This study examined the relationship between behaviors of nursing staff and resident responses in interactions in long-term care settings, specifically residents diagnosed with Alzheimer's Dementia. Observation of interactions within two situations, dressing the resident and an interpersonal contact, yielded a total of 239 interactions with each unique nurse/resident dyad appearing once in each situation. Ratings for both resident and nurse behaviors were done using the Interaction Behavior Measure (IBM) for nurse behaviors and a modified version of the IBM for resident behaviors. Information was also collected on additional variables including resident attention span, presence of family on the unit, use of smiling and touch by the nurse, and interruptions of the interaction by another person.

Findings included significant relationships between nurse variables of interpersonal orientation, flexibility, and relaxation to resident behaviors of flexibility, relaxed, calm, and cooperation. A significant effect was found for the type of interaction on both nurses' and residents' behavior, with more significant relationships found between variables in a task situation. The effect of mental status was not significant for all nurse behaviors, but noted differences of lower interpersonal orientation and interest were found in individual nurse behaviors with low-mental status residents.

Effects of other variables were also significant, with interruption, attention span of resident, and time of day all showing differences for nurse and resident behaviors. The effect of nurse smiling and touch was not significant for resident behavioral outcomes, but some differences in individual behaviors were noted. Overall, findings give direction to nursing staff in terms of interaction behaviors that might be related to resident outcomes of difficult behaviors, as well as increasing the understanding of variables important in interactions with cognitively-impaired elderly.