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Updated: Apr 7, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
[Rejection of Care (Nursing or Medication) in Elder Psychiatric Patients]
1Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Hellersdorf, Berlin.
Objective:
Rejecting nursing or medication is an increasing challenge for professional care in elderly people.
Methods:
This explorative study was part of the Gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within 3 years (1266 admissions).
Results:
150 cases (11.8 %) rejected care. 94 (7.4 %) refused nursing and 89 (7.0 %) medication intake. 79.3 % of them suffered from organic brain diseases, particularly from delirium superimposed on dementia (ICD-10 F05.1). Nursing was more often rejected by older and more severely cognitive impaired patients, while refusal of medication was associated with delusions.
Conclusions:
Resisting nursing and refusing medication are 2 separate behavioral syndromes that may also occur together.
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