TY - JOUR
T1 - Special care units for dementia in nursing homes
T2 - A controlled study of effectiveness
AU - Frisoni, G. B.
AU - Gozzetti, A.
AU - Bignamini, V.
AU - Vellas, B. J.
AU - Berger, A. K.
AU - Bianchetti, A.
AU - Rozzini, R.
AU - Trabucchi, M.
PY - 1998
Y1 - 1998
N2 - The management of behavioral disturbances in the demented patient is a debated issue both in the medical and the social fields. Aim of this study was to evaluate the effectiveness of an integrated model of care (special care units SCU in long-term care facilities) to control behavioral disturbances in dementia and to compare it to the more traditional nursing home model. The study is multinational (Italy, France and Sweden) and is funded by the European Commission (DG V). Thirty-one cases (in SCU) and 35 controls (in traditional nursing homes = NH) were enrolled in 43 long-term facilities and assessed 7-14 days after admission and 3 months afterwards. On admission, cases and controls had similar sociodemografic status, cognition, diagnoses, somatic health, and psychotropic drug use, but the former tended to have more severe behavioral disturbances and to be less restrained (19 versus 46%) over the first week after admission. On 3-month follow-up, behavioral disturbances had improved in cases and controls, but with a different pattern: delusions, hallucinations, and agitation improved in the former, and anxiety, euphoria/elation, and irritability/lability in the latter. Sleep disturbances improved in both groups and depression improved in cases and worsened in the controls. Psychotropic drug prescription had not significantly changed in either group. However, notwithstanding the higher frequency of physical restraint use in the controls soon after admission, on 3-month follow-up this was even greater (69%), while it remained low (26%) in the cases. The data suggest that special care unit care of behavioral disturbances in the demented can succesfully control symptoms without additional psychotropic drug and restraint use.
AB - The management of behavioral disturbances in the demented patient is a debated issue both in the medical and the social fields. Aim of this study was to evaluate the effectiveness of an integrated model of care (special care units SCU in long-term care facilities) to control behavioral disturbances in dementia and to compare it to the more traditional nursing home model. The study is multinational (Italy, France and Sweden) and is funded by the European Commission (DG V). Thirty-one cases (in SCU) and 35 controls (in traditional nursing homes = NH) were enrolled in 43 long-term facilities and assessed 7-14 days after admission and 3 months afterwards. On admission, cases and controls had similar sociodemografic status, cognition, diagnoses, somatic health, and psychotropic drug use, but the former tended to have more severe behavioral disturbances and to be less restrained (19 versus 46%) over the first week after admission. On 3-month follow-up, behavioral disturbances had improved in cases and controls, but with a different pattern: delusions, hallucinations, and agitation improved in the former, and anxiety, euphoria/elation, and irritability/lability in the latter. Sleep disturbances improved in both groups and depression improved in cases and worsened in the controls. Psychotropic drug prescription had not significantly changed in either group. However, notwithstanding the higher frequency of physical restraint use in the controls soon after admission, on 3-month follow-up this was even greater (69%), while it remained low (26%) in the cases. The data suggest that special care unit care of behavioral disturbances in the demented can succesfully control symptoms without additional psychotropic drug and restraint use.
KW - Alzheimer's disease
KW - Behavior in dementia
KW - Long-term care
KW - Special care units
UR - http://www.scopus.com/inward/record.url?scp=0031659155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031659155&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0031659155
VL - 27
SP - 215
EP - 224
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
SN - 0167-4943
IS - SUPPL. 6
ER -