The main reason why residents with dementia may have increased levels of agitation and aggression is because they may lead lives that lack purposeful activity. Over the past few years, the concept of “engagement” has emerged as a means of understanding the behavioral pattern often seen in residents with dementia. For that matter, “Engagement” is best understood as “being involved or occupied with external stimuli”.

The study of engagement is a necessary foundation for the development of non-pharmacological interventions for persons with dementia, whether the interventions address depression, agitation, apathy, loneliness, or boredom. The analysis of different forms of engagement of people with dementia is expected to help such people by reducing boredom and loneliness, and by increasing interest and positive emotions. It is also expected to help staff members by providing them with tools that they can utilize in caring for these people. Although apathy, boredom, depression, and loneliness frequently accompany the progression of dementia, engagement of the residents in constructive, meaningful activities creates a possibility for enhancing the level of their daily functioning. It also prevents the manifestation of loneliness, boredom, and the problem behaviors associated with dementia.

There have been a lot of questions about the effectiveness of “person centered” activities: From an operational and cost perspective, person centered care is always more expensive and/or time consuming: The need for better assessments, more research and preparation, additional resources and staffing often make the personalization of engagement prohibitive. The question from a cost driven point becomes: is there a real difference between good quality engagement and good quality individualized engagement?

This study suggests that people living with dementia, guided individualized interventions based on interests lead to improved levels of engagement and attitude. The results show that guided interaction increased engagement duration for some activities (in personal, leisure, and work categories). This study confirms numerous data on the relatively important role to health of guidance and of tailoring the content of interaction to the participant’s characteristics and needs. The negative impact of apathy in participation and level of engagement in nontailored interaction was also specially highlighted.

A great follow up question would be: How can engagement outcomes be measured to see if it offsets expenses from and operational standpoint? – to be continued!