Agitation and Aggressiveness: The Importance of a Consensus

(From: Highlights of the Consensus Conference Agitation and Aggressiveness in the Cognitively Impaired Elderly Patient, Queen Elizabeth Hotel, Montréal, April 19 1990, STA Communications.)

Bernard Groulx, MD

"The purpose of a consensus conference is, quite obviously, to arrive at a consensus on a particular subject, insofar as it is possible, one which will serve as a standard for other caregivers; in this particular case, these would be mostly general practitioners who are faced with the psychogeriatric problem much more than we are," explained Dr. Bernard Groulx at the opening of the consensus conference on agitation and aggressiveness in the cognitively impaired elderly, held on April 19, 1990 at the Queen Elizabeth Hotel in Montreal. Dr. Groulx is psychogeriatrician at Ste. Anne's Hospital in Sainte-Anne-de-Bellevue and professor at McGill University in Montreal.

"Of the six psychiatrists seated at this table today, three are fathers of psychogeriatric medicine in Quebec, and five have been, or are now, president of the Société de psychogériatrie du Québec," continued Dr. Groulx. "They will discuss a problem which is of major importance: agitation and aggressiveness in the patient with dementia, a clinical disorder which is common, sometimes devastating, and often poorly understood and inadequately treated."

"To begin with, it must be understood that everything we discuss today must be seen in the context of the relationship with the patient. Secondly, the management of the environment, internal and external, must be taken into account. Finally, there is a need for better understanding of the psychopharmacology which is available to us."

"We must look forward to an ever increasing number of elderly people," explained Dr. Groulx. "It is, therefore, predictable that problems of agitation and aggressiveness will increase considerably in the coming years, not only in institutions, but very frequently in the home as well."

"We might well ask ourselves, continued Dr. Groulx, what impact this increase will have on the health care system, which as well as being unable to meet all the demands for institutionalization, will also be faced with the clinical distress of caregivers, manifested in such phenomena as ‘burnout' and depression." Dr. Groulx concluded by underlining the importance of being able to give general practitioners clear concepts on aggressiveness and agitation, reminding them of their foremost importance in the identification and treatment of these behavioral disorders.