Preview

Aged Care

Best Essays
Open Document
Open Document
5001 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Aged Care
Caring For People with Disruptive Behaviours

Caring for older people can be very complex, due to the effects that aging has on the body, add to this complex situation, dementia, and it becomes even more complex. The behavioral disturbances that are common for this group of people are, hitting, screaming, biting, resisting care, wandering, self-harm, nocturnal wakefulness, refusal to eat, frequent and unnecessary toilet requests, and intrusion (Adams, 2008). Acute care nurses are expected to deal with serious illnesses along with the behaviour issues of elderly people, which can be exacerbated by hospitalization. (Adams, 2008). This paper will examine the behaviours displayed by people with dementia in the acute setting, and strategies to provide appropriate care and manage these behaviours.

In the acute setting and some residential aged care facilities, the nursing approach to these situations is to ignore the patient or to rely on the restrictive measures, for example, physical or chemical restraints (McCloskey, 2004). Physical restraints are anything that prevents a person from free flow of moment. Chemical restraints are sedatives, antipsychotics etc (Wang&Moyle, 2004). These approaches are initiated to minimize or eliminate the particular behavior in question, thus reflecting ignorance to the needs of the older person with dementia (SullivanMarx, 2001: GP and Residential Aged Care Kit, 2006).

Nurses can no longer take a reactive approach to these issues due to the scope and complexity of the issues. Nursing staff should adopt a more proactive approach and carefully plan the care for patients who have dementia (Dewing, 2001: GP and Residential Aged Care Kit, 2006). There are models of care that can be followed, which help to reduce the stress factors for these patients, thus in turn reducing the stress, frustration and aggravation for the nursing staff. These models of care have also been proven to enhance the level of care and improve the quality of life for



