Navigating Care for Dementia Patients with Behavioral Disturbances

Dementia is a complex disorder that impacts various aspects of the patient’s lives as well as the lives of their caregivers. It is worth noting that behavioral disturbances are among the most difficult concerns in the care of patients with dementia. These upsets can comprise irritability, combative behavior, pestering queries, pacing, and many more, which are troublesome to the patient in addition to the caretaker. They are in different ways sensitive, and, therefore, discerning the best intervention strategies calls for a blend of empathy and tolerance coupled with sound knowledge of the privacy identity/autonomy/security dynamics of persons with dementia.

Perception of Behavioral and Psychological Symptoms of Dementia

Disturbances in patients with dementia can present in numerous ways due to behavioral changes from different causes like environmental stimuli, discomfort, the need for certain assistance or care, and changed mental status. Such behaviors are used to communicate something: a patient’s distress, confusion, or discomfort, which, due to their state of mental health, cannot be articulated well. Knowing that one is engaging in such behaviors is the first step towards controlling such behaviors, or rather preventing them.

The Role of Care Providers

Namely, caregivers directly intervene in behavioral disturbance management. Thus, their encounters with persons with dementia should be personalized according to the peculiarities of each patient. This is true because of the patient’s medical history, the patient as a person, and the type and severity of dementia. Health care providers also need to avoid so-called ‘proxy decisions,’ that is, making choices on behalf of patients, because clients’ rights cannot be violated too.

Observational research conducted on care relating to dementia has proved that the relationship plan relating to the patients and providers is a multifaceted event that is usually informed by power struggles between preserving the dignity of the patients while addressing other factors. For instance, a patient may completely refuse to bathe or engage in other hygienically related activities, an aspect that triggers irritation to the nature of care among the patients as well as the eventual or inherent caretakers. In the aforementioned circumstances, healthcare givers are required to work on other measures that embrace the patient’s self-governance and integrity but at the same time will observe the well-being and sanitation of the patient.

Yearwise Publication Trend on dementia

Find publication trends on relevant topics

Personal Privacy, Self Image, Self Determination, and Protection

Dignity and privacy remain a big issue when dealing with patients who have dementia. Privacy is also compromised in patients with dementia due to the necessity of personal care by other people. However, the subject’s privacy should be ensured in order not to violate his/her right to dignity and identity. One important component that care providers have to take into consideration is the patient’s right to privacy; they must work to ensure that the patient receives care with as much regard for this right as possible.

The next important element of the care of patients with dementia is the issue of identity. One of the orphans of the disease is personal identity since individuals suffering from dementia lose their ability to perform many tasks. Concerning the patient’s identity, the care providers should include the patient in goal-directed activities that are relevant to the patient and recognize the patient’s preferences and background. It plays a role in maintaining the individuality of the patients and minimizes the chance of personality fluctuations.

Privacy paradoxically equates to freedom and, further, to identity. It is also worth noting the element of patients’ depersonalization since individuals suffering from dementia are no longer able to make decisions on their own. Nevertheless, the possible degree of patient independence should be supported as much as possible for the patient to be comfortable. This can be achieved by patient participation in healthcare decisions, the provision of options each time, and honoring the patient’s desires.

Protection of the person from harm and emotional distress is a necessity that remains with the person all the time, more so for a patient with dementia. Thus, behavioral disturbances can be an outcome of feeling insecure or developing fear. The precariousness of a generalized live-in patient’s existence can be countered by maintaining the structure of the home to be as stable as possible, being responsive to the patient’s anxiety, whether mild or severe, and pacifying it where necessary.

Behavioral problems continue to be a cause of concern for physicians who work with mentally ill patients and caregivers since they affect the quality of care and the mental well-being of the patients.

Controlling aggression in dementia patients entails the involvement of intervention measures aligned to the environment, words, and action frameworks catering to the uniqueness of the patient.

Environmental Modifications: It can also be ascertained that the environment plays a crucial role in influencing the patient’s behavior, especially dementia patients. This implies that keeping the environment for the patients calm, relaxed, and free from any stimuli that may trigger aggression is a good step towards managing such issues. This may involve the absence of loud and confusing sounds, the elimination of confusion-causing objects, and sticking to familiar objects and routines.

