The underlying meaning of stimuli: Impact on engagement of persons with dementia.

In a previous article, we discussed a theoretical framework asserting that a combination of stimulus attributes, personal attributes and environmental attributes as well as interactions among these affects engagement with stimuli by persons with dementia [Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M.S., 2009. Engagement in persons with dementia: The concept and its measurement. American Journal of Geriatric Psychiatry 7, 299-307]. Based on this framework, we tested the impact on engagement of the personal meaning of stimuli, specifically examining work-like stimuli, stimuli based on the person's identity, and gender role-based activities. We hypothesized that having such meanings will render stimuli more engaging than stimuli without these meanings. Participants were 193 residents of 7 Maryland nursing homes. All participants had a diagnosis of dementia. Results confirmed the hypotheses, demonstrating that the meaning of the stimulus impacts engagement shown by persons with dementia. Interventions that involve objects or tasks with meaning specific to the person with dementia will be more likely to engage that person. Future research could explore more identity roles as well as other mechanisms affecting engagement.