Author:
Voyer Philippe,Verreault René,Azizah Ginette M,Desrosiers Johanne,Champoux Nathalie,Bédard Annick
Abstract
Abstract
Background
Verbal and physical aggressive behaviours are among the most disturbing and distressing behaviours displayed by older patients in long-term care facilities. Aggressive behaviour (AB) is often the reason for using physical or chemical restraints with nursing home residents and is a major concern for caregivers. AB is associated with increased health care costs due to staff turnover and absenteeism.
Methods
The goals of this secondary analysis of a cross-sectional study are to determine the prevalence of verbal and physical aggressive behaviours and to identify associated factors among older adults in long-term care facilities in the Quebec City area (n = 2 332).
Results
The same percentage of older adults displayed physical aggressive behaviour (21.2%) or verbal aggressive behaviour (21.5%), whereas 11.2% displayed both types of aggressive behaviour. Factors associated with aggressive behaviour (both verbal and physical) were male gender, neuroleptic drug use, mild and severe cognitive impairment, insomnia, psychological distress, and physical restraints. Factors associated with physical aggressive behaviour were older age, male gender, neuroleptic drug use, mild or severe cognitive impairment, insomnia and psychological distress. Finally, factors associated with verbal aggressive behaviour were benzodiazepine and neuroleptic drug use, functional dependency, mild or severe cognitive impairment and insomnia.
Conclusion
Cognitive impairment severity is the most significant predisposing factor for aggressive behaviour among older adults in long-term care facilities in the Quebec City area. Physical and chemical restraints were also significantly associated with AB. Based on these results, we suggest that caregivers should provide care to older adults with AB using approaches such as the progressively lowered stress threshold model and reactance theory which stress the importance of paying attention to the severity of cognitive impairment and avoiding the use of chemical or physical restraints.
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
Reference59 articles.
1. Patel V, Hope RA: A rating scale for aggressive behaviour in the elderly-the RAGE. Psychol Med. 1992, 22: 211-221.
2. Chou KR, Kaas MJ, Richie MF: Assaultive behavior in geriatric patients. J Gerontol Nurs. 1996, 22: 30-38.
3. Cohen-Mansfield J, Werner P, Culpepper WJIII, Wolfson MA, et al: Wandering and Aggression. The Practical Handbook Of Clinical Gerontology. 1996, California: Sage Publications, 374-397.
4. Giancola P, Zeichner A: Aggressive Behavior in Elderly: A Critical Review. Clin Geronto. 1993, 13: 3-21. 10.1300/J018v13n02_02.
5. Patel V: Aggressive Behavior in elderly People with Dementia: A Review. Int J Geriatr Psychiatry. 1993, 8: 457-472. 10.1002/gps.930080603.
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