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Easing agitation in residents with 'sundowning' behaviour
- Authors:
- FORBES Rebecca, GRESHAM M. D.
- Journal article citation:
- Nursing and Residential Care, 13(7), July 2011, pp.345-347.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
People with dementia tend to come more agitated and confused from late afternoon to evening, a phenomenon known as 'sundowning'. This article provides insights into possible underlying causes, together with practical strategies for supporting residents and helping to reduce these behaviours.
Exploring dementia and agitation: how public policy needs to respond
- Authors:
- BEACH Brian, THOMAS Laura
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2019
- Pagination:
- 22
- Place of publication:
- London
A report of the key findings from the MARQUE research study, to provide a greater understanding of agitation for people living with dementia and their paid and unpaid carers. The study MARQUE (Managing Agitation and Raising Quality of Life in Dementia) was funded by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). The findings cover the prevalence of agitation and effect on quality of life; the cost of dementia and agitation for people living in care homes; impact of managing agitation on care staff; person-centred behaviours in care homes; agitation at home; and psychosocial interventions and outcomes for people living with dementia in care homes. The results found that agitation is a significant issue for people living with dementia, care home staff, and families. It reduces quality of life for people living with dementia and that family carers need more support to adopt coping strategies. When people with agitation are admitted care homes, staff are often not able to deliver the quality of care that they want to deliver. It also finds that interventions that can improve quality of life - such increasing staff to resident ratios or organisation activities in care homes - may not be enough to reduce agitation. Additional resources to implement interventions are required to ensure that people are enabled to use them. (Edited publisher abstract)
Nurses in distress? An explorative study into the relation between distress and individual neuropsychiatric symptoms of people with dementia in nursing homes
- Authors:
- ZWIJSEN S.A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(4), 2014, pp.384-391.
- Publisher:
- Wiley
Objectives: To optimize care and interventions to improve care, and to reduce staff burden, it is important to have knowledge of the relation between individual neuropsychiatric symptoms and distress of care staff. We therefore explored the relation between frequency and severity of individual neuropsychiatric symptoms and distress of care staff. Design: This is an explorative study with a cross-sectional design.Participants and setting: Care staff was interviewed regarding 432 residents of 17 nursing homes for people with dementia. Measurements: Behavioural problems were assessed using the Nursing Home version of the Neuropsychiatric Inventory (NPI-NH) questionnaire. The distress scale of the NPI-NH was used to determine the distress of care staff. Results: Agitation/aggression had the highest mean distress score and was also the most prevalent symptom. Disinhibition and irritability/lability also had high mean distress scores, whereas euphoria/elation, hallucinations and apathy had the lowest mean distress score. The symptom severity of each symptom strongly predicted the distress score, whereas the frequency of the symptoms was a less important factor. Conclusions: Although some of these findings are in accordance with studies among informal caregivers, there are also notable differences. Apathy caused little distress among care staff. Therefore, care staff might not feel the urgency to explore the causes of this symptom. The findings of this study emphasize the importance of supporting care staff in the management of behavioural problems, especially aggression and apathy. (Publisher abstract)
Long term care staff beliefs about evidence based practices for the management of dementia and agitation
- Authors:
- AYALON Liat, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(2), February 2009, pp.118-124.
- Publisher:
- Wiley
Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of this American study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Results found paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation.
The impact of nurse and care staff education on the functional ability and quality of life of people living with dementia in aged care: a systematic review
- Authors:
- BAUER Michael, et al
- Journal article citation:
- Nurse Education Today, 67, 2018, pp.27-45.
- Publisher:
- Churchill Livingstone
- Place of publication:
- Scotland
... agitation, anxiety, mood and quality of life. The most consistent improvement in functional ability due to education may be in the execution of activities of daily living. More successful programs included multi-faceted components (e.g. hands on support, clinical auditing) in conjunction with didactic teaching. There is a need for more rigorous and well-designed studies to test interventions. (Edited publisher abstract)