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Non-pharmacological interventions for aggressive behavior in older adults living in long-term care facilities

Published online by Cambridge University Press:  17 February 2006

Philippe Landreville ,
Annick Bédard ,
René Verreault ,
Johanne Desrosiers ,
Nathalie Champoux ,
Johanne Monette  and
Philippe Voyer
Philippe Landreville
Affiliation:
School of Psychology, Université Laval, Québec, Canada
Annick Bédard
Affiliation:
School of Psychology, Université Laval, Québec, Canada
René Verreault
Affiliation:
Department of Social and Preventive Medicine, Université Laval, Québec, Canada
Johanne Desrosiers
Affiliation:
Research Centre on Aging, Sherbrooke Geriatric University Institute, and Department of Family Medicine, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
Nathalie Champoux
Affiliation:
Montreal Geriatric University Institute, Montréal, Canada
Johanne Monette
Affiliation:
Division of Geriatric Medicine, Centre for Clinical Epidemiology and Community Studies, Solidage: McGill/Université de Montréal Research Group on Integrated Services for Older Persons, Jewish General Hospital, McGill University, Montréal, Canada
Philippe Voyer
Affiliation:
Laval University Geriatrics Research Unit and Faculty of Nursing Sciences, Université Laval, Québec, Canada
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Abstract

Background: Aggressive behavior (AB) is common in institutional settings. It is an important issue because of its consequences on both the person manifesting such behaviors and their caregivers. Although there are numerous studies assessing non-pharmacologic strategies to manage AB in older adults, no extensive review of the literature is available. This review synthesizes the current knowledge on the effectiveness of non-pharmacological interventions in institutional settings.

Method: Papers describing the assessment of a non-pharmacological intervention to manage AB in which participants were at least 60 years old and living in a long-term care facility were selected mainly by searching various databases.

Results: A total of 41 studies were identified and included in the review. These studies mainly use quasi-experimental designs and include less than 30 participants. Sixty-six percent (27/41) of the studies report either a statistically or behaviorally significant reduction of AB as a result of a non-pharmacological intervention. Staff training programs and environmental modifications appear to be the most effective strategies.

Conclusion: Non-pharmacological interventions seem effective for managing AB. Future studies on the effectiveness of these interventions need to be more rigorous. Development in this field needs to be based on knowledge regarding the determinants of AB in older adults.

Keywords

patient assaulttreatmenttreatment outcomesnursing homesresidential care institutionshomes for the aged
Type
Review Article
Information
International Psychogeriatrics , Volume 18 , Issue 1 , March 2006 , pp. 47 - 73
Copyright
© International Psychogeriatric Association 2006

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