Agitation, Aggresion, and Rejection of Care in Residential Care Facilty Residents With Dementia

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Conference Proceeding

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Objectives: To estimate prevalence and co-occurrence of agitation, aggression, and rejection of care in persons with dementia (PwDs) in USA residential care facilities.

Methods: Cross-sectional analysis of the 2010 National Survey of Residential Care Facilities involving 3,434 residents with dementia. Behavioral symptoms data for past 30 days were obtained from interviews with staff. Presence of behaviors was based on the recorded value for behavioral items on the survey. PwDs exhibiting ‘being excessively noisy’ and/or ‘moving aimlessly’ were considered agitated. Those exhibiting ‘destroying property’, ‘verbally threatening other persons’, or ‘being physically aggressive towards other persons’ were considered aggressive. ‘Refusing to take prescribed medicines’ and/or ‘refusing to bathe’ was considered rejection of care.

Results: Of 3,434 PwDs, 55.2% (n=1,895) exhibited one of the three behaviors in previous month, with 40.3% exhibiting agitation, 21.7% aggression, and 35.9% rejection of care. Prevalence of aggression (1.7%, n=59) occurring alone was much lower than prevalence of agitation alone (12.8%, n=438) and rejection of care alone (10.8%, n=354). Among PwDs exhibiting any behavior, behaviors mostly co-occurred with 6.9% (n=131) exhibiting agitation and aggression, 17.3% (n=327) agitation and rejection of care, and 3.7% (n=70) aggression and rejection of care and 25.5% (n=483) exhibiting all three behaviors.

Conclusion: These are the first national estimates for agitation, aggression, and rejection of care in PwDs living in residential care facilities, indicating a high prevalence and co-occurrence. Identifying subgroups of co-occurring behaviors may facilitate developing effective treatment strategies for these behaviors as the context in which they occur may be different.

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Citation / Publisher Attribution

Innovation in Aging, v. 1, issue suppl_1, p. 1402