Effect of Relocation on Neuropsychiatric Symptoms in Elderly Adults Living in Long-Term Care.

OBJECTIVES

To determine the evolution of behavioral and psychiatric symptoms of dementia (BPSD) in nursing home (NH) residents after an environmental change through a relocation to a more architecturally suitable facility, while conserving the same medical staff.

DESIGN

Prospective, single arm study.

SETTING

Long-term care unit.

PARTICIPANTS

NH residents (N=116; median age 82.3, range 75.5-89.2; median Neuropsychiatric Inventory for the Nursing Home (NPI/NH) score 22, range 11-34.5; 66.3% female), of whom 102 lived in regular units and 14 in specialized care units (SCUs).

MEASUREMENTS

Neuropsychiatric symptoms were evaluated as part of a comprehensive geriatric assessment for each resident 1 week before the relocation and 3 times after the relocation (1, 4, 12 weeks) using the NPI/NH.

RESULTS

A mixed-effect linear model found no significant change in global NPI/NH score in the regular unit and a significant decrease in overall NPI/NH score 4 weeks after relocation in the SCUs (β-coefficient for time by SCU=-11.5, 95% confidence interval (CI)=-17.9-5.2, p < .001), reaching a total decrease of 13 points by 12 weeks after relocation (β-coefficient for time by SCU=-12.8, 95% CI=-19.1-6.4, p < .001). A statistically significant decrease of 3 points for disinhibition, apathy, and agitation accompanied the NPI/NH score in the secured unit. An increase of 3 points in aberrant motor behavior was seen by 12 weeks after relocation in the SCU.

CONCLUSION

Relocation to an architecturally different facility significantly reduced BPSD of NH residents 1 month after relocation. J Am Geriatr Soc 66:2183-2187, 2018.