The objective of this review was to arrive at an answer to the question "can physical restraints on dementia patients be avoided in emergency". The first aim was to determine emergency on the part of dementia patients and secondly the safety of the nursing staff who attend them.
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(Koch Susan and Lyon Cheryl, 2001) Purely clinical emergency necessitating medical care on dementia patients does not pose any problem for the attending health staff and nurses. Dementia patients at this juncture are either passive or unconscious. Use of physical restraints on these types of patients does not arise. When the patients turn aggressive, the progress of medical attendance is blocked. This prompts the nursing staff to use physical restraints on the patients. Immediate attention towards reducing the aggression of the dementia patients dilutes the emergency in the atmosphere. Dementia patients suddenly turn hostile towards the attending nurses and agitate for reasons not known to the staff and not expressible by the patients. Agitation refers to a range of behaviors associated with dementia, including irritability, sleeplessness and verbal or physical aggressions. Often these types of behavior problems progress with stages of dementia, from mild to more severe. Pilot research studies designed to measure how agitation manifested, to measure the severity of agitation and to identify the nursing practices used to manage and their outcome revealed in the past that nurse actions triggered the majority of most highly rated episodes of agitated behavior in dementia patients.
Three databases CINHAL, PROQUEST, AMERICAN JOURNAL OF GERIATRIC SOCIETY and BLACKWELL SYNERGY were searched using search terms 'dementia', 'physical restraints', and 'emergency'. On viewing the guidelines for using the physical restraints a book by Noreen Cavan Frisch is also found apt.
On pressing the contents of the papers through the sieve of two main views extracted it is found that emergency arising out of aggressions of dementia patients is differently perceived by nurses and other beholders and safety related dilemma in nursing staff is due to the double sided pressure from both statutory enforcement and clinical guidelines for procedural therapy.
EMERGENCY ARISING OUT OF AGGRESSIONS IN DEMENTIA PATIENTS:
Gerry Farrel (2005) analyzed 28 aggression management-training programs and found that use of restraints on patients of mental health department is obligatory. Since the concentration of the research was mainly on industrial and other professional fields wherein aggression management programs are conducted, the stress of the same in mental health area is minimal although the authors made a mention that many of the AMPs did not address psychological aspects.
(Gerry Farrell, Katrina Cubit, 2005)
Some of the greatest challenges of nursing staff with the dementia patients are the personality and behavior changes that often occur. The nurses are given training to meet these challenges by using creativity, flexibility, patience and compassion. Before thinking of the decision to use physical restraints on the dementia patients so that treatment can take its smooth course, it is obligatory on the part of attending nurses to tactfully handle the troubling behavior of the patients. Trying to change the person
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Their behaviours and personalities are erratic due to their inability to control their emotions. Due to physiological changes in their senses, they may be hallucinating or are able to see and hear things that are not there (Alzheimers.org, 2013a). This paper aims to critically reflect about the development of a system designed to safeguard and promote ethically the well-being of people with dementia within a residential care (US National Library of Medicine, 2012, p.
The momentous ability to control oneself behaviorally or emotionally is lost when a patient is in the throes of dementia. The principal motivating factor for development of dementia in older people over age 65 is recognized as Alzheimer’s disease (AD) because of its potential to negatively affect all brain functions like memory, perception, cognitive skills, mental or emotional behavior, and reasoning.
One of the common diseases faced majorly by 5% of adults in their 60s is Dementia. Sadly, current researches have shown that not only aged people face the issues of Dementia but adults below 60’s are also suffering from this brain dysfunction. Dementia is a mental disorder in which a person loses his cognitive ability.
Physical intervention and restraint with people, who have intellectual disabilities, are sometimes necessary, even though it's known to present dangers to both patients and staff and service users. The UK, the Department of Health (2002) guideline suggests that the use of restraint in the management of imminent violence in a psychiatric setting should be geared to prevent imminent harm to the patient and/or others, if other means are not effective and appropriate, and to prevent serious disruption of the treatment program or significant damage to the environment.
The answer to the frequently posed question 'What is the difference between Alzheimer's disease and dementia' is that, in a sense, there is no difference-Alzheimer's disease is one of the many different types of dementia (Brian Draper; 2004)
Thirdly, policies with regard to dementia particularly shall be highlighted. Next, recommendations for best practices shall be given. A final conclusion shall review the main arguments and support the implementation of integrated support services for home-based carers and service users.
mpassionate perceptive responses in working with vulnerable families, and in providing competent care, yet there has been very little literature to orient family nursing practice (Bomar, 2004).
Because of the complex changes taking place within family nursing practice, it is
Research has shown that most hospital nurses do not have the expertise to handle behavioural disturbances like dementia which are mostly managed in mental health wards, thus making management of acutely ill elderly patients very complex
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