BEHAVIORAL-PROBLEMS IN SYDNEY NURSING-HOMES

The prevalence of significant behavioural disturbance in 46 Sydney nur sing homes was examined. All 2445 residents were rated on a brief scre ening questionnaire by senior nurses, who decided that 704 (29%) displ ayed at least one problem behaviour for much of the time. Primary care nurses (PCNs) then rated these 'screen-positive' residents using the Cohen-Mansfield Agitation Inventory (CMAI). In one nursing home the PC Ns rated all 100 residents on the CMAI and found that 24 of 58 'screen -negative' residents displayed CMAI behaviours once daily or more. Of CMAI behaviours rated as occurring daily or more often, 30% were manif ested by 'screen-negative' residents. Prevalence figures based on 'scr een-positive' residents are underestimates. Interrater reliability bet ween PCNs was good. We report that at least 3.3% of residents paced an d 0.45% screamed several times an hour. Each of the following behaviou rs was manifested daily or more often by 10-15% of the residents: rest lessness, pacing, repetitive sentences, constant calls for help, cursi ng/verbal aggression and complaining. Aggressive behaviours (eg hittin g, kicking, biting) were less common, and a relationship to cognitive impairment was demonstrated. Increased research on assessment and mana gement of these behaviours is needed.