A 6-month-long educational program combined with unit-based, resident-centered consultation can reduce use of physical restraints in nursing homes effectively and safely. Whether extending the intervention will achieve greater reduction is not known from these results.

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There is an abundant literature about the experience of caregiving for a spouse living with Alzheimer’s disease (AD), but there are very few qualitative studies about caregiving for persons living with Frontotemporal Degeneration (FTD). FTD causes a change in personality and affected persons may lose the ability to adhere to social norms. Thus, the emotional loss caregivers experience is often confounded by anger in response to embarrassing and socially inappropriate behaviors. In this paper, we offer a glimpse of this lived experience through the voices of two spouses whom we interviewed, each with experience caring for persons living with FTD. We suggest that FTD caregivers experience a loss of emotional attachment to their spouse because of their partner’s behavioral symptoms. This loss gives rise to feelings of isolation and anger as caregivers assume new roles and reimagine their future. The findings from these interviews illuminate the need for more research and greater attention and support for FTD caregivers early in the disease trajectory.

Aggressive behavior is the observable manifestation of aggression and is often associated with developmental transitions and a range of medical and psychiatric diagnoses across the lifespan. As healthcare professionals involved in the medical and psychosocial care of patients from birth through death, nurses frequently encounter—and may serve as—both victims and perpetrators of aggressive behavior in the workplace. While the nursing literature has continually reported research on prevention and treatment approaches, less emphasis has been given to understanding the etiology, including contextual precipitants of aggressive behavior. This paper provides a brief review of the biological, social, and environmental risk factors that purportedly give rise to aggressive behavior. Further, many researchers have focused specifically on aggressive behavior in adolescence and adulthood. Less attention has been given to understanding the etiology of such behavior in young children and older adults. This paper emphasizes the unique risk factors for aggressive behavior across the developmental spectrum, including childhood, adolescence, adulthood, and late life. Appreciation of the risk factors of aggressive behavior, and, in particular, how they relate to age-specific manifestations, can aid nurses in better design and implementation of prevention and treatment programs.

Background/Objectives As the population ages, delirium superimposed on dementia is becoming a common problem. Family caregivers may provide critical information to assist with early detection. The purpose of this study was to explore agreement between the Family Confusion Assessment Method (FAM-CAM) for delirium identification and interviewer-rated CAM delirium ratings. Design Exploratory analysis of agreement. Setting Community. Participants 52 family caregivers and 52 elders with pre-existing impairment on standardized cognitive testing. Measurements The interviewer-rating for delirium was determined by fulfillment of the Confusion Assessment Method (CAM) algorithm. Results The total sample included 52 paired CAM:FAM-CAM assessments completed across 52 dyads of elders with pre-existing cognitive impairment and family caregivers. The point prevalence of delirium was (7/52)13%. Characteristics did not differ significantly between the delirium and non-delirium groups. The FAM-CAM questions that mapped directly to the original four-item CAM algorithm had the best overall agreement with the interviewer-rated CAM, kappa=0.85 (95% confidence interval, CI 0.65–1.0), sensitivity 88% (CI 47–99%) and specificity 98% (CI 86–100%). Conclusion The FAM-CAM is a sensitive screening tool for detection of delirium in elders with cognitive impairment utilizing family caregivers, with relevance for both research and clinical practice.