Behavioral and Psychological Symptoms in Dementia in Nursing Home Residents: The Economic Implications

2000 ◽  
Vol 12 (S1) ◽  
pp. 51-57 ◽  
Author(s):  
Judith A. O'Brien ◽  
Lori A. Shomphe ◽  
J. Jaime Caro

A variety of behavioral and psychological symptoms are inherent to dementia, such as delusional thinking, hallucinations, agitation, violent behavior, verbal outbursts, wandering, sleep disturbances, and sexually inappropriate behavior (Jackson et al., 1989; Reisberg et al., 1987; Teri et al., 1992; Yeager et al., 1995). Although opinions in the literature differ concerning behavioral problems and how they relate to caregiver burden and institutionalization (Martinson et al., 1995; Mega et al., 1996; Reisberg et al., 1987), this analysis focuses on their role in increasing the level of care once the patient is placed in permanent residential care.

Author(s):  
Peter R. Grant

ABSTRACTAdmission data from 159 residents of four Saskatchewan nursing homes were analysed in order to identify predictors of level of care. Multiple regression analyses showed that a high level of care was assigned to those who were unable to perform various activities of daily living, those who had behavioral problems, and those who had recently experienced a stressful life event; with these variables and a nursing home variable explaining 47.2% of the variance. Appropriately, the most important predictor is activities of daily living. The other major predictor is behavioral problems which, the results suggest, are caused by either an organic psychotic disorder or a high level of stress. It is recommended that, following admission, new residents with behavioral problems caused by stress should be the recipients of programs designed to help them cope with this stress and mitigate their behavioral problems. Then, they should be reassessed and, where appropriate, reassigned to a lower level of care.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Majic ◽  
J.-P. Pluta ◽  
T. Mell ◽  
A. Decker ◽  
A. Heinz ◽  
...  

Background:Behavioral and Psychological Symptoms of Dementia (BPSD) include agitation, apathy, hallucinations, and depression. These symptoms are a challenge to professional nursing care, resulting in frequent psychiatric hospitalization, which incur high costs to the national healthcare systems.Objective:To estimate the prevalence of BPSD in nursing home residents in 16 representative nursing homes in Berlin, Germany.Methods:In a cross-sectional clustered cohort study, BPSD were assessed using the Dementia Mood Assessment Scale (DMAS), the Neuropsychiatric Inventary (NPI) and the Cohen-Mansfield Agitation Inventory (CMAI). Dementia stage severity was measured by Functional Assessment Staging (FAST) and the Mini-Mnetals State Examination (MMSE). Furthermore, the patients" history recording psychotropics and number of psychiatric hospitalizations were registered. The prevalence and incidence rates of BPSD as well the duration of hospitalization and the quantity of drug prescription were estimated.Results:BPSD are common above all in nursing home residents with dementia, exhibiting prevalence rates of above 60% of all nursing home residents suffering from dementia. The severity of BPSD was related to number of psychiatric hospitalizations, the amount of psychotropics prescribed, and caregiver burden (p < .05).Conclusion:The high prevalence rate of BPSD reflects a significant problem in nursing home care, and is related to negative health outcomes and caregiver burden. Thus, nursing home care could be improved by minimizing the severity of BPSD, as well as the amount of drugs prescribed and the frequency of demented patients" hospitalization.


2020 ◽  
Vol 46 (11) ◽  
pp. 17-27
Author(s):  
Justine S. Sefcik ◽  
Caroline Madrigal ◽  
Allison R. Heid ◽  
Sheila L. Molony ◽  
Kimberly Van Haitsma ◽  
...  

2018 ◽  
Vol 31 (08) ◽  
pp. 1137-1149 ◽  
Author(s):  
Gubing Wang ◽  
Armagan Albayrak ◽  
Tischa J. M. van der Cammen

ABSTRACTBackground:Non-pharmacological interventions for Behavioral and Psychological Symptoms of Dementia (BPSD) have been developed; however, a systematic review on the effectiveness of this type of intervention from a perspective of ergonomics is lacking. According to ergonomics, the capabilities of Persons with Dementia (PwD) should be considered in the interventions for the outcomes to be reliable. We aimed to systematically review the non-pharmacological interventions for BPSD in nursing home residents with an additional assessment criterion based on ergonomics, specifically, capability consideration.Methods:The electronic databases MEDLINE, EMBASE, and PsycINFO were searched for non-pharmacological interventions treating BPSD in nursing homes. The interventions were categorized according to the capabilities of PwD required to participate. Study quality was assessed by National Health and Medical Research Council (NHMRC) evidence hierarchy and the capability consideration.Results:Sixty-four clinical trials met the inclusion criteria; 41 trials reported a significant reduction in at least one BPSD symptom; 20 trials reported no significant reduction in BPSD symptoms; three trials reported adverse effects after the intervention. Interventions were categorized into sensory-, cognition-, and movement-oriented. Capabilities of PwD were not considered in 28 trials, especially for sensory capabilities.Conclusions:The majority of the clinical trials reported a significant reduction in BPSD. The quality of evidence for nonpharmacological interventions in these trials is low due to the lack of capability consideration, data inhomogeneity, and inadequate study design and reporting. Future studies should focus on improving the quality of evidence by including capability consideration and examining if a relationship between capability consideration and effectiveness of non-pharmacological interventions exists.


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