What Environmental and Staffing Characteristics Predict Behavioural and Psychological Symptoms of Dementia in Nursing Home Residents?

Background: Behavioural and psychological symptoms of dementia (BPSD) are common in nursing home residents and distressing. Factors leading to their occurrence are incompletely understood. Aim: To investigate environmental and staffing variables associated with the prevalence of BPSD. Methods: Survey of Directors of Nursing and 505 residents of 11 nursing homes in the eastern suburbs of Sydney. Resident variables included measures of cognition, dependency, and BPSD using the BEHAVE‐AD. Directors of nursing completed a questionnaire that rated physical design, staff and resident characteristics. Results There was a two‐to three‐fold difference in the prevalence of total and subscale scores on the BEHAVE‐AD. Higher scores were associated with higher resident to bedroom ratio, living with less functional residents, lower levels of staffing, less staff training, fewer activities for residents and management less geared towards managing difficult behaviours. Conclusion: The number of residents sharing a bedroom, the mix of residents' functional capacity, staff numbers and training and the use of activity programs may influence BPSD.