Short Research Report Treatment in Nursing Home versus Hospital for Patients with Behavioral and Psychological Symptoms of Dementia A Pilot Study Stein-Arne Hval 1 , Kari Midtbø Kristiansen 1 , Bernhard Lorentzen 1 , Lisbeth Fagerstrøm 2 , and Lars Tanum 3 1 Department of Geriatric Psychiatry, Diakonhjemmet Hospital and Medical College, Oslo, Norway, 2 Buskerud University College, Campus Drammen, Norway, 3 Department of Research and Development in Psychiatry, Akershus University Hospital and University of Oslo, Norway GeroPsych, 25 (2), 2012, xxx–xxx DOI 10.1024/1662-9647/a000058 Abstract. Introduction: This article is concerned with the optimal treatment of behavioral and psychological symptoms present in patients with dementia. This pilot study compares the benefits of an ambulant treatment intervention in nursing homes to hospital admission . Material and Methods: Patients referred for hospital admission were randomized to either hospital admission or ambulant treatment intervention in their nursing home. Registration of behavioral and psychological symptoms of dementia (BPSD) together with the care- giver’s distress were assessed at T1, T2, and T3 using the Neuropsychiatric Inventory (NPI). Results: Both treatment groups showed a statistically significant reduction in BPSD, and there was no significant difference between the groups in total score of NPI. NPI-reported carer distress was reduced in both groups, and this was statistically significant for the intervention group. Keywords: geriatric psychiatry, dementia, BPSD, neuropsychiatric symptoms of dementia, treatment intervention Introduction The most common term used to describe the many psycho- logical reactions, psychiatric symptoms, and the inappropri- ate conduct that may develop in individuals with moderate to severe dementia is behavioral and psychological symptoms of dementia (BPSD) (Finkel, Costa[in refs Costa e Silva], Cohen, Miller, & Sartorius, 1996). Its usual manifestations may be divided into three symptom clusters (Mirakhur, Craig, Hart, Mcllroy, & Passmore, 2004; Robert et al., 2005): – hyperactivity, including aggression, psychomotor agita- tion, irritability and lack of social inhibition, – psychotic symptoms, including hallucinations, and de- lusions, – affective symptoms, including depression, anxiety and apathy. Persons with severe BPSD usually need long-term treat- ment and special health care services (Finkel et al., 1996). A recent national study in Norway showed that up to 81% of the residents in nursing homes suffered from dementia, and that 72% thereof had already developed BPSD or dis- played a range of the symptoms (Selbaek, Kirkevold, & Engedal, 2007). In Norway, the municipalities and their nursing homes treat most patients with BPSD.m, whereas patients with se- vere BPSD are admitted to geriatric psychiatric hospital ser- vices. Due to the increasing number of elderly people, geri- atric psychiatric hospital services will probably need to inter- act more closely with the municipalities and their nursing homes in order to meet the health challenges posed by BPSD. A further aspect of BPSD is that the condition may wors- en if the patients are taken out of their daily routines and surroundings and admitted to a hospital (Nygård, 2008). It may, therefore, be beneficial to perform treatment within the patient’s existing social and physical environment. GeroPsych 25 (2) © 2012 Hogrefe Publishing