Abstract
BackgroundThe treatment of pain and treatment of anxiety are two of the most complex issues in nursing homes worldwide, mainly because of the large numbers of people with cognitive impairment who reside in this environment.AimThe aim of this study was to investigate the administration of analgesics and anxiolytics to people living in nursing homes, taking into account cognitive status.MethodsFor this cross-sectional study, we used data from 404 residents who lived in nine randomly selected nursing homes in the Czech Republic and participated in the Czech-Austrian Long-Term Care Research Project called DEMDATA. Information about medication administration was obtained from medical records. Cognitive impairment was evaluated by the Mini-Mental State Examination, and pain was measured by the Pain Assessment in Advanced Dementia. To measure anxiety, we used the Behavioral Pathology in Alzheimer’s Disease Rating Scale in residents with severe-to-moderate dementia and also the standardized questionnaire EuroQol in other residents.ResultsIn all, 68% (95% CI 62–74) of residents with pain did not receive any analgesic medication and 31% (95% CI 25–38) of residents were administered some analgesics and continued to report pain. The lowest reported occurrence of pain, as well as the lowest prevalence of analgesic administration, was in residents with moderate-to-severe dementia. We found that an alarming percentage of residents in the nursing homes were not treated sufficiently.ConclusionThis study indicates that treatment effects should be better monitored.
Highlights
IntroductionAnxiety, and depression are the most common psychiatric disorders in nursing homes.[1] These conditions, together with pain, may decrease the quality of life of older persons
Dementia, anxiety, and depression are the most common psychiatric disorders in nursing homes.[1]
Even when a person with dementia is recognized as being in pain, the prescription of analgesic medications often falls short of best-practice recommendations.[7]
Summary
Anxiety, and depression are the most common psychiatric disorders in nursing homes.[1] These conditions, together with pain, may decrease the quality of life of older persons. It is relatively well known that cognitively impaired nursing home residents are prescribed and administered significantly less analgesic medications, in terms of both frequency and dosage, than their more cognitively intact peers.[5] Why those with more severe cognitive impairment receive fewer analgesics than others is not quite clear.[6] even when a person with dementia is recognized as being in pain, the prescription of analgesic medications often falls short of best-practice recommendations.[7] While analgesic administration in people with dementia is known to Clinical Interventions in Aging 2018:13 2511–2515. Aim: The aim of this study was to investigate the administration of analgesics and anxiolytics to people living in nursing homes, taking into account cognitive status. The lowest reported occurrence of pain, as well as the lowest prevalence of analgesic administration, was in residents with moderate-to-severe dementia.
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