The influence of everyday acoustic environments on the challenging behaviour in dementia: a participatory observation study in Nursing Homes

Objective Dementia is a progressive illness characterized by cognitive and functional decline and often co‐occurs with a behaviour change. ‘Challenging behaviour’ (CB) is a group of behaviours, reactions and symptoms due to dementia, which can be challenging for the (professional) caregivers. The study aims to research the influence of acoustic on CB in people with dementia (PwD). Design An ethnographic design was used to study the daily life of PwD in their nursing homes with a specific focus on how people react to everyday environmental sounds. Setting/participants Thirty‐five residents were included in the sample based on a purposeful, homogeneous group characteristics sampling. Empirical data were collected using 24/7 participatory observations. The collected data were analyzed using a phenomenological‐hermeneutical Method: a naïve understanding, a structural analysis, and a comprehensive understanding. Results The onset of CB depends on whether the resident feels safe and is triggered by an excess or lack of stimuli. The excess or shortage of stimuli and whether and when it affects a person is highly personal. It depends on various factors, such as the person’s state and the time of day. In addition, the nature of the stimuli, familiarity or strangeness is also a determining factor for the onset and progression of CB. Conclusion CB is an indirect consequence of something that threatens the well‐being of the PwD. This unsettling feeling can find its cause in the acoustic environment. The results can form an essential basis for developing soundscapes to make the PwD feel safe and reduce CB.