Rita Jablonski, PhD, RN, ANP

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Reducing Care-Resistant Behaviors in Persons with Dementia

The focus of Associate Professor, Dr. Jablonski’s program of research is on the development of interventions to reduce care-resistant behaviors exhibited by persons with dementia.

Jablnoski is the principal investigator of a $1.4 million dollar R01 grant funded by NINR (1R01NR012737-01). Working with nursing home residents, Dr. Jablonski will be working to evaluate the effectiveness of a non-threatening method for providing oral hygiene. She hopes that the outcomes of this project will not only include the reduction of stress and care-resistant behaviors in persons with dementia but also data to determine the efficacy of generalizing this type of intervention to other activities of daily living. 

Her research focuses on testing clinical interventions for individuals with dementia in nursing homes who exhibit care-resistant behaviors. The purpose of her R01 is to test an intervention using threat reduction to reduce care resistant behaviors which prevent adequate daily oral hygiene. Specifically, the project examines an intervention to improve oral hygiene in this population.

The oral health of nursing home residents deteriorates quickly without daily oral hygiene leaving them vulnerable to a range of ill effects ranging from gum disease to systemic infections to heart disease. Nursing home residents with dementia may be unable to perform their own mouth care and demonstrate care resistant behaviors such as agitation or aggression when provided with assistance. Dr. Jablonski hypothesized that that attempts at oral care are interpreted as threatening by older adults with dementia. The intervention combines best care practices such as using warm water for rinsing with threat reduction strategies such as smiling, distraction, and cueing (the use of polite one-step commands), while avoiding patronizing language. Dr. Jablonski’s research is conducted in nursing homes around the Birmingham area employing numerous undergraduate and graduate students as trained observer/raters.

Dr. Jablonski’s research has the potential to directly improve the oral health of elderly nursing home residents, facilitate the work experience of nursing him employees, and serve as a model for other populations and other care resistant behaviors.

For more information, please contact Dr. Jablonski at This email address is being protected from spambots. You need JavaScript enabled to view it.

Persons with dementia may fight off any attempts to provide mouth care. This 30-minute video contains simple and effective ways to provide mouth care to someone who resists. Both professional and family caregivers will find this video helpful.
Oral Hygiene & Care-resistant Behaviors: Making a Difference


Selected Publications

Jablonski, R. A. (2012). Oral Health and Hygiene Content in Nursing Fundamentals Textbooks. Nursing Research and Practice. Volume 2012.

Fulmer, T., Jablonski, R. A., Mertz, E., George, M., & Russel, S. (2012). Oral Health (Editorial). Nursing Research and Practice, Volume 2012,

Spence, A., Jablonski, R., & Loeb, S. J. (2012). Hypertensive African-American Women and the DASH Diet. The Nurse Practitioner Journal, 37(2), 41-6.

Booker S, Murff S, Kitko L, Jablonski R. (2013). Mouth care to reduce ventilator-associated pneumonia. Am J Nurs. 2013 Oct;113(10):24-30; quiz 31.

Jablonski RA. (2013). Dementia is not dementia is not dementia. J Gerontol Nurs. 2013. Jan;39(1):3-5.

McCaughey, D., McGhan, G.El, Kim, J., Brannon, D., Leroy, H. & Jablonski, R.A.. (2012). Workforce Implications of Injury Among Home Health Workers: Evidence from the National Home Health Aide Survey. Gerontologist, 52(4):493-505.


Lauren Antia

205.934.2145
This email address is being protected from spambots. You need JavaScript enabled to view it.