The Research Question

"Other than use of physical restraints or prescription of psychotropic medications, what interventions, strategies, and/or practices have proven effective in preventing and managing agitation and aggression in long term care residents with dementia?”

• EVIDENCE UPDATE

• FULL REPORT

• 4-PAGE SUMMARY

• 1-PAGE BRIEFING NOTE

• ONLINE COMPANION DOCUMENT

Background

The Newfoundland and Labrador Department of Health and Community Services (DHCS) and its four Regional Health Authorities (RHAs) formally asked the Contextualized Health Research Synthesis Program (CHRSP) to identify and evaluate the best available research-based evidence on the management of aggression in long-term care (LTC) residents with dementia. Though this research topic was initially suggested by authorities at Eastern Health, consultations with the province’s other RHAs and with the DHCS revealed that this was a high-priority issue across the province.

CHRSP personnel assembled a project team that included officials from Eastern Health and two other RHAs. Dr. Neena Chappell, Canada Research Chair in Social Gerontology and Professor of Sociology at the University of Victoria, agreed to serve as Academic Team Leader for the project.

In their initial description of the topic, Eastern Health officials framed the issue as follows:

“Aggression in residents with dementia poses both safety and quality care issues for all stakeholders in LTC (i.e. resident, family, nursing, allied health, etc.)…. By understanding what triggers aggression and the strategies and interventions that work best to reduce aggression, we can achieve and maintain a safer environment for residents and staff in LTC.”

At the first project meeting, team members decided that the scope of the requested synthesis should be broadened to include evidence on prevention and management of two closely-linked behavioural symptoms of dementia: agitation and aggression. At the same time, because moderate-to-severe dementia is far more prevalent in LTC than in other senior care settings, the team decided to restrict the focus of the synthesis to LTC, rather than including personal care homes or assisted living facilities.

The CHRSP Project Team:

• Dr. Neena Chappell, Professor of Sociology University of Victoria (Team Leader)
• Dr. Stephen Bornstein, Director, NL Centre for Applied Health Research (CHRSP Program Director)
• Rob Kean, Research Officer, NL Centre for Applied Health Research (CHRSP Project Coordinator)
• Sarah Mackey, Research Assistant, NL Centre for Applied Health Research (CHRSP Research Assistant)