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Stealing lately: a case of late-onset kleptomania
- Authors:
- McNEILLY Dennis, BURKE William J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 13(2), February 1998, pp.116-121.
- Publisher:
- Wiley
Discusses the case of a 77-year-old woman first diagnosed with kleptomania to indicate a possible late-onset course of this disorder. Particularly striking about this patient's history of shoplifting behaviours was the absence of an onset prior to the age of 73. Her pattern of stealing did not begin at an early age, and was not sporadic or episode over the course of several years. The treatment course and patient outcome are discussed.
Behavioural and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment
- Authors:
- FINKEL S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(11), November 1997, pp.1060-1061.
- Publisher:
- Wiley
Provides a definition of the behavioural and psychological stress and symptoms of dementia. Concludes with a summary of current thinking on approaches to this problem.
Single case evaluation of the effects of aromatherapy and massage on disturbed behaviour in severe dementia
- Authors:
- BROOKER Dawn J.R., et al
- Journal article citation:
- British Journal of Clinical Psychology, 36(2), May 1997, pp.287-296.
- Publisher:
- Wiley
Aromatherapy and massage could provide a useful addition to psychological therapeutic interventions with clients suffering from dementia. Evaluates the effects of aromatherapy and massage on disturbed behaviour in four individuals with severe dementia using a single-case research design. Results found that the treatments were mixed. The opinion of the staff providing treatment was that all participants benefited. On close scrutiny, only one of the participants benefited from the aromatherapy and massage to a degree that reached statistical significance. In two of the cases aromatherapy and massage led to an increase in agitated behaviour. The importance of the single case study approach with this client group is discussed.
Aggressive behaviour and environmental characteristics in Australian nursing homes
- Authors:
- SHAH A., CHIU E., AMES D.
- Journal article citation:
- Aging and Mental Health, 4(1), February 2000, pp.43-47.
- Publisher:
- Taylor and Francis
Aggressive behaviour is commonly observed in nursing homes for the elderly. It causes distress to carers, and leads to hospitalisation, over-medication and physical restraint. Environmental factors can influence aggressive behaviour. A 6-month prospective study was undertaken examining the relationship between aggressive behaviour and environmental characteristics of nursing homes in Melbourne. There is no significant relationship between aggressive behaviour and environmental characteristics of the nursing homes. Methodological issues may explain this lack of association. Avenues of future research are discussed.
The outcomes of an inpatient treatment program for geriatric patients with dementia and dysfunctional behaviors
- Authors:
- HOLM Alvin, et al
- Journal article citation:
- Gerontologist, 39(6), December 1999, pp.668-676.
- Publisher:
- Oxford University Press
Evaluates the outcomes of an inpatient programme in the USA, designed to reduce severe agitated behavior in geriatric patients with dementia who could not be successfully treated on an outpatient basis. An individualized treatment plan was created for each patient that involved pharmacological and nonpharmacological interventions with behavioural, environmental, and psychological components. Significant improvements on these assessments were observed. Concludes that the longitudinal, multidisciplinary approach used in this study was effective in significantly reducing intrusive and dangerous behaviours while preserving or enhancing patients' cognitive and functional abilities.
Typology of disruptive vocalizations in older persons suffering from dementia
- Authors:
- COHEN-MANSFIELD Jiska, WERNER Perla
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(11), November 1997, pp.1079-1091.
- Publisher:
- Wiley
Verbal and vocal disruptive behaviours (VDB) are important clinical features in dementia because they frequently signal discomfort experienced by an elderly person and because they are disturbing to caregivers; thereby affecting the care of elderly persons manifesting them. This article describes a typology of VDB, the Typology of Vocalisations - TOV. The article reports interrater reliability of the typology and validates it against Ryan's classification of verbal and vocal disruptive behaviours. Critical dimensions of the typology are examined and used for its refinement. Finally, use of the TOV for matching individuals to the most effective intervention is demonstrated.
Behaviour changes in dementia 2: are there behavioural syndromes?
- Authors:
- HOPE Tony, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(11), November 1997, pp.1074-1078.
- Publisher:
- Wiley
Reports on research seeking to establish whether robust behavioural 'syndromes' can be identified from among the widely heterogeneous behavioural changes which occur in dementia. Participants were elderly people with a diagnosis of Alzheimer's Disease or vascular dementia and who were living at home with a carer in Oxfordshire. Each subject's behaviour was assessed in detail at each interview using the Present Behavioural Examination to assess the subject's behaviour over the preceding four weeks. Three syndromes identified: overactivity, aggressive behaviour and psychosis. The same syndromes were found using data collected at three different time points and by using a variety of statistical techniques, confirming their robustness. Concludes that overactivity, aggressive behaviour and psychosis form three distinct behavioural syndromes in dementia.
Dealing with and understanding challenging behaviours
- Author:
- PARKER Jonathan
- Journal article citation:
- Elders the Journal of Care and Practice, 4(3), August 1995, pp.5-16.
Presents some of the content of workshops which were run by the author to prepare staff to deal with challenging and difficult behaviours.
A randomized, placebo-controlled trial of thiothixene in agitated, demented nursing home patients
- Authors:
- FINKEL Sandford I., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(2), February 1995, pp.129-136.
- Publisher:
- Wiley
The therapeutic efficacy of thiothixene in the treatment of behaviourally agitated dementia nursing home patients was studied in a double-blind, randomised, placebo-controlled clinical trial. Thiothixene was significantly more effective than placebo in the reduction of agitation at the end of eleven weeks treatment. Symptoms tended to return after discontinuation. The results suggest the efficacy of low doses of thiothixene for well-defined agitation in specifically selected demented nursing home patients.
A retrospective study of the behavioural and psychological symptoms of mid and late phase Alzheimer's disease
- Authors:
- HART D. J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(11), November 2003, pp.1037-1042.
- Publisher:
- Wiley
This article seeks to document the behavioural and psychological symptoms in patients with a diagnosis of established Alzheimer's disease (AD) for at least 3 years. Patients with a 3 year history of AD (NINCDS/ADRDA) were recruited from old age psychiatrist and elderly care memory clinics. Information regarding duration of symptoms and non-cognitive symptomatology was obtained during interview with a carer or next-of-kin who had contact with the patient at least 3 times a week and for at least 3 years. MMSE, FAST and NPI including caregiver distress, were used to assess cognition, function and behavioural/psychological disturbance respectively. With each non-cognitive symptom the carer was asked to estimate its onset. The mean age of patients was 77 years and duration of illness 87 months. Mean MMSE was 8/30 and FAST score 6d. Of the psychological symptoms occurring at any stage, depression (56%), delusions (55%) and anxiety (52%) were most common, with hallucinations, elation and disinhibition occurring less frequently. In general, behavioural changes were more common with apathy occurring in 88% of patients, motor behaviour in 70%, aggression in 66%, irritability and appetite changes in 60% and sleep disturbance in 54%. All symptoms except apathy became less common when the carer was asked if they were still present in the last month. Mean onset of psychological symptoms was 47 months. Mean onset of behavioural symptoms was 48 months. Behavioural disturbance seemed to cause more care-giver distress than psychological change. The results show behavioural and psychological symptoms in AD are common and distressing for carers. They appear to require a consistent period of neurodegeneration in order to emerge.