RESIDENTIAL CARE FOR ELDERLY PEOPLE - THE PREVALENCE OF COGNITIVE IMPAIRMENT AND BEHAVIORAL-PROBLEMS

Aims: to investigate the prevalence of and interrelationship between c ognitive impairment and behavioural problems in older people in reside ntial care. Subjects: all those aged 65 years and over resident on one night in any type of residential care within the Leicestershire Distr ict Health Authority. Methods: an assessment form for each resident wa s completed by care staff. The assessment included demographic informa tion and functioning (both mental and physical) during the previous we ek. Cognitive impairment was measured by the confusion sub-scale of th e Crichton Royal Behavioural Rating Scale. Results: 6079 people were e numerated in 241 establishments, including hospitals, homes and hostel s provided by the National Health Service (NHS), local authority socia l services and private and voluntary agencies. Thirty-eight percent (2 219) were moderately or severely cognitively impaired and behavioural problems were present in 11.5%, most being associated with the presenc e of cognitive impairment. Compared with elderly people in private res idential homes, residents in local authority (part III) homes had sign ificantly higher odds of demonstrating offensive behaviour of 1.40 (95 % confidence interval 1.11-1.78) after adjustment for age, sex and cog nitive impairment. No significant association between number of patien ts in the home and the proportion exhibiting offensive behaviour was f ound in any of the non-NHS facilities. Conclusions: this survey of old people in institutional care found that most of those with behavioura l problems were cognitively impaired. This has implications for staff training in the management of behavioural problems in demented people.