The elderly, dementia, aggression and risk assessment

Hindley, Nick; Gordon, Harvey

doi:10.1002/(sici)1099-1166(200003)15:3<254::aid-gps103>3.0.co;2-t

Cited by 9 publications

(20 citation statements)

References 37 publications

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“…With regard to the precipitants of homicidal aggression by older offenders, the most significant parameter in one study was a quarrel between offender and victim, especially where the homicide occurred within the family . Hindley and Gordon described the case history of a patient with dementia who committed homicide while in residential care; in their opinion, the absence of any significant previous criminal record or other deviant or violent behavior in the patient suggests that exacerbation of previous personality traits does not explain the homicide or other aggressive behavior . Cohen suggests that the following antecedent factors increase the risk for homicidal behavior in persons with dementia: History of previous violence or “other‐directed” behaviors. History of alcohol abuse. Active paranoia and other psychotic symptoms. Psychotic depression. Vascular dementia. History of catastrophic reactions. Traits such as low frustration tolerance and aggressiveness. Military/law enforcement/firefighter history. …”

Section: Resultsmentioning

confidence: 99%

“…106 Hindley and Gordon described the case history of a patient with dementia who committed homicide while in residential care; in their opinion, the absence of any significant previous criminal record or other deviant or violent behavior in the patient suggests that exacerbation of previous personality traits does not explain the homicide or other aggressive behavior. 109 Cohen suggests that the following antecedent factors increase the risk for homicidal behavior in persons with dementia: 110 • History of previous violence or "other-directed"…”

Section: Risk Assessment For Dangerousnessmentioning

confidence: 99%

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Violent and criminal manifestations in dementia patients

Cipriani

Lucetti

Danti

et al. 2015

Geriatrics Gerontology Int

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Although the older adults have been studied as victims of violence, geriatric patients can display violent behavior. The purpose of the present review was to explore the phenomenon of criminal violations and violent acts in people with dementia. The authors used PubMed to search the MEDLINE database and other sources for original research and review articles on criminal and violent manifestation in demented patients combining the terms "criminal manifestation," "violence, aggressive behavior," "homicide," "suicide" and "homicide-suicide" together with "dementia". Possible biomarkers of violence are considered. The present review highlights the risk factors for violence in patients suffering from dementia, and reviews the literature about criminal violations and homicidal/suicidal behavior in this patient group. Geriatr Gerontol Int 2016; 16: 541-549.

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Section: Resultsmentioning

confidence: 99%

Section: Risk Assessment For Dangerousnessmentioning

confidence: 99%

Violent and criminal manifestations in dementia patients

Cipriani

Lucetti

Danti

et al. 2015

Geriatrics Gerontology Int

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“…At the same time, more serious aggressive incidents occasionally occur, including self‐harm (De Jonghe et al . 2005) and homicide (Hindley & Gordon 2000). Aggressive behaviour is more common among people with dementia than among older people who do not have dementia (Chou et al .…”

Section: The Context Of Aggressive Behaviourmentioning

confidence: 99%

Aggressive behaviour by people with dementia in residential care settings: a review

Pulsford

Duxbury

2006

Psychiatric Ment Health Nurs

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This paper considers the phenomenon of aggressive behaviour perpetrated by people with dementia in residential care settings. Aggressive behaviour is defined in the context of people with dementia, and the problem of ascertaining the incidence of aggression among people with dementia is discussed. The emotional impact of assaults on nurses and other professionals is highlighted, and differing perspectives on the causation of aggressive behaviour are considered. Management strategies derived from the physical/pharmacological; environment management; behaviour modification and person-centred approaches are reviewed. Our conclusion is that while certain strategies appear to reflect good and common sense practice, in particular those deriving from the person-centred approach, there is no clear research evidence for the general effectiveness of any one management approach, and each has drawbacks of a practical or ethical nature. There is also little empirical information about how professional carers actually manage aggressive behaviour in practice.

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“…The presence of agitation in a person with dementia is associated with fewer visits from relatives, poorer quality of life [ 7 ] and social isolation [ 8 ]. Furthermore, it puts the person who is agitated at risk of triggering responses from other residents [ 9 ], causing potential serious risk of harm not only to the person who is agitated, but to other residents and staff. Agitation and other BSC are not an inevitable consequence of dementia, they reflect an expression of unmet needs by a person with dementia in response to poor quality care [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the effectiveness and cost-effectiveness of Dementia Care Mapping™ to enable person-centred care for people with dementia and their carers (DCM-EPIC) in care homes: study protocol for a randomised controlled trial

Surr

Walwyn

Lilley-Kelly

et al. 2016

Trials

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BackgroundUp to 90 % of people living with dementia in care homes experience one or more behaviours that staff may describe as challenging to support (BSC). Of these agitation is the most common and difficult to manage. The presence of agitation is associated with fewer visits from relatives, poorer quality of life and social isolation. It is recommended that agitation is treated through psychosocial interventions. Dementia Care Mapping™ (DCM™) is an established, widely used observational tool and practice development cycle, for ensuring a systematic approach to providing person-centred care. There is a body of practice-based literature and experience to suggests that DCM™ is potentially effective but limited robust evidence for its effectiveness, and no examination of its cost-effectiveness, as a UK health care intervention. Therefore, a definitive randomised controlled trial (RCT) of DCM™ in the UK is urgently needed.Methods/designA pragmatic, multi-centre, cluster-randomised controlled trial of Dementia Care Mapping (DCM™) plus Usual Care (UC) versus UC alone, where UC is the normal care delivered within the care home following a minimum level of dementia awareness training. The trial will take place in residential, nursing and dementia-specialist care homes across West Yorkshire, Oxfordshire and London, with residents with dementia. A random sample of 50 care homes will be selected within which a minimum of 750 residents will be registered. Care homes will be randomised in an allocation ratio of 3:2 to receive either intervention or control. Outcome measures will be obtained at 6 and 16 months following randomisation. The primary outcome is agitation as measured by the Cohen-Mansfield Agitation Inventory, at 16 months post randomisation. Key secondary outcomes are other BSC and quality of life. There will be an integral cost-effectiveness analysis and a process evaluation.DiscussionThe protocol was refined following a pilot of trial procedures. Changes include replacement of a questionnaire, whose wording caused some residents distress, to an adapted version specifically designed for use in care homes, a change to the randomisation stratification factors, adaption in how the staff measures are collected to encourage greater compliance, and additional reminders to intervention homes of when mapping cycles are due, via text message.Trial registrationCurrent Controlled Trials ISRCTN82288852. Registered on 16 January 2014.Full protocol version and date: v7.1: 18 December 2015.Additional fileThe online version of this article (doi:10.1186/s13063-016-1416-z) contains supplementary material, which is available to authorized users.

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The elderly, dementia, aggression and risk assessment

Cited by 9 publications

References 37 publications

Violent and criminal manifestations in dementia patients

Violent and criminal manifestations in dementia patients

Aggressive behaviour by people with dementia in residential care settings: a review

Evaluating the effectiveness and cost-effectiveness of Dementia Care Mapping™ to enable person-centred care for people with dementia and their carers (DCM-EPIC) in care homes: study protocol for a randomised controlled trial

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