References: Adams, T. (2008). Dementia Care Nursing: Promoting Well-Being In People with Dementia and their Families. Hampshire: Palgrave MacMillan. Agahi, N. (2004). Developement in health and health promotion in later life: a compliation of competencies. Stockholm Gerentology Research Center. Sweden . Bakker, R. (2003). Sensory loss, dementia,and environments. Generations , 46-51. Bartels, Stephen, J., Dums, Aricca, R., Oxan, Thomas, E., Schneider, Lon, S., Arean, Patricia, A., Alexopolous,George,S. and Jeste,Dillip, V. (2004). Health Care. Focus The Journal in Lifelonf Learningin Phsychiatry , 11(2), 268-280. Bassiony, Medhat,M. and Lyketos, G. (2003). Delusions and Halluciantions in ALzheimers Disease: Review of the Brain Decade. Psychosomatics , 44(5),388-400. Bergman, J. & Lerner, V. (2002). Successful use of donepezil for the treatment of psychotic symptoms in patients with Parkinson 's disease. Clinical Neuropharmacology , 25:107-110. Bergmark, A. Parker,M.G.Thorslund, M. (2000). Priorities in care and services for elderly people: a path without guidelines. Journal Of Medical Ethics , 26(5)312-318. Brooker, D. (2007). Person-Centred Care. London: Jessica Kingsley Publishers. Cohen-Mansfield, J. (2004). Nonpharmacologic Interventions for Inappropriate Behaviours in Dementia:A Review,Summary, and Critique. Focus The Journal of Lifelong Learning In Psychiatry , 2:288-308. Dewing, J. (2001). Care for older people with a dementia in acute hosputal settings. Nursing Older People , 13:18-20. Dyer, C.B., Hyer,K., Feldt,K.S., Lindeman,D.A., Busby-Whithead,J., Greenberg,S., Kennedy, K.D., and Flaherty, E. (2003). Frail older patient care by interdiciplinary teams: a primer for generalists. Gerontoloy and Geriatric Education. , 24(2)51-62. Edvardsson, David.& Nay,Rhonda.(2009).Acute Care and Older People: challenges and ways forward. Australian Journal Of Advanced Practice,27(2)62-69 Fergusson, E Gilster, S. Acconrinti,K. Dalessandro,J. (2002). Providing a continuum of care for persons with Alzheimer 's disease. Alzheirmer 's Care Quarterly , 3:103-115. GP and Residential Aged Care Kit,(2006). Clinical Information Sheet- Dementia: Behavioural and Psychological Symptons. The North West Melbourne Division of General Practice. Retrieved May 1st, 2010, from nwmdgp.org.au Jeste, D.V.& Twamley, E.W Lawlor, B. (2002). Managing behavioural and psychological symptoms in dmentia. British Journal of Psychiatry , 181:463-465. Lindsbeth,M.A., Marhaug, V., Norberg,A.,& Uden G. (2008). Registered nurses ' and physicians ' reflections on their narratives about ethically difficult care episodes. Journal of Advanced Nursing , 20(2)245-250. Lucero, M. (2002). Intervention strategies for exit seeking wandering behaviour in dementia residents. American Journal Alsheimer 's disease other dementias , 17:277-280. Madan,S (2005). Music Intervention for Disruptive Behaviourd in Term Care Residents with Dementia. Annals of Long Term Care , 13:12. McCloskey, R. (2004). Caring for patients with dementia in an acute care environment. Geriatric Nursing , 25(3). Miller, C. (1999). Nursing care of older adults:theory and practice 3rd ed. Philadelphia: Lippincott. Neurgroschi, M. (2002). How to manage behaviour disturbances in the older patient with dementia. Geriatrics , 33-37. Neville, Christine. C. and Byrne, Gerard. (2002). Behaviour of older people admitted to Residential Respite Care. Australian Journal Of Advanced Nursing , 20 (1) 8-12. Nordam, A. Sorlie, V. & Forde, R. (2003). Integrity in the care of elderly people, as narrated by female physicians. Nursing Ethics , 4:388-403. Overshott, R., Byrne, J., & Burns, A. (2004). Nonpharmacologicol and pharmacological interventions for symptoms in Alzheimer 's disease. Expert Review of Neurotherapeutics , 4: 809-821. Smith, Marianne and Buckwalter, Kathleen. (2005). Behaviours Associated with Dementia. American Journal of Nursing , 105(7),40-52. Sorlie, V., Kihlgren A.& Kihlgren, M. (2005). Meeting ethical challenges in acute nursing care as narrated by registered nurse. Nursing Ethics , 2:134-142. Sullivan-Marx, E. (2001). Achieving restraint-free care of acutely confused older adults. Journal of Gerontology Nursing , 28:56-61. Targum, S. (2001). Treating psychotic symptoms in elderly patients. Primary Care Companion to the Journal of Clinical Psychiatry , 3:156-163. Torjuul, Kirsti., and Sorlie, Venke. (2006). Nursing is different than medicine: ethical difficulties in the process of care in surgical units. Journal of Advanced Medicine , 56(4) 404-413. Uden, G., Norberg, A., Lindseth A. & Marhaug, V. (1992). Ethical reasoning in nurses ' and physicians ' stories about care episodes. Journal of Advanced Nursing , 9:1028-1034. Wang, Wei Wei, and Moyle, Wendy. (2004). Physical Restraint Use On People With Dementia: A Review Of The Literature. Australian Journal Of Advanced Nursing , (22)4,46-52. Willick, Cheryl & Willick Rebeeca. (2005). Dementia Care in Acute Care: A literature Review. Alzeimers Association , Retrieved May 10th, 2010, from www.alzheimers.org.au.

You May Also Find These Documents Helpful

  • Good Essays

    Ms. Lee is a 96 year old female who lives alone. Lately she has become a hazard to herself. She leaves pots on the stove and they could possibly burn her apartment down. She needs assistance with a cane but refuses to use it. Ms. Lee is a potential hazard to herself and possible to others who live in her building. Ms. Lee could possibly overdose from several pills being laid out and scattered everyone.…

    • 740 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    At present dementia patients often receive very poor treatment at the end of life; possibly for the reasons stated above, possibly because of attitudes among health professionals and carers. They may suffer pain and discomfort because of their inability to communicate or complain. They may be treated with a lack of dignity and respect because of their dementia.…

