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Violence in older people with mental illness

  • Charlotte E. O'Callaghan (a1), Anna V. Richman (a2) and Biswadeep Majumdar (a3)

Summary

Aggression is common in older people with mental illness, with 15–43% of community referrals to old age psychiatry services and 44–65% of older people with Alzheimer's disease living in the community exhibiting such behaviour. In psychiatric in-patient units, assaults on staff are most common on wards for elderly people with organic mental illness. There is little high-quality research into the management of aggressive behaviour in dementia. We consider the available literature, which has shown certain behavioural measures and different classes of medication to be of benefit. We discuss factors associated with violence in elderly people with mental illness and potential management options.

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Copyright

Corresponding author

Dr Biswadeep Majumdar, Waterloo Day Hospital, Park Road, Liverpool L22 3XR, UK. Email: deep.majumdar@merseycare.nhs.uk

Footnotes

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Declaration of Interest

None.

Footnotes

References

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Violence in older people with mental illness

  • Charlotte E. O'Callaghan (a1), Anna V. Richman (a2) and Biswadeep Majumdar (a3)

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Violence in older people with mental illness

  • Charlotte E. O'Callaghan (a1), Anna V. Richman (a2) and Biswadeep Majumdar (a3)
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eLetters

Gagan Preeti, CT3 South West London and St George�s Mental Health Trust
10 February 2011

O’Callaghan et al very rightly have highlighted that non-pharmacological management is a realistic intervention in elderly patients to reduce the risk of aggression and violence. NICE guidelines (1)mention individually tailored care plans and approaches like aromatherapy,multisensory stimulation, therapeutic use of music and/or dancing, animal-assisted therapy and massage to be considered in order to reduce agitationand aggression.

I remember during my MRCPsych CASC examination I had to explain thesenon-pharmacological interventions to a patient’s relative who seemed very pleased and relieved that there were some alternatives to medication.

On the one hand, some hospitals and /or care homes don’t provide these services. On the other hand, in the current climate with NHS and social care facing a lot of cuts in near future, it makes me wonder if elderly patients would continue to have access to these very useful therapies. Losing access to the therapies mentioned above could have a detrimental effect on our patients physical and mental health. I think as mental health professionals we have a role in highlighting the importance of these useful approaches that help our patients to a great extent and reduce the risk of violence making it safer for patients, staff and carers.

(1) CG42 Dementia: NICE Guideline, 1.7.1 Non-pharmacological interventions for non-cognitive symptoms and behaviour that challenges
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Conflict of interest: None Declared

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