What affects pleasure in persons with advanced stage dementia?

Jiska Cohen-Mansfield*, Marcia S. Marx, Laurence S. Freedman, Havi Murad, Khin Thein, Maha Dakheel-Ali

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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. Analysis showed that pleasure is related to stimulus category, personal attributes and environmental conditions. In the multivariate analyses, all types of social stimuli (live and simulated, human and nonhuman), self-identity stimuli, and music were related to significantly higher levels of pleasure than the control condition. Females and persons with higher ADL and communication functional status exhibited more pleasure. Pleasure was most likely to occur in environments with moderate noise levels. These results demonstrate that these nursing home residents are indeed capable of showing pleasure. Caregivers of nursing home residents with dementia should incorporate social, self-identity, and music stimuli into their residents' care plans so that eliciting pleasure from each resident becomes the norm rather than a random occurrence.

Original languageEnglish
Pages (from-to)402-406
Number of pages5
JournalJournal of Psychiatric Research
Issue number3
StatePublished - Mar 2012


  • Environment
  • Nonpharmacological intervention
  • Nursing home residents with dementia
  • Personal characteristics
  • Pleasure


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