Comparative study of two on aged care-based occupational (professional) training in medical home for aged and dependant patients with neuro-psychiatric behaviours

Background: Neuro-psychiatric behaviours of the elderly is the main issue for caregivers' distress, burn out and high turn-over. This situation will steadily worsen with longer lifetime. Aim of the study: Specialised training of medical staff may decrease their distress: we compare both training programs Humanitude (R) et Formadep (R) outcomes. Methods: A comparative open multicentric non randomised study included 459 elderlies of 9 EHPAD of Korian Company into 3 training groups: Humanitude (R) , Formadep (R) and a group control, with 29 weeks follow-up. We studied the scoring NPI-ES (FG and R), BMS-10, ECPA and GIR, medications, caregivers' burn out/absences/turn-over levels. Statistical significance were done by Wilcoxon signed-rank test, Ancova and linear regression. Results: 320 caregivers and 3 groups of nearly 150 elderlies each, with around 50% dementia. In Formadep (R) group : lower scoring for a short time of total NPI-R (p<0.05), sustained lower scoring of NPI-FG "agitation/agressivity" (p=0.035) but transitional for its NPI-R (p<0.05), sustained higher scoring of NPI-FG "apathy/indifference" (p=0.002) but transitional for its NPI-R (p=0.003), sustained lower scoring of NPI-R (p=0.0039) for Motor Aberrant Behaviours (MAB). In Humanitude (R) group: transitional higher scoring of NPI-R (p=0.025) for MAB et transitional lower scoring NPI-R (p=0.0032) for depression (Alzheimer Disease sub-groupe). No change for other parameters. Conclusion: Despite high variability of the neuropsychiatric behaviours in elderly, Formadep (R) training has shown a positive impact on the global distress and on three main challenging behaviours, compared to Humanitude (R) : this may be depend on their own philosophy. But caregivers' burden in dementia is not a one-factor problem.