Characteristics of Aggressive Subjects in Australian (Melbourne) Nursing Homes
|Ajit Shah a1, Edmond Chiu a2, David Ames a2, Susan Harrigan a2 and Dean McKenzie a3|
a1 Imperial College School of Medicine, London, England, UK
a2 Department of Psychiatry, The University of Melbourne, Melbourne, Australia
a3 Department of Psychological Medicine, Monash University, Australia.
Background: Aggressive behavior is common in nursing homes for the elderly. It causes distress to carers and can lead to hospitalization, overmedication, and physical restraint. Method: A 6-month prospective study examining the characteristics of aggressive subjects in 11 nursing homes in Melbourne using validated, reliable instruments. Results: During the study, 121 and 143 subjects were rated aggressive on the Rating Scale for Aggressive Behavior in the Elderly and the Staff Observation Aggression Scale, respectively. Aggressive behavior was associated with younger age, men, subsequent mortality, and prescription of psychotropic drugs including neuroleptics, antidepressants, and benzodiazepines. Conclusions: Educational programs in the use of psychotropic drugs directed at staff involved in the care of nursing home residents may be of value because these drugs have modest efficacy, have significant side effects, and may simply sedate the patient rather than treat aggressive behavior.
(Received May 18 1999)
(Accepted September 7 1999)