When Boredom Leads to Staff Overload

The Paradox of Understimulation

In a typical community, the care team's days are packed: between meals, assisting with personal hygiene, medication, mobility transfers, and documentation, there is little time to pause. In this context, an agitated resident or one who refuses care can turn a tight schedule into an impossible one.

In the middle of this race against time sits the residents’ contrasting reality, which may very well be boredom. In fact, studies have demonstrated that what's often labeled "challenging behavior" is a communication of unaddressed needs, including the need for stimulation.

How Boredom Becomes Agitation

This kind of unmet need rarely announces itself as a crisis. Research on advanced dementia links boredom and understimulation to a specific category of behavior: “physically nonaggressive agitation”, which includes pacing, restlessness, repetitive movements, and wandering the halls without a clear destination. None of these behaviors require alarm on their own¹. But each one still pulls a member of the care team away from a scheduled task to redirect, supervise, or simply keep a resident safe. Multiply that across a dozen residents on one floor, and a schedule built for routine care starts absorbing time it was never planned for.

For the residents, this also means a hard day: after all, engagement, enjoyment, and something to do are basic human needs that go unanswered. As dementia progresses, that need for stimulation also gets harder and harder to identify and communicate. 

How Agitation Becomes Turnover

This is also where the paradox becomes a cycle. When stimulation is missing, agitation rises. Care takes longer. Staff have even less time left for the kind of engagement that would have prevented it in the first place. Because of staff turnover, residents are surrounded by people who do not know them as well and are less equipped to anticipate their specific needs.

Fortunately, this cycle can be inverted, and it works just as well for the community: meeting the need for stimulation lowers agitation, which frees up staff time, which builds trust and morale, which helps keep good staff on the floor. Fewer people leaving means less spent on recruiting, and more time spent on care itself.

What that looks like, without adding to your team's load

A good place to start is to look for stimulation tools that are built specifically for seniors living with dementia. An activity built for seniors will tap into what they still know and help reminisce: for example, familiar places or activities that remind them of their youth.

For us at Eugeria, this is part of the essential criteria that determine whether we choose to carry a product or not. For a product to pass this test, it must be of good quality, meaning that it must be built to last and safe to use in a care environment. The outcomes of using the product, specifically on seniors living with dementia, have to be backed by science. It also needs to be useful to caregivers in order to lighten, not increase, their workload. Finally, it must be dignifying and empowering, for example with images suited to adults.

Below are a few carefully selected solutions for which our clients have reported positive outcomes in breaking apathy:

• An interactive projector, the Tovertafel, turns any surface into a game table that residents and family can activate themselves. Mounted on the ceiling, it requires no additional setup. A two-month study following 25 residents using the Tovertafel found a measurable drop in apathy, plus more visible participation3. 
• For residents who find a group activity too much some days, intentionally paced content built for memory loss — like Memory Lane TV — offers a gentler way to stay engaged during that late-afternoon window. It streams through regular technologies including Apple TV and Roku. Unlike regular tv, there is no plot to follow and the pacing is adapted to meet residents where they are cognitively.
• Virtual reality represents another strong option to offer moments of real stimulation, relaxation and escape. The Lumeen  system even allows for group sessions where one tablet controls multiple helmets. 

Conclusion

Once a community starts treating agitation as a possible symptom of understimulation, the fix doesn't have to be sweeping. In fact, positive changes will come little by little and compound into more visible results. One well-chosen tool, tried on one floor, is often enough to gently tip the paradox back in the right direction: calmer residents, a lighter caseload, and a team with a little more time to spend on the reason they chose this work in the first place.

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Bibliography

1. Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M. S., Thein, K., & Regier, N. G. (2015). Which unmet needs contribute to behavior problems in persons with advanced dementia? Psychiatry Research, 228(1), 59–64. https://doi.org/10.1016/j.psychres.2015.03.043

2. Kolanowski, A., Litaker, M., Buettner, L., Moeller, J., & Costa, P. T. (2011). A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents. Journal of the American Geriatrics Society, 59(6), 1032–1041. https://doi.org/10.1111/j.1532-5415.2011.03449.x

3. Konrad, R., Güttler, C., Öhl, N., Heidl, C., Scholz, S., & Bauer, C. (2024). Effects of the Tovertafel® on apathy, social interaction and social activity of people with dementia in long-term inpatient care: results of a non-controlled within-subject-design study. Frontiers in Neurology, 15, 1455185. https://doi.org/10.3389/fneur.2024.1455185