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Behavioral Symptoms in Residential Care/Assisted Living Facilities: Prevalence, Risk Factors, and Medication Management
Author(s) -
GruberBaldini Ann L.,
Boustani Malaz,
Sloane Philip D.,
Zimmerman Sheryl
Publication year - 2004
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2004.52451.x
Subject(s) - medicine , dementia , depression (economics) , psychiatry , assisted living , activities of daily living , psychosis , assisted living facility , mental health , long term care , behavioral activation , cognition , gerontology , disease , pathology , economics , macroeconomics
Objectives: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. Design: Cross‐sectional study. Settings: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). Participants: A total of 2,078 RC/AL residents aged 65 and older. Measurement: Behavioral symptoms were classified using a modified version of the Cohen‐Mansfield Agitation Inventory. Additional items on resistance to care were also examined. Results: Approximately one‐third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two‐thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). Conclusion: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long‐term setting.