Agitated - Older Nursing Home Patients - YouTube.mov

Summary

This script explores the challenges of managing agitation in elderly nursing home residents with dementia. It emphasizes three key principles: anticipate behaviors, tolerate abnormal actions, and avoid further agitation. Through various vignettes, it demonstrates how professionals can creatively and patiently address these situations, often requiring trial and error to find effective solutions that promote calm and understanding for both residents and caregivers.

Takeaways

• 😖 Agitation in elderly individuals, especially those with dementia, can be challenging and potentially dangerous for both the person and caregivers.
• 🔮 The three guiding principles for managing agitation are: anticipate, tolerate, and don't agitate.
• 👵 Anticipation involves recognizing common behaviors among dementia patients and preparing for them to prevent agitation.
• 🤔 Tolerance requires accepting behaviors that are not normal but are common in dementia patients, which can help maintain calm for both the caregiver and the patient.
• 🧐 Understanding the patient's perception as their reality is crucial, as reorientation may not always be helpful and could exacerbate agitation.
• 👨‍⚕️ Caregivers should approach situations with creativity, trial and error, and patience when finding solutions to agitation.
• 🍽️ Routine is important for residents, and disruptions can cause agitation; recognizing and respecting this can help avoid conflicts.
• 🌿 Visual spatial defects in dementia patients can lead to misunderstandings, such as mistaking a planter for a toilet, which caregivers should be aware of.
• 🏠 When residents express a desire to go home, it's important to understand their perception and reality, and to approach the situation with empathy and creativity.
• 📞 Communication techniques, such as asking for a resident's name or involving family members, can help diffuse agitation and provide comfort.
• 👂 Listening and responding to a resident's concerns with patience and understanding can lead to more effective solutions for agitation.
• 👨‍🦳 Fluctuating moods in elderly residents can be managed with a calm and positive approach, even when the resident is already agitated.

Q & A

What are the three guiding principles for managing agitation in elderly care settings as mentioned in the script?

The three guiding principles are anticipate, tolerate, and don't agitate. Anticipate certain behaviors common among residents with dementia, tolerate behaviors that are not normal to remain calm, and avoid actions that may further agitate the elderly person.

Why is it important to anticipate behaviors in elderly care?

Anticipating behaviors can help caregivers avoid episodes of agitation by understanding and preparing for common actions and reactions among residents with dementia.

What does the script suggest about tolerating behaviors that are not normal?

Tolerating abnormal behaviors can allow caregivers to remain calm and assist the resident in staying calm as well, and it may provide clues to the underlying causes of agitation.

How does the script illustrate the principle of not agitating further?

The script shows that understanding the resident's perception as their reality, such as not forcing reorientation on a confused person, can help in reducing agitation.

What is the situation with Mrs. Williams at lunchtime in the nursing home?

Mrs. Williams is agitated because she believes her lunch has been taken away. The nurse resolves the situation by recognizing Mrs. Williams' routine and seating preferences and addressing them accordingly.

What is the issue with Mr. Jackson's behavior in the script?

Mr. Jackson, who has early onset Alzheimer's, is agitated and acting inappropriately, likely because he cannot find the bathroom and is unable to communicate his needs.

How does the nurse handle Mr. Jackson's agitation in the second vignette?

The nurse in the second vignette calmly tolerates Mr. Jackson's behavior, avoids getting angry, and asks for assistance to take him back to his room, demonstrating patience and understanding.

What is the main challenge for Mrs. Owens in the script?

Mrs. Owens, who has Alzheimer's dementia, is agitated because she wants to go home and believes she is in a hospital. She is also struggling with the recent move to the nursing home.

How does the doctor and nurse approach Mrs. Owens' agitation in the last vignette?

The doctor and nurse approach Mrs. Owens' agitation by acknowledging her feelings, using calming techniques like the stethoscope, and redirecting her focus to something positive, like a photo album of her family.

What is the issue with Mrs. Mahoney's interaction with the nurse in the script?

Mrs. Mahoney, who has had a stroke affecting her visual fields, is startled because the nurse approached her from her blind side, causing her agitation.

How does the nurse in the script handle Mr. Sherman's agitation about calling his daughter?

The nurse initially tries to calm Mr. Sherman by offering a snack and changing the subject. When that doesn't work, she allows him to use the phone to call his daughter, demonstrating flexibility and understanding of his needs.