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Dementia And Aggression Psy 492 M7a2 Levea. B
- 1. Dementia and Aggression: Can aggression be reduced with better quality of care? PSY 492 Billie Jo LeVea 8-16-10
- 5. The Findings Beth Nolan results showed that as daily living skills decreased there was a slight increase in aggressive behavior (Nolan, 2003). The highest correlation was with recall and recognition; as these abilities lessened, the aggressive behaviors increased (Nolan, 2003) This study shows that aggressive behavior seems to be most prevalent as memory functioning worsens. Sutor found by understanding that medical and psychiatric illnesses can also cause for aggression as well as lack of communication or poor caregiver skills; it is necessary to assess the person in a multi faceted approach to cover all areas of their history and provide a multi systematic approach to care (Sutor, et al, 2001). Volicer & Hurley’ s study showed going through different frameworks including behavioral, psychiatric and comprehensive models and using the appropriate terminology will allow for better quality of care. Findings of the Lakeview Ranch study show that the residents of Lakeview Ranch have less medication cost as well as less behaviorally related hospitalizations compared to the regional costs.
- 9. The Findings Results Of Skovdahl’s study showed that the important part of creating good working relations with each other was the increase need for support. This could include feedback, confirmation and supervision. Residents had fewer behaviors if they felt respected and caregivers who look at the resident’s behaviors for meaning and have mastery caregiver skills were more successful in curbing behaviors (Skovdahl, 2003). Changes in behavior were noticed in 3 of the 4 residents in Egan’s study. Ten staff was interviewed and all felt that the life history was very helpful and half the staff reported a change in the care they provided after reading the life histories (Egan, et al 2007). Results of Speziale’s study showed that aggressive behavior declined in 6 months, staff response was better and the use of physical restraints decreased. The results of Taiwan study showed that those who received the in home training had higher self-efficacy scales as well as better management skills. The patients had less non-physically aggressive behaviors as well.
Hinweis der Redaktion
- Person centered care/planning occurs when the individuals in need of services are allowed to have say over what they want out of their life and the team assisting the person listens, sees the person as an individual and develop a plan that will assist them in meeting their goals. An example of this could be that Sally, a person with dementia in a nursing home loved to tend to her garden when she lived on her own, since moving into the nursing home she has not been able to do this and has been acting out. The staff with a person centered plan would try to obtain a way (this requires creativity at times) to replicate good experiences that Sally had in order to give her back some of her independence. She may not have a garden, but maybe she could plant flowers outside, or in pots to have for her room. If the staff were aware of others wanting the same thing, they could start a garden club or assist the residents in potting plants for their rooms or loved ones.
- Lakeview Ranch is a residence that focuses on preventative care by increasing nursing/patient ratios, in house RN staffing, specialized staff training including attention to residents emotional needs and medication reviews (Berry, et al 2008). By specifying the difference between “agitation and resistiveness to care” the caregivers will be able to provide better management techniques as well as improve their self-efficacy in dealing with behaviors (Volicer & Hurley, 2003). Beth Nolan’s study went from April 1992-May 1995 where data was collected on 413 new residents in 87 different nursing home facilities located in Washington, North Carolina and Michigan (Nolan, 2003). This study looked at the aggressive behavior of people with dementia in relation to recall, recognition, medication use and ability to care for them selves.
- Many people with dementia are on medications to control behaviors. These studies looked at lowering or removing medication to see if behaviors were still present.
- The last studies looked at training, patient history, and caregiver skills to see if an increase in knowledge would lead to fewer behaviors The Taiwan study had the groups divided evenly. This study used two groups: the control and the experimental group (Huei-Ling, et al, 2003). Scores for agitation, aggression, and caregivers self efficacy were recorded before the training and three months after the training. Speziale’s training consisted of learning more about dementia and how it affects the brain as well as learning personal histories of residents and better intervention and prevention strategies (Speziale, 2009). Mary Egan did a study in which looked at the correlation with sharing patient history with staff and a decrease in patient problem behaviors and change in staff perception of residents (Egan et al, 2007). Skovdahl & Kihlgren also wanted to see if attitudes of staff could prevent or promote behaviors of patients with dementia.
- Physical behaviors decreased on both sides of the Taiwan study.