Ablehnendes Verhalten bei älteren psychiatrischen Patienten

 

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Zusammenfassung

Anliegen: Charakterisierung von älteren psychisch Kranken mit ablehnendem Verhalten.

Methoden: Auswertung der Daten von 1266 stationären Aufnahmen (≥ 65 Jahre).

Ergebnisse: 150 (11,8 %) Patienten zeigten ablehnendes Verhalten. 89 (7,0 %) verweigerten die Einnahme von Medikamenten und 94 (7,4 %) pflegerische Maßnahmen. Während pflegerische Maßnahmen vor allem von schwerer Demenzkranken abgelehnt wurden, verweigerten besonders Patienten mit einer wahnhaften Symptomatik die Medikamenteneinnahme.

Schlussfolgerung: Ablehnende Verhaltensweisen treten bei verschiedenen psychiatrischen Störungen im Alter in unterschiedlichem Maße auf.

Abstract

Objective: Rejecting nursing or medication is an increasing challenge for professional care in elderly people.

Methods: This explorative study was part of the Gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within 3 years (1266 admissions).

Results: 150 cases (11.8 %) rejected care. 94 (7.4 %) refused nursing and 89 (7.0 %) medication intake. 79.3 % of them suffered from organic brain diseases, particularly from delirium superimposed on dementia (ICD-10 F05.1). Nursing was more often rejected by older and more severely cognitive impaired patients, while refusal of medication was associated with delusions.

Conclusions: Resisting nursing and refusing medication are 2 separate behavioral syndromes that may also occur together.

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