Psychoactive medications in the long-term care setting: differing perspectives among physicians, nursing staff, and...

Differences in perceptions among nursing home patients, nursing staff, and physicians were compared in this preliminary study regarding nighttime disorders and psychoactive medications. Nighttime disorders, including both insomnia and behavior problems, are prevalent among institutionalized elderly and are frequently managed with psychoactive medications. All nursing home patients receiving psychoactive medications, the nursing staff, and the physicians involved in their care were interviewed regarding the description, etiology, management, and impact of the nighttime disorder including side effects of the prescribed medications. Overall, the differences in responses among the three groups ranged from 47% to 63%. While both physicians and nurses reported problems more often than did the patients, nurses reported problems more frequently than did physicians. This preliminary study suggests that patients, nursing staff, and physicians perceive nighttime disorders and their management differently. These differences point to the need for improved methods of communication and education to mutually identify the targeted disorder and develop appropriate management.