Approximately three-quarters of hospitalized persons with Alzheimer?s disease and related disorders (ADRD) experience behavioral and psychological symptoms of dementia (BPSD). In hospitalized patients BPSD is associated with accelerated and lasting functional and cognitive impairment, increased resource consumption, institutionalization, caregiver burden, and premature death. The current standard of care is to use person- centered behavioral approaches when responding to BPSD rather than psychoactive medications which are frequently ineffective and often cause complications. An understanding of the factors influencing the individual?s clinical presentation, needs, and response to treatment guides these approaches, including intrinsic factors such as gender. Given that about two-thirds of persons with a diagnosis of Alzheimer?s dementia are women, there is surprisingly little rigorous work on gender differences in the expression of BPSD, and even less on staff response to BPSD by patient gender. The minimal research that has been done in this area has been largely conducted in long term care and suggests that BPSD in men are more likely to be identified and managed. Lack of identification and management of BPSD in women can result in emotional distress, a decrease in the quality of interactions they have with staff., and increased complications. The purpose of this supplement, entitled, Gender differences in Well-being, Behavior, and Related Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD), is to utilize our ongoing study testing the efficacy of Family -centered Function focused Care (Fam-FFC) versus Education Only (EO) in 438 patients in three hospitals (two units each) to examine gender differences in how nursing staff identify and manage behavioral and psychological symptoms associated with dementia (BPSD) among men and women during hospitalization. In Fam-FFC nurses purposefully engage family CGs in the assessment, decision-making, care delivery and evaluation of function-focused care during hospitalization and the 60-day post-acute period in order to improve behavioral and functional outcomes.
We aim to use baseline data from this study and some additional data to answer the aims of this supplement as follows:
Aim 1 : Test for gender differences in staff identification and management of BPSD;
Aim 2 : Test for gender differences in quality of staff/patient interactions and patient emotional wellbeing;
Aim 3 : Explore formal nursing staff experiences with the identification, documentation and management of BPSD among women and men. This study is aligned with the Trans-NIH Strategic Plan for Women?s Health Research goal of leveraging data sources to consider sex and gender influences that enhance research for the health of women. Our long-term goal is to improve the care delivered to the estimated 3.2 million U.S. women living with ADRD during periods of acute illness requiring hospitalization.
This supplement entitled, Gender differences in Well-being, Behavior, and Related Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD), is focused on the behavioral and psychological symptoms associated with dementia (BPSD) among men and women during hospitalization. We will evaluate differences in staff /patient interaction, patient emotional wellbeing and the care provided to females versus males. We will also explore the views of nursing staff about how they identify and respond to BPSD based on patient gender.
| Galvin, James E (2018) Using Informant and Performance Screening Methods to Detect Mild Cognitive Impairment and Dementia. Curr Geriatr Rep 7:19-25 |
| Boltz, Marie; Kuzmik, Ashley; Resnick, Barbara et al. (2018) Reducing disability via a family centered intervention for acutely ill persons with Alzheimer's disease and related dementias: protocol of a cluster-randomized controlled trial (Fam-FFC study). Trials 19:496 |
| Boltz, Marie; Resnick, Barbara; Chippendale, Tracy et al. (2014) Testing a family-centered intervention to promote functional and cognitive recovery in hospitalized older adults. J Am Geriatr Soc 62:2398-407 |
