PURPOSE: The purpose of this study was to examine group differences in verbal agitation, verbal interaction, bed restraint, pain, analgesic and neuroleptic medication use, and medical comorbidity among agitated nursing home residents who died during a 6-month clinical trial compared with residents of the same gender and similar initial cognitive status who did not die during the trial. DESIGN AND METHODS: We conducted a two-group secondary data analysis of prospective observational data from 10 nursing homes in Birmingham, Alabama. By means of chart review, resident assessments, surveys of certified nursing assistants, and direct observation of residents' daily behaviors and environment, 32 residents (87.34 +/- 7.29 years) with a Mini-Mental State Examination (MMSE) score = 4.31 (+/-5.54) who died were compared with 32 residents (84 +/- 6.96 years) with a mean MMSE score = 4.28 (+/-5.49) who did not die during the clinical trial. RESULTS: Residents who died displayed more verbal agitation, less time in verbal interaction with staff, and almost twice as much time restrained in bed during observation time in comparison with residents who did not die during the clinical trial. However, groups did not differ significantly in severity of comorbid illness, functional status, number of painful diagnoses, certified nursing assistants' reports of residents' pain, or opioid or nonopioid analgesic prescription or dosage. Surviving residents were more likely to receive neuroleptic medication than residents who died. IMPLICATIONS: Results suggest that agitated nursing home residents may exhibit a heightened level of verbal agitation, decreased verbal interaction with staff, and increased bed restraint up to 3 months prior to death. Prospective observational studies are needed to identify markers for imminent mortality among nursing home residents.
PURPOSE: The purpose of this study was to examine group differences in verbal agitation, verbal interaction, bed restraint, pain, analgesic and neuroleptic medication use, and medical comorbidity among agitated nursing home residents who died during a 6-month clinical trial compared with residents of the same gender and similar initial cognitive status who did not die during the trial. DESIGN AND METHODS: We conducted a two-group secondary data analysis of prospective observational data from 10 nursing homes in Birmingham, Alabama. By means of chart review, resident assessments, surveys of certified nursing assistants, and direct observation of residents' daily behaviors and environment, 32 residents (87.34 +/- 7.29 years) with a Mini-Mental State Examination (MMSE) score = 4.31 (+/-5.54) who died were compared with 32 residents (84 +/- 6.96 years) with a mean MMSE score = 4.28 (+/-5.49) who did not die during the clinical trial. RESULTS: Residents who died displayed more verbal agitation, less time in verbal interaction with staff, and almost twice as much time restrained in bed during observation time in comparison with residents who did not die during the clinical trial. However, groups did not differ significantly in severity of comorbid illness, functional status, number of painful diagnoses, certified nursing assistants' reports of residents' pain, or opioid or nonopioid analgesic prescription or dosage. Surviving residents were more likely to receive neuroleptic medication than residents who died. IMPLICATIONS: Results suggest that agitated nursing home residents may exhibit a heightened level of verbal agitation, decreased verbal interaction with staff, and increased bed restraint up to 3 months prior to death. Prospective observational studies are needed to identify markers for imminent mortality among nursing home residents.
Authors: Rebecca S Allen; Beverly E Thorn; Susan E Fisher; John Gerstle; Karen Quarles; Michelle S Bourgeois; Katinka Dijkstra; Louis D Burgio Journal: J Am Geriatr Soc Date: 2003-04 Impact factor: 5.562
Authors: Susan E Fisher; Louis D Burgio; Beverly E Thorn; Rebecca Allen-Burge; John Gerstle; David L Roth; Scott J Allen Journal: J Am Geriatr Soc Date: 2002-01 Impact factor: 5.562
Authors: David E Vance; Louis D Burgio; David L Roth; Alan B Stevens; J Kaci Fairchild; Ann Yurick Journal: J Gerontol B Psychol Sci Soc Sci Date: 2003-03 Impact factor: 4.077
Authors: Ronald S Schonwetter; Beth Han; Brent J Small; Brenda Martin; Kimberly Tope; William E Haley Journal: Am J Hosp Palliat Care Date: 2003 Mar-Apr Impact factor: 2.500
Authors: Dilip V Jeste; Dan Blazer; Daniel Casey; Thomas Meeks; Carl Salzman; Lon Schneider; Pierre Tariot; Kristine Yaffe Journal: Neuropsychopharmacology Date: 2007-07-18 Impact factor: 7.853