Communication Strategies: The first significant aspect of behavioral disturbances is the need to have proper communication. Attendants should avoid using complex language when speaking to users, and they should try and accompany what they say with gestures. The innominate patient should also be listened to and have their feelings as a patient acknowledged, even if they speak or act inappropriately.

Individualized Care Plans: Due to this, it will be good to note that each dementia patient is different, and his/her care plan should show. This could involve the provision of occupation in the form of purposeful activities that the patient can engage in as well as specifically targeted interventions to address the patient’s behavioral symptoms. The patient-healthcare provider interaction may be followed by an examination of the event in an attempt to establish the strengths and weaknesses of the process. It is useful in establishing better ways of handling behavioral problems in that it must be noted that the thematic analysis of these dialogues can provide ideas of what is repetitive and rampant in patients with dementia and their etiquette, as well as the patrons’ reactions to the former group of individuals. This could be beneficial in the assessment of the degree of behavioral disturbances and assist in the design of better treatment plans.

Recent Publications on dementia

Find publications on relevant topics

The Support for Caregivers

The welfare of the caregiver as well as the dementia patient should be well catered for by health facilities and other health organizations. The responsibility placed on the caregivers causes them to deal with much stress and fatigue. Audio Caring for caregivers: education; equipment, records, and recognitions can assist the overburdened caregivers in communicating their stress and doing more for their charges.

Education interventions should ensure that the caregivers or members of staff have the knowledge and skills to address behavioral problems in the best way possible. Educational programs offered by hospitals or community centers can offer advice, and caregivers can speak to other caregivers about their experiences and coping mechanisms.

Conclusion

Managing deterioration in dementia patients entails being faced with the issue of aggressive behavior that comes with the management of the disease, and this is a big challenge that demands interpersonal care. If these behaviors are understood in terms of their causes and the interventions used do not invade the patient’s privacy, crush their identity, enslave their autonomy, or endanger their security, then the quality of dementia patient care can be improved and their well-being can be optimized. Furthermore, more attention has to be paid to caregivers and their needs concerning resources and education to meet the challenges of dementia care and achieve a good outcome for the patients as well as their caregivers.

References

  1. Graneheim, Ulla Hällgren et al. “Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and “behavioural disturbances”, and on her care providers.” Journal of advanced nursing 36 2 (2001): 256-65 .
  2. Söderberg S, Lundman B. Transitions experienced by women with fibromyalgia. Health Care Women Int. 2001 Oct-Nov;22(7):617-31. doi: 10.1080/07399330127169. PMID: 12141840.
  3. Shields L, King SJ. Qualitative analysis of the care of children in hospital in four countries-Part 1. J Pediatr Nurs. 2001 Apr;16(2):137-45. doi: 10.1053/jpdn.2001.23466. PMID: 11326401.
  4. Shields L, King S. Qualitative analysis of the care of children in hospital in four countries-Part 2. J Pediatr Nurs. 2001 Jun;16(3):206-13. doi: 10.1053/jpdn.2001.16541. PMID: 11398133.
  5. Long, T. and Johnson, M., 2000. Rigour, reliability and validity in qualitative research. Clinical effectiveness in nursing4(1), pp.30-37.
  6. Sandelowski M. The call to experts in qualitative research. Res Nurs Health. 1998 Oct;21(5):467-71. doi: 10.1002/(sici)1098-240x(199810)21:5<467::aid-nur9>3.0.co;2-l. PMID: 9761143.
  7. Olson MS, Hinds PS, Euell K, Quargnenti A, Milligan M, Foppiano P, Powell B. Peak and nadir experiences and their consequences described by pediatric oncology nurses. J Pediatr Oncol Nurs. 1998 Jan;15(1):13-24. doi: 10.1177/104345429801500103. PMID: 9473889.
  8. Barroso J. Social support and long-term survivors of AIDS. West J Nurs Res. 1997 Oct;19(5):554-73; discussion 573-82. doi: 10.1177/019394599701900502. PMID: 9330563.

Top Experts on “dementia