Daytime vocal activity in institutionalized severely demented patients identified as vocally disruptive by nurses

This study aimed at exploring vocal activity in severely demented patients with vocally disruptive behaviour as identified by nurses. Continuous tape‐recordings (07.00 am–07.00 pm) of the vocal activity of 33 residents in psychogeriatric wards were analysed regarding duration, level, number, type, content and direction. The activity lasted for a mean of 338.7 minutes/patient and the longest episode of each patient had a mean duration of 103.5 minutes and turned into shouting in 17 cases. The vocal activity consisted of (1) inarticulate sounds or syllables; (2)predominance of inarticulate vocal activity; (3) articulate words or sentences; (4) predominance of articulate vocal activity; and lastly (5) "dialogue vocal activity". No significant relationships emerged when a multiple regression analysis with type as dependent and demographic data as independent variables was applied. The vocal activity was: impossible to interpret, directed to others, responsive, or non‐directed utterances. The communicative function of the words used related to need for someone, incompetence, protest, need for help, in pain and despair/fear—hence, relating to an emotionally negative content, and less often to a positive emotional content. The vocal activity seemed possible to interpret as a "language" stemming from strong emotions mostly of a negative nature and a "language" used in monologues which could represent a self‐stimulating "language", thus meeting the need for activity. The results indicated that patients' emotional state must be attended to. Copyright © 1993 John Wiley & Sons, Ltd.