Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey

Abstract

Objectives: To determine the prevalence of antipsychotic use in care homes. To explore which behaviours care home staff can find difficult to manage and which non-pharmacological interventions are currently used within care homes to help cope with behavioural and psychological symptoms of dementia.

Method: A postal survey sent to all care homes registered as specialising in the care of older people or/and older people with dementia within four counties in the East of England (n = 747).

Results: Questionnaires were returned from 299 care home managers (40%). The vast majority (n = 200, 73%) reported having at least one resident with an antipsychotic prescription in their home. Twelve percent (n = 1027) of care home residents were reported to be prescribed antipsychotic medications. Aggression was most frequently reported, by 37% (n = 109) of care home managers, as a difficult behaviour to manage. Non-pharmacological interventions were reported to be used in 87% (n = 253) of care homes. The interventions most commonly used in care homes to manage difficult behaviours were reminiscence (75%, n = 219) and music therapy (73%, n = 213).

Conclusion: This survey was a first attempt to estimate the use of antipsychotics in care homes. Despite measures to reduce antipsychotic use for all people with dementia in England, we found that 12% of care home residents were still prescribed antipsychotic medication. Around half of all care home managers reported they had experienced behaviours they found difficult. Antipsychotic medications and a variety of non-pharmacological interventions appear to be used concurrently in many care homes.

Keywords:

• care homes
• homes for the aged
• antipsychotic agents
• non-pharmacological interventions
• behavioural and psychological symptoms of dementia (BPSD)

Acknowledgements

Sponsor: This work was supported by the University of East Anglia; however, the university played no role in the design, execution, analysis, interpretation of data or the writing of this paper.