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Physicians’ practice and familiarity with treatment for agitation associated with dementia in Israeli nursing homes

Published online by Cambridge University Press:  30 October 2012

Jiska Cohen-Mansfield ,
Atarah Juravel-Jaffe ,
Aaron Cohen ,
Iris Rasooly  and
Hava Golander
Jiska Cohen-Mansfield*
Affiliation:
Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel Minerva Center for the Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
Atarah Juravel-Jaffe
Affiliation:
Maccabi Health Services, Jerusalem and the Surrounding Region, Israel
Aaron Cohen
Affiliation:
Geriatric Division, Israel Ministry of Health, Tel Aviv, Israel Department of Geriatrics and Rehabilitation, Mount Scopus Hadassah University Hospital, Jerusalem, Israel
Iris Rasooly
Affiliation:
Community Services Department, Geriatric Division, Israel Ministry of Health
Hava Golander
Affiliation:
Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel Department of Nursing, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Correspondence should be addressed to: Professor Jiska Cohen-Mansfield, PhD, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978, Israel. Phone: +972-3-6409544, +972-3-6407336; Fax: +972-3-6407339. Email: [email protected].
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Abstract

Background: To clarify physicians’ actual practice in treating agitation in the nursing home and to elucidate the relationship between background factors, familiarity with interventions, and practice.

Methods: A survey of actual practice for agitation in persons with dementia was administered to 67 physicians aged 31–70+ working in nursing homes in Israel. Questionnaires were administered by personal interview, self-completed, or a combination of the two.

Results: Psychotropic medications are prescribed by 92.5% of physicians for treating agitation, most notably, Haloperidol (39%). Non-pharmacological treatment was also reported to be common, though to a lesser extent, with environmental change being the most prevalent non-pharmacological intervention. Generally, physicians showed low familiarity levels with non-pharmacological interventions, with higher levels noted for physicians with a specialty in geriatrics compared to those who were non-specialized. Physicians who were non-Israeli and younger also reported higher familiarity levels compared to their respective counterparts (i.e. Israeli and older) but this difference did not reach significance.

Conclusion: The findings indicate that, despite current guidelines, psychotropic medications are the treatment of choice among nursing home physicians in Israel. While rates of use of non-pharmacological interventions are substantial, their in-practice application may be hindered by lack of familiarity as well as system barriers. The results have implications for system and education changes.

Keywords

non-pharmacological interventionspsychotropic medicationagitationdementiaolder persons
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 2 , February 2013 , pp. 236 - 244
Copyright
Copyright © International Psychogeriatric Association 2012

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