Residential aged care staff perceptions and responses towards neuropsychiatric symptoms: a mixed methods analysis of electronic healthcare records. (1st February 2023)

• Record Type: Journal Article
• Authors: Eikelboom, Willem S.; Koch, Jana; Beattie, Elizabeth; Lautenschlager, Nicola T.; Doyle, Colleen; van den Berg, Esther; Papma, Janne M.; Anstey, Kaarin J.; Mortby, Moyra E.
• Is Part Of: Aging & mental health. Volume 27:Number 2(2023)
• Page Start: 243
• Page End: 250
• Publication Date: 2023-02-01
• Subjects: 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.); Older people -- Mental health -- Periodicals; Geriatric psychiatry -- Periodicals; Older people -- Psychology -- Periodicals; Aging -- Psychological aspects -- Periodicals; Aged -- psychology -- periodicals; Mental Health -- periodicals; Mental Health Services -- periodicals; Aging -- psychology -- periodicals; Aged, 80 and over -- psychology -- periodicals; 618.97689
• DOI: 10.1080/13607863.2022.2032597
• Languages: English
• ISSNs: 1360-7863

Abstract

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 .