Contextual factors associated with disturbing behaviors in institutionalized elders

Data from a longitudinal clinical trialfunded by tbe National Institute of Aging, testing the effects of staff education and consultation on restraint reduction in nursing homes, were used to examine disturbing behavior in institutionalized elders and to identify related environmental and personal characteristics. Subjects were 586 residents from thive well-matched musing homes. Kayser-Jones’s (1989) model on environment and quality of life in long-term care institutions served as the organizing framework. Data on disturbing behaviors fmm the Psychogeriatric Dependency Rating Scale were factor analyzed. Three factors, Agitated Psychomotor Behaviors, Aggressive Interpersonal Communication, and Expressive Difficulty, emergedfrom the principalfactor analysis and accounted for 35% of the variance. The Kayser-Jones model partially explained Agitated Psychomotor Behavior (R²=.22). A model comparison appmach indicated that the addition of an organizational variable, staff mix, significantly increased the amount of variance explained over and above that contributed by the personal variables.