Interventions for treating disruptive behavior in demented elderly people.

Studies aimed at explaining and decreasing disruptive behaviors need to be designed within conceptual frameworks. A number of researchers provide examples of such efforts. Meddaugh is examining the theory of reactance, Matteson et al are examining Piagetian concepts (personal communication, 1992), and Hurley is examining the concept of resistance. Such efforts will serve to enlighten our understanding of the dynamics of disruptive behavior and eventually may result in a common multicausal conceptualization of its cause. Additional study of the cause of disruptive behaviors also is needed. Currently the explanations for disruptive behaviors involve a variety of conceptual frameworks with little consistency among studies. Furthermore, many studies designed to decrease these behaviors do not clearly base their interventions on conceptual explanations for the behaviors. Studies aimed at explaining and decreasing disruptive behaviors need to be designed within conceptual frameworks. A number of researchers provide examples of such efforts. Meddaugh is examining the theory of reactance, Matteson et al are examining Piagetian concepts (personal communication, 1992), and Hurley is examining the concept of resistance. Such efforts will serve to enlighten our understanding of the dynamics of disruptive behavior and eventually may result in a common multicausal conceptualization of its cause. This developing conceptualization of causes needs to encompass biologic as well as psychosocial explanations. A number of researchers are conducting studies that will contribute to the understanding of the role of biologic factors. Examples of such efforts include Kolanowski's and Satlin et al's work on the effects of artificial lighting on disruptive behavior and Meddaugh's study of the role of exercise. As interventions are designed for decreasing disruptive behaviors, systems of care that use these interventions need to be evaluated for their cost effectiveness and their impact on quality of life.