Behavioral problems among patients in skilled nursing facilities.

Abstract

This survey of a 33 per cent random sample (1,139) of 3,456 patients in 42 skilled nursing facilities (SNFs) in upstate New York yielded 64.2 per cent with significant behavioral problems. Of these, 257 (22.6 per cent) of the total sample had what were defined as "serious" problems (i.e., excluding those with only impaired judgment and/or physical restraint orders). Details of the problem behaviors of this group, their previous history, current management, frequency of psychiatric consultation, and adequacy of documentation were analyzed. Median age was the same as the general SNF population, a slightly lower proportion was female, and, while 66.5 per cent had diagnoses indicating organic brain syndrome, very few had specific psychiatric diagnoses, and only 4.7 per cent had been admitted from a psychiatric facility. The attending physician had noted the behavioral problem in the record in only 9.7 per cent and had requested psychiatric consultation in 14.8 per cent of these "serious" cases. The need for more staff training in mental health care, and more physician and psychiatric consultative assistance are discussed. (Am J

A Longitudinal Examination of Agitation and Resident Characteristics in the Nursing Home

“…Key Words: Agitation, Nursing home, Longitudinal methods, Direct observation Agitation among residents with dementia is one of the major problems in delivering quality care in nursing home settings (Jackson, Templeton, & Whyte, 1999;Zimmer, Watson, & Treat, 1984). Agitation is defined as verbal, vocal, and motor activities that are repetitive, outside of social standards, and considered inappropriate by staff (CohenMansfield & Billig, 1986).…”

Recommendations for the Management of Behavioral and Psychological Symptoms of Dementia

“…1 -S97 documented in numerous studies, [7][8][9][10][11][12] with estimates of frequency of up to 90% of patients at some point during the course of the i l l n e s s . 6 While likely most common in long-term care institutions, [13][14][15] they occur frequently in outpatient populations and community samples as well. 8,16 Many of these behaviours are most prevalent during the moderate and moderately severe stages of dementia, 8 though symptoms such as agitation, apathy and aberrant motor behaviour may continue to increase with progressive cognitive decline.…”

Teaching and Maintaining Behavior Management Skills With Nursing Assistants in a Nursing Home

“…Surveys of nursing home residents have reported moderate to severe behavior problems in 80% of the population (Swearer, Drachman, O'Donnell, & Mitchell, 1988;Zimmer, Watson, & Treat, 1984). Traditionally, nursing homes have responded to episodes of disruptive behavior with restrictive interventions, such as antipsychotic drugs or physical restraints.…”