Managing behavioral problems in nursing home residents with dementia (Grip op probleemgedrag) (WC2008-088)
Background
Starting date: 01/03/2010There are over 330 NHs in the Netherlands for more than 67.000 residents. About 50% of all NH-residents are receiving care in long stay dementia special care units. Of major concern in dementia are accompanying behavioral problems (BPs). Clinically relevant BPs (aggression, agitation, apathy) occur frequently. 85% of NH residents with dementia suffer from at least one BP. BPs are mostly chronical and result in considerable distress and workload for nursing staff. They are associated with high costs and diminished quality of life. Frequently, antipsychotics (APs)are used to treat BPs, although their efficacy is very limited and negative side effects (extrapyramidal symptoms, somnolence, pneumonia, increased mortality) often occur. Restraints (belts, bedrails), also used to control BPs, likewise have negative side effects.
All current dementia guidelines (APA, IPA, NICE, CBO) recommend psychosocial interventions as a first line treatment for BPs. Yet, so far, this recommendation is not common practice.
