Abstract
Objective
This case series describes the various contributors of disruptive behavior in demented nursing home residents and outlines the necessary steps to identify and treat them.
Design
Evaluation of overall clinical improvement and agitation at discharge from the hospital and at follow‐up.
Setting
Nursing home residents consecutively admitted to the geriatric psychiatry service of a psychiatric university hospital in the New York metropolitan area.
Patients
15 elderly demented nursing home residents with agitation.
Measures
Overall clinical improvement was assessed with the ‘global assessment of functioning scale’. Agitation was evaluated with the ‘brief agitation rating scale’ and the ‘nursing home scale for agitation’. Medication side‐effects were measured with the ‘Simpson–Angus scale’ and the ‘abnormal involuntary movement scale’.
Results
The patients showed significantly more overall clinical improvement at discharge compared with admission. Additionally, agitation scores were significantly lower at discharge and at follow‐up compared with admission.
Conclusion
A comprehensive medical and neurological assessment, an accurate identification of comorbid psychopathology, evaluation of drug toxicity, and a thorough history of psychotropic medication trials are essential steps for a successful treatment. Copyright © 2001 John Wiley & Sons, Ltd.