Problem Behavior in the Last Year of Life: Prevalence, Risks, and Care Receipt in Older Americans

Abstract

Problem behavior is relatively common in older people in the last year of life and is not confined to nursing home residents or people suffering from dementia.

Impact of Problem Alcohol Use on Patient Behavior and Caregiver Burden in a Geriatric Assessment Clinic

“…Instead, it may reflect a long-term impact of problematic alcohol use on the central nervous system, its effect on the relationship of the patient to his or her environment and caregiver, and/or its effect on personality features that may lead to both behavior difficulties and alcohol misuse. This finding is similar to the finding of Bedford et al, 9 who suggested that problem behaviors were related to alcohol use in previous years, suggesting that behavior disturbances were not just related to acute alcohol use.…”

End-of-Life Care in U.S. Nursing Homes: Nursing Homes with Special Programs and Trained Staff for Hospice or Palliative/End-of-Life Care

“…28,29 Furthermore, cognitive impairments and behavioral problems are common among nursing home residents aged 85 or older and are not just confined to nursing home residents with dementia diagnoses. 30,31 Therefore, pain management and behavior management of dying residents are critical components of hospice or palliative/end-of-life care in nursing homes, and skill in this care (as reflected by SPTS for dementia and behavioral symptoms) may precede SPTS for hospice and/or palliative/end-of-life care. Also, our finding that nursing homes with SPTS for mental health services have a 1.6 greater likelihood of having SPTS for hospice and/or palliative/end-of-life care likely indicates a facility's focus on reducing unmet mental health treatment needs and its ability to facilitate the integration of mental health clinicians into the care team-a prerequisite for SPTS in hospice and palliative/end-of-life care.…”

Potentially Modifiable Resident Characteristics That Are Associated With Physical or Verbal Aggression Among Nursing Home Residents With Dementia

“…Nationally, 88 000 (6.8%) of the approximately 1.3 million residents in US nursing homes are physically aggressive each week. 1 Dementia [2][3][4][5][6][7][8][9][10][11][12][13][14][15] and psychosis 5,[16][17][18][19] have been linked to increased physical aggression in almost all studies. There are conflicting findings about the association of physically aggressive behavior with sex, 3,[5][6][7][8][9]11,13,16,[20][21][22] depression, [6][7][8]13,15,16 level of activities of daily living (ADL) dependence,* and reported pain.…”