Benzodiazepine use in elderly residents of a ritirement village in Sandton: Knowledge, attitudes and perceptions of the patients, the nursing staff and the prescribing doctors

Abstract

Residents of a Retirement Village (Rosehaven), in both the frail and the non-frail sections, were the subjects for this study. They were interviewed to determine demographic characteristics and attitude towards sleep and sleep problems. Subjects living in the frail care facility were compared to those living independently. In addition, the chronic use of benzodiazepines, and the perceptions of both the subjects, and the medical and nursing personnel caring for them, was studied. The physical and mental status of subjects currently taking benzodiazepines was compared with those who were not. No significant differences in demographic features, was found between the frail and the non-frail subjects. However, when subjects taking benzodiazepines were compared with those who were not, several interesting differences were determined. Frail subjects were more likely to be taking benzodiazepines. Sleep difficulties, and perception of poor sleep quality was more likely in the benzodiazepine group. Subjects taking benzodiazepines were more likely to be anxious, and to have suffered falls and resulting injuries. The daily functioning of subjects was rated using three well-validated scales: Instrumental Activities of Daily Living, Mini Mental State Examination, and the Geriatric Depression scale. Those subjects taking benzodiazepines scored significantly worse on all of these scales, independent of frail status (i.e. within both frail and nonfrail groups, subjects taking benzodiazepines scored significantly worse). In spite of the above findings, subjects’ perception of benzodiazepines was positive, and they believed them to be helpful. Nursing staff also perceived benzodiazepines to be beneficial medications. Most of the general practitioners questioned had doubts as to the safety of benzodiazepine use in elderly patients, however they were also generally happy to continue to prescribe them.