    • 1872 Words
    • 8 Pages
    Satisfactory Essays
  • Good Essays

    In the article, two sample were used 1) residents living in as nursing homes and 2) newly residents admitted. They recruited 26 psychogeriatric wards from 13 nursing homes throughout various regions in the Netherland for studies. From these homes 6 homes were allocated to EXBELT intervention group and 7 homes were allocated to control group (Gulpers et.al 2012, p. 1475). The settings were psychogeriatric wards in nursing homes. The study design is not described in detail in this article.…

    • 982 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Due to the natural course of dementia commonly patients are diagnosed with behavioural and psychological symptoms (BPSD). Whereby their behaviours show strong correlation with the degree of functional and cognitive impairment such as agitation, irritability, depression, anxiety and sleep or appetite changes (Cerejeria, Lagarto & Mukaetova-Ladinska, 2012). Patricia had shown signs of agitation and restlessness once being administered into hospital and it is important that we prevent and minimise her BPSD through key management principles. In order to minimise the progression of BPSD it requires an approach that includes psychiatric symptoms, management of Patricia’s physical wellbeing and environmental factors (Tanaka et al., 2015). For instance, reality orientation allows Patricia to familiarise herself with her surrounds and situations. This is important as often people with dementia have difficulties in adapting to their environment which in return the environment has to adapt to them. BSPD can be prevented if we provide verbal prompts, reminders, explanations, visual cues and repetition of information (Edberg, Moyle & Chan, 2012). An approach can involve making proper…

    • 405 Words
    • 2 Pages
    Good Essays
  • Better Essays

    By using the theories learned through nursing education and practical experience nurses gain insight and use this to formulate answers to ethical questions. There are times when additional resources are needed. “Ethics committees in health care institutions should be educational and advisory in purpose. Generally, the function of the ethics committee should be to consider and assist in resolving unusual, complicated ethical problems involving issues that affect the care and treatment of patients within the health care institution.”(American Medical Association [AMA], 1994, ¶ 2) The recommendations given by an ethics committee do not have to be followed, but it is encouraged that those recommendations be given serious consideration. Ethics committees are typically made up of physicians, nurses and other providers of healthcare…

    • 1113 Words
    • 5 Pages
    Better Essays
  • Good Essays

    Falls Risk Assessment

    • 1113 Words
    • 5 Pages

    The RN has an important role in coordinating, supervising and delegating staff to provide safe and quality care to older residents with dementia. As the EENs, ENs and PCAs are in the direct contact with residents more often, the RN has the responsibility to gather and redistribute information to all caregivers (ACN, 2016). Staff may not always have the prerequisite dementia knowledge, skills or training, and this requires staff to be supervised by a RN (Hickman, Neville, Fischer, Davidson, & Phillips, 2016). Preventing functional decline and optimising functional outcomes of residents involves staff promoting health and safety of their residents through strategies set up by the RN (ACN, 2016). Strategies involving promoting mobility, promoting…

    • 1113 Words
    • 5 Pages
    Good Essays
  • Powerful Essays

    Byers, D.C., & France, N.E.M. (2008), The lived experience of registered nurses providing care to patients with dementia in the acute care setting: A phenomenological study. International Journal for Human Caring, 12, 44–49.…

    • 2371 Words
    • 10 Pages
    Powerful Essays
  • Satisfactory Essays

    Dementia Care

    • 320 Words
    • 2 Pages

    Don’t try and stop people with dementia from doing something just because it isn’t being done “properly”. Give them time to do things in their own way at their own pace.…

    • 320 Words
    • 2 Pages
    Satisfactory Essays
  • Better Essays

    My personal experience in working with patients with AD has rarely been the best. When I knew that I would be assigned a patient that has Alzheimer’s disease, I would immediately become frustrated because of the high demands. I recall them climbing out of their beds and I would fear them falling due to their unsteady gaits. Attempting to get the patients to take their medications as ordered would sometimes take hours. The other nurses would often have to help hold the patient due to their combative behavior if an IV or a catheter would need to placed. I felt that they always required more attention than the other patients. Once I started getting more patients with AD, I started to better understand their behaviors and it became easier to anticipate their needs. After a while, I recognized the other nurses felt the same way. Eventually I would start volunteering to take these patients because I didn’t see them the way that I used to.…

