When PTSD Is Present, Veterans With Dementia May Show Aggression When Rejecting Care

A behavioral assessment analysis of 66 veterans with dementia who were long-term care residents identified four patterns of triggers and resulting behaviors, according to a study published online ahead of print in the Journal of Advanced Nursing. 

“Classifying behavioral symptoms with their triggers rather than solely by behaviors provides important new information for developing person-centered, nonpharmacological interventions to improve outcomes for veterans with dementia,” researchers wrote. 

The study analyzed text data for 66 veterans with dementia from the Staff Training in Assisted Living Residences-Veterans Health Administration (STAR-VA) intervention from 2013 to 2016.  

The four trigger-behavior patterns identified in the study were: (1) unmet physical needs or emotional distress triggering nonaggressive behavior; (2) unsolicited direct care triggering care refusal, resistance, or combativeness; (3) interpersonal interactions that interfere with self-direction triggering aggressive behavior; and (4) uncontrolled stimulation from environment triggering nonaggressive behaviors. 

Veterans with dementia and posttraumatic stress disorder tended to reject care with aggression compared with veterans with dementia without coexisting posttraumatic stress disorder, according to the study. 

“Distinct patterns of symptom manifestations between veterans with and without posttraumatic stress disorder suggest a tailored approach is required to meet each veteran’s unique biopsychosocial needs,” researchers advised.

Reference: 

Kang B, Karel MJ, Corazzini KN, McConnell ES. A mixed methods study on the manifestations of behavioural symptoms of dementia among veterans with and without posttraumatic stress disorder. J Adv Nurs. 2021;77(7):3176-3188. doi:10.1111/jan.14864