The Need for Institutionalization for Patients with Agitation in Alzheimer’s Dementia from Caregiver and Prescriber’s Perspectives

Background
Agitation associated with Dementia due to Alzheimer’s disease (AADAD), characterized by exaggerated motor activity and verbal and/or physical aggression, is common in Alzheimer’s disease, and often increases caregiver burden resulting in the need for institutionalization. This study compares attitudes and perspectives of informal caregivers (ICs), formal caregivers (FCs), and prescribers (PRs) towards institutionalization.
Methods
This is a cross-sectional non-interventional study based on data collected in an online survey administered in the United States. Respondents were recruited and consented through panel employing the IRB approved screening questions and consent form.
Results
Among 164 ICs, 150 FCs, and 153 PRs; 98%, 44%, and 100% respectively answered the survey considering a non-institutionalized person. When answering questions regarding institutionalization, physically aggressive behavior was the most likely trigger across all respondents, but with different thresholds. An increase in physically aggressive behavior from a weekly to daily occurrence resulted in an increased proportion of respondents considering institutionalization: 47% to 82% for ICs, 47% to 77% for FCs, and 33% to 44% for PRs. Verbally aggressive behaviors were less likely to prompt institutionalization but remained important with high frequencies. Approximately 20% of all respondents would not consider institutionalization solely due to non-aggressive behaviors.
Conclusion
Our findings reveal that FC and IC are more likely than PR to consider institutionalization when frequent physically aggressive behaviors increase. This study highlights the significant impact of agitation on caregiving burden, the similarities and differences of agitation impact among various types of healthcare providers and their considerations for patient care setting.