Dementia In Acute Care Research Articles

Hospital Dementia Services Project: Aged care and dementia services in New South Wales hospitals

To describe the availability of aged care and dementia services in public hospitals in New South Wales (NSW), Australia in 2006/2007. Hospitals were surveyed about issues relevant to dementia in acute care including the types of aged care wards and staff, policies, practices, clinics, community services and resources for dementia care. Responses were obtained from 163 hospitals (82%); responding hospitals represented 93.4% of NSW hospital beds, 96.7% of multiday episodes of care. Hospitals that had a Specialist Mental Health Service for Older People (SMHSOP) and an Aged Care Service (ACS) had the highest levels of dementia-related services and policies. Few hospitals without ACS or SMHSOP had clinics for dementia assessment, secure beds for disturbed behaviour, or services to manage patients with dementia and medical or behavioural comorbidity in the community. Dementia services in NSW hospitals are closely aligned with ACS and SMHSOP, with limited dementia services in hospitals without ACS or SMHSOP.

Best practice for the management of older people with dementia in the acute care setting: a review of the literature

Aim. This paper reviews the theoretical and research-based literature related to the management of people with chronic confusion as a consequence of dementia in the acute care setting. Background. People aged 65 years and over are at increased risk of poor outcomes when admitted to the acute care setting as a result of comorbity and mismanagement of their chronic confusion. The challenge of caring for people with dementia in acute care is one that requires special attention. Results. The theoretical literature outlines a number of principles of care necessary for best practice in the care of people with dementia. A number of different models of care are reported in the literature and some evaluative research has been undertaken to assess the benefits of the different models. Conclusion. There are a number of interventions that if put into place in acute care may improve care of people with dementia and reduce the burden of care. There is emerging evidence that interventions such as staff education, skilled expertise, standardized care protocols and environmental modification help to meet the needs of people with dementia in acute hospital settings. This paper adds to our current understanding of management of dementia in the acute care setting, an area that demonstrates the need to move from descriptive to intervention studies to ensure evidence for care of persons with a dementing condition.

Understanding challenging behaviour in patients with dementia

The fifth and final article in the series on patients with dementia in acute care examines challenging behaviour. Hospital admission, combined with unfamiliar surroundings and memory problems, can be frightening and disorientating for those with dementia. This can lead to behaviour which is perceived as 'disruptive' or 'difficult'. Aspects of the hospital environment or care practice can contribute to problems that may be misinterpreted and lead to challenging behaviour. Staff should seek to understand the cause of challenging behaviour, assess the possible causes and use strategies to reinforce familiarity and minimise distress for these patients.

Pacing of activity as a predictor of agitation for persons with dementia in acute care.

Pacing of activity as a predictor of agitation for persons with dementia in acute care.

A descriptive survey of acute bed usage for dementia care in old age psychiatry.

To examine the reasons why patients are admitted to acute dementia care assessment beds in one large district health authority (Leicestershire). A prospective questionnaire was completed by the RMO for every admission to dementia care assessment beds over a 6-month survey period. The most common reasons for admission were behavioural problems (most frequently aggression). Other common reasons included self-neglect, psychotic symptoms and comorbidity with functional psychiatric illness. Classification of patients by their social circumstances before admission indicated different patterns of presenting features, length of stay and place of discharge. The need for acute beds is demonstrated by the large number of emergencies, with a significant proportion admitted under the Mental Health Act, the type and complexity of reasons for admission and the preceding involvement of community mental health services. Multi-axial classifications including presenting problems and social circumstances, rather than the traditional method of looking purely at diagnosis, may offer some advantage in assessing outcomes.