Behavioural management in nursing and residential homes: a randomised controlled trial.
BACKGROUND
As more and more elderly people are being cared for in residential and nursing homes, how best can their psychiatric needs be met? We report on evaluation of a behavioural intervention by an old-age psychiatry hospital outreach team.


METHODS
This randomised controlled trial of a training and education intervention over 6 months was done in south Manchester, UK. 12 matched nursing and residential homes were randomised to the control or intervention group and within each, the staff selected 10 residents whose behavioural problems made them difficult to care for. Care staff in the intervention homes attended seminars from the hospital outreach team and received weekly visits from a psychiatric nurse to assist in developing care planning skills. The main outcome measures were cognitive impairment and depression, behavioural disturbance, and functional ability, assessed by the geriatric mental state schedule, Crichton Royal behaviour rating scale, and Barthel index, respectively.


RESULTS
Residents in the intervention group had significantly improved scores for depression (before-and-after change difference -0.5 [95% CI -0.8 to -0.1]) and for cognitive impairment (-0.7 [-1.1 to -0.2]) but not for behaviour rating or Barthel index.


CONCLUSIONS
Elderly residents can benefit from improved quality of care achieved by training from a hospital outreach team.
Withington Hospital, Manchester, UK.
R
R
Proctor
A
A
Burns
H S
HS
Powell
N
N
Tarrier
B
B
Faragher
G
G
Richardson
L
L
Davies
B
B
South
D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D003704:Dementia / Q000534:rehabilitation*; D004739:England; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006801:Humans; D007318:Inservice Training; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D009735:Nursing Homes; D010347:Patient Care Planning