Residential aged care staff perceptions and responses towards neuropsychiatric symptoms: a mixed methods analysis of electronic healthcare records

Abstract

Objectives

To investigate electronic care notes to better understand reporting and management of neuropsychiatric symptoms (NPS) by residential aged care (RAC) staff.

Methods

We examined semi-structured care notes from electronic healthcare notes of 77 residents (67% female; aged 67–101; 79% with formal dementia diagnosis) across three RAC facilities. As part of standard clinical practice, staff documented the NPS presentation and subsequent management amongst residents. Using a mixed-method approach, we analyzed the type of NPS reported and explored care staff responses to NPS using inductive thematic analysis.

Results

465 electronic care notes were recorded during the 18-month period. Agitation-related behaviors were most frequently reported across residents (48.1%), while psychosis (15.6%), affective symptoms (14.3%), and apathy (1.3%) were less often reported. Only 27.5% of the notes contained information on potential causes underlying NPS. When faced with NPS, care staff responded by either providing emotional support, meeting resident’s needs, removing identified triggers, or distracting.

Conclusion

Results suggest that RAC staff primarily detected and responded to those NPS they perceived as distressing. Findings highlight a potential under-recognition of specific NPS types, and lack of routine examination of NPS causes or systematic assessment and management of NPS. These observations are needed to inform the development and implementation of non-pharmacological interventions and care programs targeting NPS in RAC.

Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2032597 .

Keywords:

• Aggression
• apathy
• behavioral and psychological symptoms of dementia (BPSD)
• dementia
• electronic health records
• neuropsychiatric symptoms
• residential aged care facilities
• dementia and cognitive disorders
• institutional care (nursing homes
• etc.)

Disclosure statement

The authors report no conflict of interests.

Data availability statement

Data used in this study cannot be shared because of confidential information.

Additional information

Funding

Alzheimer Nederland; Australian Research Council; Alzheimer Nederland and Memorabel ZonMw; NHMRC and Australian Research Council Dementia Research Development Fellowship; Vereniging Trustfonds Erasmus Universiteit Rotterdam.