Key Unmet Needs Associated with Behavior Problems in Dementia Patients


In a study of 89 residents who had both dementia and behavior problems in six Maryland nursing homes, a team associated with Innovative Aging Research found most of the patients had important, unmet needs.

Publishing in Psychiatry Research, the authors wrote that, “Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs. Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining).”

The authors identified a number of strategies for uncovering these needs, but identified that detecting unspoken “discomfort and pain” among these patients could be significantly more challenging.

Cohen-Mansfield, Jiska, Maha Dakheel-Ali, Marcia S. Marx, Khin Thein, and Natalie G. Regier. “Which Unmet Needs Contribute to Behavior Problems in Persons with Advanced Dementia?” Psychiatry Research 0, no. 0. Accessed April 23, 2015. doi:10.1016/j.psychres.2015.03.043. (Abstract)


  1. So the punishment for the terrible crime of “complaining” because you don’t have your basic human needs met is going to get you put on drugs which will further damage your brain and lead to earlier death. I don’t have words for that.

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  2. see great movie Alive Inside, it shows there are so many ways to connect and reconnect with people.
    Lately I have been asking people what drugs their parents were taking when they died…ask that question and you will be amazed how many were on antipsychotics. This is scary and it is happening so often.

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    • The neuroleptics are used for controlling behavior in older people who find themselves confined to nursing homes. I know because I was a full-time chaplain in a retirement center/nursing home. If you dare complain about anything or become the least bit vocal, or don’t want to go to bed at 6 PM like the staff want you to do, you will find a little doctor’s order in your chart for antipsychotics. The nurses tell the medical director of such places that the old people need an antipsychotic and walla, there the order is in the chart and perfectly sane older people are turned into drooling zombies who are confined to Gerry chairs. We’re using these damned toxic drugs against old people and kids simply to control behavior. It’s criminal!

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  3. My wife’s dad had dementia and was in a nursing facility where she visited him. She saw that he was thrashing his head from side to side, had very rigid muscles, and appeared to be trying to say something but was unable to talk. She called me and I told her to check what he was taking – sure enough, they’d put him on Risperdal because he was gripping the staff’s arms when he was trying to tell them something and felt he wasn’t being heard. She and her sister convinced her mom to take him off of it. Within three days, he was talking, laughing, telling stories, and seemed as much his normal self as possible under the circumstances. The doctor was FURIOUS that her mom had taken him off without consulting him and tried to insist he go back on. No one at the nursing home appeared to notice his incredible distress, and the fact that it resolved within three days when the drug was stopped had no impact on the doctor’s view of its usefulness. Apparently, a person unable to move or talk is preferable to one who expresses his needs in a way that is inconvenient for the caretakers. I think it’s pretty clear why in most cases this stuff is given to seniors. It is a chemical restraint, no more.

    — Steve

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