Management of agitation in nursing home patients - Treatment options

被引:1
作者
Billig, N
机构
[1] Geriatric Psychiatry Program, Georgetown University Medical Center, Washington, DC
[2] Department of Psychiatry, Georgetown University Medical Center, Washington, DC 20007
关键词
D O I
10.2165/00002512-199609020-00004
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Agitation in demented nursing home residents is a major clinical problem with which patients, families and staff are required to cope. Agitation may be secondary to a variety of psychiatric, environmental and medical problems, and thus attempts must be made be clarify aetiological issues before initiating a treatment plan. Treatments for agitation are imperfect, and clinicians should be prepared to work through several to find the best for a given patient and clinical situation. Cognitive/behavioural/environmental treatments have the advantage of few or no adverse effects and no drug-drug interactions. Some of these define rather basic nursing management techniques for coping with agitated older adults, while others attempt to diminish specific behaviours. The use of pharmacological interventions should be reserved for those patients in whom other measures have been unsuccessful. While the range of medications that have been used to treat various kinds of agitated behaviours is large, there are few double-blind, placebo-controlled trials in this area and fewer still in nursing home populations. No one class and no one medication has been identified as a treatment of choice. While we work to find the aetiological mechanisms of irreversible forms of dementia, and the possible treatments for the underlying disorders, the challenge to develop more effective medications with better adverse effect profiles is before us.
引用
收藏
页码:93 / 100
页数:8
相关论文
共 51 条
[1]   DEMENTIA, AGITATION, AND CARE IN THE NURSING-HOME [J].
ARONSON, MK ;
POST, DC ;
GUASTADISEGNI, P .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1993, 41 (05) :507-512
[2]   TRANQUILIZING DRUGS IN THE CLINICAL MANAGEMENT OF MENTAL DISEASE IN GERIATRIC-PATIENTS - DISCUSSION [J].
AYD, FJ ;
GOLDMAN, D ;
KLINE, NS ;
PARSONS, EH ;
SCHIELE, BC .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1958, 6 (05) :379-396
[3]  
BEBER CR, 1965, DIS NERV SYST, V26, P591
[4]   PHARMACOLOGICAL TREATMENT OF AGITATION IN A NURSING-HOME [J].
BILLIG, N ;
COHENMANSFIELD, J ;
LIPSON, S .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1991, 39 (10) :1002-1005
[5]  
BILLIG N, 1995, GROWING OLDER WISER
[6]   SEROTONIN REUPTAKE INHIBITORS FOR THE TREATMENT OF COEXISTING DEPRESSION AND PSYCHOSIS IN DEMENTIA OF THE ALZHEIMER-TYPE [J].
BURKE, WJ ;
FOLKS, DG ;
ROCCAFORTE, WH ;
WENGEL, SP .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 1994, 2 (04) :352-354
[7]  
COCCARO EF, 1990, AM J PSYCHIAT, V147, P1640
[8]   A DESCRIPTION OF AGITATION IN A NURSING-HOME [J].
COHENMANSFIELD, J ;
MARX, MS ;
ROSENTHAL, AS .
JOURNALS OF GERONTOLOGY, 1989, 44 (03) :M77-M84
[9]   SCREAMING IN NURSING-HOME RESIDENTS [J].
COHENMANSFIELD, J ;
WERNER, P ;
MARX, MS .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1990, 38 (07) :785-792
[10]   AGITATED BEHAVIORS IN THE ELDERLY .2. PRELIMINARY-RESULTS IN THE COGNITIVELY DETERIORATED [J].
COHENMANSFIELD, J .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1986, 34 (10) :722-727