Problem: Acute behavioural disturbances are challenging to manage in an elderly population, who are at increased risk of adverse outcomes. This is further complicated following declaration of a public health emergency 29/1/2020 due to the coronavirus pandemic.
Aims: Assess the impact of COVID-19 in management of acute behavioural disturbances in an elderly population.
Methods: Retrospective cohort study of management of acute behavioural disturbances in an elderly (≥65 years-old) cohort in 2020 (n=100) when compared with preceding 2019 (n=100) within a tertiary centre. Data was collected from electronic records and discharge summaries.
Results: There was no significant difference in the usage of oral risperidone as a first-line agent (p=0.5), nor between the choice of an oral route vs. alternate route in first-line agents (p=0.66). There was a statistically higher rate of documentation of non-pharmacological approach in 2020 (47%), over 2019 (24%) (p=0.00001). There was increased employment of ancillary services (geriatric consult, delirium nurse, consult liaison psychiatry) to aid with management in 2020 (30.33%), when compared with 2019 (22%) (p=0.02). Whilst there was no significant difference between the rate of sedative agents continued on discharge (p=0.6), in both years only 1% of discharge summaries relayed weaning plans.
Conclusions: This study found no statistically significant difference in the choice of first-line agents before and during the coronavirus pandemic. However, there was a signal that labour-intensive non-pharmacological management, or at least its’ documentation, was reduced as a result of the staff shortages and work pressures in the health sector leading up to the pandemic.