2010

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