USE OF NON-PHARMACOLOGICAL METHODS FOR THE PREVENTION OF AGGRESSION IN SENIORS IN INSTITUTIONAL CARE

Radka Bužgová¹, Kateřina Ivanová^2
1Ostravská univerzita, Zdravotně sociální fakulta, Ústav ošetřovatelství a porodní asistence; ²Univerzita Palackého v Olomouci, Lékařská fakulta, Ústav sociálního lékařství a zdravotní politiky

Korespondenční autor: Radka Bužgová (radka.buzgova@osu.cz)

ISSN 1804-7858 (On-line)

Full verze:

Submitted:6. 8. 2008
Accepted: 15. 10. 2008
Published online: 29. 12. 2008

Summary

The aggressive behaviour is one of behavioural disorders occurring in elderly people, which also occurs to a considerable extent in seniors living in institutions. The purpose of the present contribution was to use the evidence-based method of practice, to provide demonstrations supporting non-pharmacological methods for the prevention of aggression in these seniors. Based on searching in electronic data bases, 4 comprehensive reviews, 3 review articles and 15 original works were found, evaluating the efficacy of non-pharmacological approaches, which are the sensory stimulation, training programmes for employees, arrangement of environment, structured exercise, special care and psychosocial interventions. The summarization of the evidences demonstrates that the efficacy of non-pharmacological methods for the prevention of the aggressive behaviour in seniors is not unambiguous. A strong and unambiguous demonstration was only found in support of training programmes for employees.

Keywords: senior – aggression – non-pharmacological methods – prevention

Souhrn

Agresivní chování je jednou z poruch chování ve stáří, které se vyskytuje ve velké míře také u seniorů v institucionální péči. Cílem tohoto příspěvku bylo metodou praxe založené na důkazech najít důkazy podporující nefarmakologické metody pro prevenci agresivity u těchto seniorů. Vyhledáváním v elektronických databázích byly nalezeny 4 systematické přehledy, 3 přehledové články a 15 původních prací hodnotících efektivnost nefarmakologických metod a to smyslové stimulace, tréninkových programů pro zaměstnance, úpravy prostředí, strukturovaného cvičení, speciální péče a psychosociálních intervencí. Ze sumarizace důkazů je zřejmé, že efektivnost nefarmakologických metod pro prevenci agresivního chování u seniorů není jednoznačná. Silný a jednoznačný důkaz byl nalezen pouze pro podporu tréninkových programů pro zaměstnance.

Klíčová slova: senior – agresivita – nefarmakologické metody – prevence

Literatura

1. Ballard, C. G. et al.: Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia. In: Journal of Clinical Psychiatry, 2002, 63, s. 553–558. ISSN 1555–2101.

2. Benedict, R. H. B. et al.: Neuropsychological counselling improves social behavior in cognitively-impaired multiple sclerosis patient. In: Multiple Sclerosis, 2000, 6, 6, s. 391–396. ISSN 1352–4585.

3. Bužgová, R., Ivanová, K.: Porušování lidských práv v rezidenčních zařízeních pro seniory. In: Kontakt, 2008, 10, suppl. 1, s. 28–33. ISSN 1212–117.

4. Chou, K. et al.: Assaultive behavior in geriatric patients. In: Journal of Gerontological Nursing. 1996, 22, s. 31–38. ISSN 00989134.

5. Clark, M. E. et al.: Use of music to decrease aggressive behaviors in people with dementia. In: Journal of Gerontological nursing. 1998, 24, s. 10–14. ISSN 00989134.

6. Cohen-Mansfield, J.: Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia. In: The American Journal of Geriatric Psychiatry. 2001, 9, 4, s. 361–381. ISSN 1545–7214.

7. Cohen-Mansfield, J., Werner, P.: The effects of an enhanced environment on nursing home residents who pace. In: The Gerontologist, 1998, 38, s. 199–208. ISSN 00169013.

8. DeYoung, S. et al.: Decreasing aggressive, agitated or disruptive behavior: participation in a behavior management unit. In: Journal of Gerontological Nursing, 2002, 28, 6, s. 22–31. ISSN 00989134.

9. Holmberg, S.: Evaluation of a Clinical Intervention for Wanderers on a Geriatric Nursing Unit. In: Archives of Psychiatric Nursing, 1997, 11, 1, s. 21–28. ISSN 0883–9417.

10. Ingresoll, D. B. et al.: The effectiveness of a solution-focused approach for problem behaviors among nursing home residents. In: Journal of Gerontological social Work, 1999, 32, s. 49–64. ISSN 1540–4048.

11. Landreville, P. et al.: Non-pharmacological interventions for aggressive behavior in older adults living in long-term care facilities. In: International Psychogeriatrics, 2006, 18, 1, s. 47–73.

12. Livingston et al.: Systematic Review of Psychological Approaches to the Management of Neuropsychiatric Symptoms of Dementia. In: The American Journal of Psychiatry. 2005, 162, 11, s. 1996–2021. ISSN 1535–7228.

13. Meyer, D. L. et. al.: Effects of a ”quiet week” intervention on behavior in an Alzheimer boarding home. In: American Journal of Alzheimer´s Care and Related Disorders and Research, 1992, 7, s. 2–7. ISSN 08884897.

14. McCallion, P. et al.: Educating nursing assistants to communicate more effectively with nursing home residents with dementia. In: The Gerontologist, 1999, 39, s. 546–558. ISSN 00169013.

15. Morgan, D. G., Steward, N. J.: High versus low density special care units: impact on the behaviour of the elderly residents with dementia. In: Canadian Journal on Aging, 1998, 17, s. 143–165. ISBN 0714–9808.

16. NCEA. Nursing Home Abuse: Risk Prevention Profile and Checklist. National Association of state Units on Aging, July 2005, 51 s.

17. Patel, V., Hope, T:. Aggressive behavior in elderly people with dementia with dementia: a review. In: International Journal of Geriatric Psychiatry. 1993, s. 457–472. ISBN 0885–6230.

18. Pidrman, V.: Demence. 1. vyd. Praha: 2007. Grada Publishing, 184 s. ISBN 978–80–247–1490–5.

19. Thomas, D. W. et al.: The effects of music on bathing cooperation for residents with dementia. In: Journal Music Therapy, 1997, 34, s. 246–259. ISSN 0022–2917.

20. Toseland, R. W. et al.: The impact of validation group therapy on nursing home residents with dementia. In: Journal of Applied Gerontology, 1997, 16, s. 31–50. ISSN 0733–4648.

21. Werner, P. et al.: Impact of a restraint-reduction program on nursing home residents. In: Geriatric Nursing, 1994, 15, s. 142–146. ISBN 01974572.

22. Woods, P., Ashley, J.: Stimulated presence therapy: using selected memories to manage problem behaviors in Alzheimer´s disease patients. In: Geriatric nursing, 1995, 16, s. 9–14. ISBN 01974572.