The impact of residential respite care on the behavior of older people

Study Aim/Purpose: The aim of this study was to examine the impact of residential care on disruptive behavior displayed by older adults, particularly those with dementia. 

Summary of Methods: The study used a quasi-experimental, longitudinal, single group design. Over a 12-month period 100 older adults (mean age of 81.8 years), who were admitted to one of several residential aged care facilities in a provincial Australian city, and their caregivers were included in this study. Baseline data were obtained for each respite recipient when the respite session was booked at admission and the frequency of their disruptive behavior was rated on the Dementia Behavior Disturbance Scale (DBDS) by the home caregiver who had the most regular contact with the respite recipient and the primary nurse in the residential facility. Data for the DBDS were collected on three occasions, 1) fortnightly, prior to the subjects entering the residential facility; 2) one to four occasions weekly during the respite care, depending on the duration of respite care; and 3) and at one and two months post-respite. 

Summary of Key Results: Time series regression analysis “confirmed significant differences in mean DBDS scores across time.” Specifically, residential respite care was associated with a lower DBDS score during the first week in residential respite care than compared to pre-respite. “In addition, the DBDS score for four weeks of residential respite care was significantly lower than for the two post-respite data collection points.” Thus, while respite had a short-term impact on the frequency of disruptive behavior in older people, “respite had no enduring impact on behavior.”

Study Limitations (as cited by authors): “There were different raters when the respite recipient was at home and in the residential aged care facilities… Although we had previously shown good inter-rater reliability between these groups of raters, it remains possible that the nurses had a higher threshold than the home caregivers for rating disruptive behavior.” The authors also pointed out that the study was not a randomized controlled trial, and the study sample was not ethnically diverse. 

Authors’ Discussion/Conclusions: Despite the study limitations the authors note that this study used a strong longitudinal prospective repeated measures design and a reasonably large sample size. The authors state that their finding of the temporary reduction in the frequency of disruptive behavior while in respite care “should reassure both family carers considering placing a relative in residential respite care and health workers considering whether to recommend such a course of action.”