Defilippi and Crismon (2000) Observed

Defilippi and Crismon (2000) observed that the field of dementia usually has few empirical studies and mostly qualitative methods conducted to investigate its state of affairs. This condition is reflected in the essay where a good percentage of the reviewed methods are meta-analysis (or thorough reviews of existent literature on the subject), as well as some that are qualitative. Several of the evidence was quantitative too.

The qualitative studies in this essay included that of Aud et al.(2001) who found that by breaking down specific categories of de-identified resident data including willingness and ability to engage in activities, frequency and number of emergency room visits as well as other hospitalizations, behavioral signs and indicators, medication conduct, general pain, and frequency of falls were all useful in making more accurate predictions of patient outcomes. The methods used in their longitudinal study included structured environmental assessments, structured observation of the residents' activities, interviews with administrators and the direct care staff, surveys mailed to families, and telephone interviews with family members. The method, in other words, revolved around observations or the family perceptions of the level of care as well as the staff's perceptions of the level of care and the residents' needs, and the administrators' reflections on the development and operation of the social model care units for dementia.

There were actually more quantitative studies (both quasi-empirical and fully empirical) than qualitative ones in this essay. Another instance, however, of a qualitative study that was included in this essay, although only peripheral to dementia was that conducted by Steinmetz (2010) who argued that the patients considered difficult because of their dementia are not in need of medical intervention and are not the ones experiencing major medical problems. Instead, they are the people who behave rudely and want a secondary gain. Patients with multiple nonspecific complaints and those with psychosomatic problems are often the most challenging to manage long-term. The study of Steinmetz (2010) was qualitative in that his aim to understand the patients in depth is, incidentally, an objective that epitomizes the qualitative agenda. The qualitative method used here was the 'long interview'.

The qualitative methods used in this study were useful in that they added to an understanding of the patient with dementia. The experimental method is helpful in that it provides more objective results and can more plausibly provide an explanation for a certain factor, but I find its usage less helpful in terms of social situations, particularly in terms of a population, such as dementia, where so many different variables are in evidence.

Qualitative methods are those studies that are conducted in a format outside the laboratory, such as field studies, or observation, discourse analysis, or focus groups. They observe and describe the behavior but do not provide reliable expansion for why the behavior occurs. Non-experimental methods figure primarily in fields such as astronomy, ecology, medical science, meteorology, political science (namely, field that deal with predicting and describing behavior).

Experiments are frequently criticized for the fact that they lack ecological validity. Fields such as human interaction are too unpredictable to be manipulated under laboratory settings. Human behavior, too, varies from place to place, and, therefore, results of one study that is conducted in one situation to one specific sample of people may not (and rarely do) have the same carryover effects to a different group of individuals conducted in a different spot or time. In other words, experimental, or quantitative, experiments necessitate that variables be closely matched and more, rather than less, homogenous. Therefore, they are best used in the hard sciences where they more often and most likely show consistent and repetitious results. The field of people is, however, more unpredictable and 'messy'. To that end, therefore, I find qualitative experiments more useful here.

This is particularly so in this specific case where we seek to zone in on difficult patients and seek to understand their motives. The characteristics of 'difficult' patients vary from case to case and from time to time with, it seems to me, attendant impossibility of structuring any rigid, consistent rules. ' Difficulty' depends on patient, mood, context, and numerous other variables all of which differ according to individual case. This situation makes it particularly difficult to examine in a laboratory type of situation. The best that can be done, therefore, is to employ a qualitative approach that focuses on the individual person and uses rich interviewing in order to gain a better understanding of the situation.