    • 1353 Words
    • 6 Pages
    Better Essays
  • Powerful Essays

    Nursing Home Abuse

    • 2149 Words
    • 9 Pages

    Approximately 1.4 million elderly people reside in long term care facilities, such as nursing homes. The families that admit their loved ones to these long term care facilities believe that excellent care is being provided to them. Many of the residents in nursing home settings receive adequate health care, but a numerous amount of other residents are subjected to abuse and neglect. It is believed that nearly one-third of all nursing homes have residents that are subjected to abuse either by staff or other residents (Masters in Health Care). Definitions of elder abuse vary. It is difficult to pinpoint exactly what actions or inactions constitute abuse. Besides a variety of definitions, the major types of abuse that occur in nursing homes are categorized into physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, financial or material exploitation. The solution to such nursing home abuse is rather simple. To prevent the inhumane treatment of the elderly in nursing homes, the nursing shortage needs to be addressed.…

    • 2149 Words
    • 9 Pages
    Powerful Essays
  • Powerful Essays

    Dementia Research Paper

    • 2031 Words
    • 9 Pages

    But more research is needed to confirm any benefit. The service that is identified in this paper is the long-term care facilities which care for alzheimer’s patients. The purpose of long-term care facilities is to help with the daily living of patients while assisting and caring for them. When caregivers are faced with alzheimer’s patients they need to keep in mind that the brain changes and can cause communication problems that can result in irrational behavior. The patient is not doing this to be annoying or to irritate, but is probably not aware of his or her actions. There are many ways that a person can receive help for their illness. One way is through seeing a health practioner and to be referred to a facility for an evaluation. If the there are symptoms that are pointing to the illness contact a health care provider to get their opinion and recommendation. You cannot just go on your own instincts and place the person in a care…

    • 2031 Words
    • 9 Pages
    Powerful Essays
  • Satisfactory Essays

    Dementia Patients

    • 195 Words
    • 1 Page

    Dealing with Dementia patients’ requires a profound knowledge base with sound clinical strategies of managing and dealing with aggressive behaviours associated with the disease process. The aim of this learning plan is to identify and develop behaviour management strategies that will enhance my confidence in dealing with patients with Behavioural Psychological Symptoms of Dementia admitted to my unit.…

    • 195 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Dementia is a horrible disease that affects the elderly population. I am currently the caregiver to my mother- in -law who has dementia, currently I had to place her in a long term care (LTC) facility and every day I wonder if it was the right thing to do, or if I could have prolonged the inevitable. I chose to explore this population and how case management (CM) interventions would have delayed placement.…

    • 318 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Optional Nursing Home

    • 1101 Words
    • 5 Pages

    In a nursing home, everyone wants what is best for the individual, so there are many case- sesitive aspects to the experience. There are numerous…

    • 1101 Words
    • 5 Pages
    Good Essays
  • Better Essays

    Of the many illnesses know today, Alzheimer 's has an effect not only on the patient but on the caregiver or nurse as well. Many journal articles, papers, and books discuss the impact on the role of the nurse and the Alzheimer 's patient. These articles show that over time the impact of this disease puts the nurse out of his or her homeostasis. Through the process of the disease the ability to control and maintain ones self stability is somewhat overwhelming and can lead to depression of the nurse caring for the patient in most cases. Depression and frustration usually comes from the fact that the Alzheimer 's patient 's mental and physical health is gradually dwindling away, and the caregiver or nurse feels helpless. This helplessness comes from the fact that the nurse or caregiver is showing care, compassion, and using all the knowledge he or she has, yet the nurse sees little to no progress in the person because the disease process is taking over. "One caregiver described the disease as being a long journey in which the undeniable end is death, no fixed route, and no estimated time of departure" (Morton, 2003 p.262).…

    • 1533 Words
    • 7 Pages
    Better Essays