Antipsychotic use for behaviours by persons with dementia in residential aged care: the relatives’ perspectives

Abstract

Objective: To explore relatives’ experience, knowledge and perceptions of challenging behavioural and psychological symptoms of dementia (BPSD) and association with antipsychotic use for persons with dementia in residential aged care.

Design: A qualitative Interpretive Description design using semi-structured interviews was used for understanding the construct and context of perceptions and experiences using a six-step process to analyse themes.

Settings: South Australia, Victoria and Western Australia.

Subjects: Six relatives of a person with dementia in residential aged care.

Main Outcome Measure: Themes describing relatives’ experiences, knowledge and perceptions of antipsychotic medication use for  the person with dementia in residential aged care.

Results: Three themes were identified: 1) lack of education and information - relatives found it difficult to differentiate between behaviours influenced by disease or antipsychotic medication; 2) need to be included in decision-making - relatives’ believed challenging behaviours resulting from BPSD could be prevented with a more person-centred approach; and, 3) influence of aged care culture on attitudes towards use of antipsychotic medication - relatives’ identified this could be problematic depending on use of agency staff and time pressures.

Conclusion: Relatives of persons with dementia require support and education about the progression of dementia, BPSD and the risks and benefits that antipsychotic medication may have on BPSD. Most importantly, relatives need to be involved in decision-making regarding the use of antipsychotic medication. Nurses have a role to educate care staff on the use of person centred care in preference to medication for better care of the person with dementia.