Person-Centered Primary Care Strategies for Assessment of and Intervention for Aggressive Behaviors in Dementia.
Anand Desai, Tracy Wharton, Laura Struble and 1 others
PMID 28128394WHAT IT FOUND
A clinician stopped treating an 89-year-old man’s aggression with sedatives and instead identified that his liquid medication burned his raw throat, causing him to believe he was being poisoned.
Coaching the son to explain tasks and tapering the drugs reduced the assaults.
Key findings
01Aggression in dementia may stem from a specific physical trigger misinterpreted by the patient, rather than the disease itself.
02Tapering psychotropic medications and coaching the caregiver on communication resulted in less frequent physical assaults and reduced confusion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The case is a fictional composite created from several real cases, which limits its generalizability. As a single case report, it cannot prove that this specific intervention works for other patients. The authors note that the behaviors occurred as presented, but the patient identity is constructed.
Declared interests
Dr. Wharton receives support from an extramural NIH LRP award. The authors declare no other conflicts of interest.
The easy way to misread this
Do not assume that tapering sedatives will always reduce aggression or confusion. This specific outcome relied on identifying a unique physical trigger (esophageal pain from liquid medication) that was misinterpreted as paranoia. Without this specific diagnosis, the intervention might not have worked.