Use of physical restraints and antipsychotic medications in nursing homes: a cross-national study.

Objectives: This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments.

Methods: Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries.

Reliability of the interRAI suite of assessment instruments: a 12-country study of an integrated health information system.

Background: A multi-domain suite of instruments has been developed by the interRAI research collaborative to support assessment and care planning in mental health, aged care and disability services. Each assessment instrument comprises items common to other instruments and specialized items exclusive to that instrument. This study examined the reliability of the items from five instruments supporting home care, long term care, mental health, palliative care and post-acute care.

[Fall risk factors and fall injuries in hospitalized elderly patients].

Fall Risk Factors have been analysed (RAI-MDS-System) in a population of patients, who were hospitalised between 1995 and 2000 in a geriatric department of a community hospital. In multivariate analysis, viseral-problems, incontinence and depression were fall-protective factors, whereas problems with transfer, the use of assistive walking-aids, female gender and age were fall risk-factors. No independent contribution to the fall-risk was delivered by memory-impairment, problems in decision-making, low body-mass-index, the use of more than three medications and the use of restraints.

[Detection and treatment of depressive symptoms in nursing home patients. An interdisciplinary challenge for the geriatric physician and nursing personnel].

40% of nursing home patients have depressive symptoms and 20% have a diagnosis of depression according to DSM-IV or ICD-10 classification. Depressive Symptoms in nursing home patients are underdiagnosed and undertreated. We report a triple pharmacological, psychosocial and staff teaching intervention in a nursing home based on the Resident Assessment Protocols (RAP) trigger mechanism of the Resident Assessment Instrument (RAI) that was able to significantly and persistently reduce the prevalence of depressive symptoms in this population.