title: [Rejection of Care (Nursing or Medication) in Elder Psychiatric Patients].
abstract: OBJECTIVE
  Rejecting nursing or medication is an increasing challenge for professional care in elderly people.
  
  
  METHODS
  This explorative study was part of the Gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within 3 years (1266 admissions).
  
  
  RESULTS
  150 cases (11.8 %) rejected care. 94 (7.4 %) refused nursing and 89 (7.0 %) medication intake. 79.3 % of them suffered from organic brain diseases, particularly from delirium superimposed on dementia (ICD-10 F05.1). Nursing was more often rejected by older and more severely cognitive impaired patients, while refusal of medication was associated with delusions.
  
  
  CONCLUSIONS
  Resisting nursing and refusing medication are 2 separate behavioral syndromes that may also occur together.
authors.affiliation: Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Hellersdorf, Berlin.
authors.forename: Tilman
authors.initials: T
authors.lastname: Wetterling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D003693:Delirium / Q000523:psychology* / Q000628:therapy*; D003702:Delusions / Q000523:psychology / Q000628:therapy; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D010343:Patient Admission; D011568:Psychiatric Nursing; D011599:Psychopathology; D016312:Treatment Refusal / Q000523:psychology*