title: Managing disruptive behaviors with neuroleptics: treatment options for older adults in nursing homes.
abstract: Disruptive behaviors are frequent among elderly individuals in long-term care centers. Neuroleptics remain the most common pharmacological treatment for controlling these challenging behavioral manifestations. However, their effectiveness is a subject of controversy and it is unclear what specific behaviors are more likely to be managed with neuroleptic medications. The objective of this study was to identify the types of disruptive behaviors for which neuroleptics are given to elderly individuals in long-term care facilities and determine if the frequency of these behaviors increases the risk of being prescribed neuroleptics. A cross-sectional study was conducted with 2,332 participants ages 65 or older living in 28 long-term care facilities. Among them, 27.8% had taken at least one neuroleptic drug in the prior week. The administration of neuroleptics was not linked to the presence of any one specific disruptive behavior. However, a significant finding was that the greater the frequency of disruptive behavior exhibited by an elderly individual, the greater the risk of them being administered a neuroleptic medication. A multi-dimensional approach to the assessment of disruptive behaviors is recommended to facilitate the identification of the underlying causes of those behaviors. Accordingly, it is suggested that non-pharmacological treatment plans be adapted to each situation and then implemented to potentially reduce the use of neuroleptics.
authors.affiliation: Faculty of Nursing Sciences, Université Laval, Québec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Voyer
authors.forename: René
authors.initials: R
authors.lastname: Verreault
authors.forename: Pamphile Nkogho
authors.initials: PN
authors.lastname: Mengue
authors.forename: Danielle
authors.initials: D
authors.lastname: Laurin
authors.forename: Louis
authors.initials: L
authors.lastname: Rochette
authors.forename: Lori Schindel
authors.initials: LS
authors.lastname: Martin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004363:Drug Utilization; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000592:standards* / Q000639:trends; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D011379:Prognosis; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D014150:Antipsychotic Agents