Behavioral and Psychological Symptoms of Dementia (BPSD) include aggression, agitation, depression, anxiety, apathy and psychosis (hallucinations or delusions) and are exhibited by up to 90% of nursing facility residents with Alzheimer?s disease and related dementias (ADRD). BPSD result in negative health outcomes, decline in physical functioning, and high cost of care. In addition, BPSD put residents at risk for inappropriate use of antipsychotic drugs and other restraining methods that reduce function, increase social isolation, result in physical harm and increase risk of physical abuse. The current standard of care is to use person-centered behavioral approaches when responding to these BPSD rather than psychoactive medications which are frequently ineffective and often harmful. The majority of individuals in nursing homes are women and women have a greater likelihood of having ADRD. Despite these findings there is little information about gender differences in the expression of BPSD, and even less on staff identification and management of these behaviors. What has been done suggests that BPSD in men is more likely to be identified and managed as these behaviors in men, particularly aggression, tend to be more distressing to staff. Lack of identification and management of BPSD in women can result in a decrease in quality of life for these individuals and a decrease in the quality of interactions they have with staff. The purpose of this supplement, entitled, The Impact of Gender differences on Identification and Treatment of BPSD in Nursing Home Residents with Dementia, is to utilize our ongoing study testing the EIT-4-BPSD versus Education Only (EO) in 50 nursing homes including 625 residents to focus on gender differences in how staff identify and manage BPSD and the impact of EIT-4-BPSD between females and males. The EIT-4-BPSD is an implementation strategy that enables staff in nursing homes to reduce BPSD using behavioral approaches while optimizing function, preventing adverse events, and improving quality of life of residents. We will use baseline data and some additional qualitative data to answer the aims of this supplement which include:
Aim 1 : To test for gender differences in identification and management of BPSD among women and men with moderate to severe dementia;
Aim 2 : To test for gender differences in quality of staff/resident interactions and quality of life;
and Aim 3 : Qualitatively explore caregivers experiences with identification, documentation and management of BPSD among women and men. This supplement will address two of the new Trans-NIH Strategic Plan for Women?s Health Research goals: (1) to develop methods and leverage data sources to consider sex and gender influences that enhance research for the health of women; and (2) to enhance dissemination and implementation of evidence to improve the health of women. Our long-term goal is to improve the care delivered to the 922,480 women who reside in our nation?s 15,000 nursing homes.
This supplement entitled, The Impact of Gender differences on Identification and Treatment of BPSD in Nursing Home Residents with Dementia, is focused on evaluation of gender differences in identification and management of behavioral and psychological symptoms associated with dementia (BPSD) among women and men with moderate to severe dementia. In addition we will test if there are differences in the quality of care and quality of life of female versus male residents and qualitatively explore with staff how they identify and manage BPSD differently in females versus males.
| Resnick, Barbara; Galik, Elizabeth; Kolanowski, Ann et al. (2018) Reliability and Validity of the Care Plan Checklist for Evidence of Person-Centered Approaches for Behavioral and Psychological Symptoms Associated With Dementia. J Am Med Dir Assoc 19:613-618 |
| Massimo, Lauren; Kales, Helen C; Kolanowski, Ann (2018) State of the Science: Apathy As a Model for Investigating Behavioral and Psychological Symptoms in Dementia. J Am Geriatr Soc 66 Suppl 1:S4-S12 |
