Agitation is a significant problem for the caregivers who take care of long-term care-residing demented persons. These behaviors increase nursing tasks and burning out risks of the nursing team.
Objective: Evaluate the tolerance of a long term care nursing team towards agitated behaviors of demented residents.
Design: Prospective study in long term care with no benefits of treatment.
Material and Method: 90 residents living in a long term care facility (69 females, 21 males), mean age 86 years have been drawned by lots. 56 residents are demented according to the Global Deterioration Scale of Reisberg. The nursing team completed the Cohen Mansfield Agitation Inventory (CMAI, 1989) who rates various agitated behaviors on a 7-point scale of frequency. As there is no scale for tolerance, tolerance has been assessed according to the visual analogical scale principle. It is a 10-point scale of intensity of bad tolerance : 0 point means very good tolerance, 10 point very bad tolerance.
Results: 93% of residents have agitated behavior in the last two weeks. Demented patients have higher scores on CMAI. Five agitated behaviors are significatively more frequent in demented (repetitions mannerisms, p<0,01; handling things improperly, p<0,05; grabbing, p<0,05, hitting, p<0,05; screaming, p<0,05). Median score of tolerance is 3. There is no significant difference for tolerance between demented and not demented residents. But tolerance is significatively worse for three of frequent agitated behaviors in demented (grabbing, p<0,05; hitting, p<0,0001; screaming, p<0,05).
Conclusion: Nurses’ tolerance is rather good towards agitated behaviors. It is not worse in demented patients. Physically and verbal aggressive behaviors are worse tolerated both in demented and not demented residents.
References 1.Cohen-Mansfield J., Marx MS, Rosenthal AS., A description of agitation in a nursing Home. J gerontology, Medical sciences 1989, 44 : M77-84. 2.Cohen-Mansfield J. (1996). Conceptualization of agitation : results based on the Cohen-Mansfield agitation inventory and the agitationbehavior Mapping instrument. International Psychogeriatrics, 8, suppl 3 : 309-315 3.Reisberg B., Ferris SH, de Leon MJ., Crook T. (1982). The global Deterioration scale for assessement of primary degenerative dementia. Am. J. Psychiatry, 1982 ; 139 : 1136-9.
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