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Dementia

Dementia. Emily Vance Ferris State University. Introduction. What is Dementia? Treatments Medications/Side Effects Non-pharmacological Doll Therapy

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Dementia

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  1. Dementia Emily Vance Ferris State University

  2. Introduction • What is Dementia? • Treatments • Medications/Side Effects • Non-pharmacological • Doll Therapy • The purpose of this assignment is to “practice collaborative leadership to advocate for quality nursing practice using evidence based knowledge”

  3. Evidence for CareDoll Therapy Nursing Problem Is this therapy effective in treating distress in dementia patients? Is it ethical to use?

  4. Evidence of Care • Nursing Theory • Katharine Kolcaba – Comfort Theory • John Bowlby – Attachment Theory

  5. Evaluation of the Evidence Methods • 1st study • Mixed methods design to collect observational data • Used Likert Scale • 14 residents • 2nd study • 66 residents • Examined case notes • 3rd study • Bradford Dementia Group Wellbeing Profiling too • 4th study • Questionnaires to 46 care staff • 37 residents • Results • All showed some decrease in agitation and wandering • However, some caregivers found it “demeaning…patronising…babish”

  6. Evaluation of the Evidence Article Critique • Nursing Research • British Journal of Nursing • Authors’ are nurses • Qualitative Study • Mainly anecdotes from other studies • Limitations • Sample sizes • Studies only done in UK and Japan • Not enough research! • Ethical concerns

  7. Patient Care Design • Nurse Leader • Nursing staff • In-services and other training options • Family • Counseling, support groups • Social Worker • Behavioral Therapists • Physical/Speech Therapy

  8. TRUEPIC Situation: Mrs. T is a 78 year old dementia patient that is newly admitted to a locked dementia unit of a nursing home. She is accompanied by her daughter who is having a hard time coping with her mother’s illness. After the daughter leaves, Mrs. T. is seen pacing the halls and entering other patient rooms. Mrs. T is easily agitated when staff try to redirect her. She is confused and keeps asking how her daughter will find her. The nurse is a 26 year old BSN prepared RN with 1 year experience working on a ortho med-surg unit. She has no experience dealing with patients with moderate to severe dementia. 3. Understand… Proposition: “If the pt’s agitation is not controlled she could injure herself or others.” Significance of Assumptions: “If pt is unaware of why she is here and doesn’t socialize then she can become depressed.” Possible Confounding Variables: “If pt is unable to be redirected then she will be unwilling to take medication to help with other health issues.” 1.Identify… 78 year old female Dementia/confused New admit Easily agitated Wandering Looking for young daughter 2. Relate… Primary Proposition: “Pt is agitated because family left her in a nursing home.” Possible Assumptions: “Pt doesn’t participate in regular social activities.” Possible Confounding Variables: “Pt has moderate dementia and is difficult to redirect.”

  9. TRUEPIC Nursing Diagnosis Risk for injury: Risk Factors: confusion, agitation. 4.Explain… Proposition: In a meaningful way , explain where her family is and why she is here. Assumptions:. Explain to her the importance of social activies Confounding Variables: Explain to family how dementia works. 5. Predict… Proposition: if agitation continues the pt will hurt herself, staff, or other pts. Assumptions: if she does not participate she could get depression and her dementia could worsen Confounding Variables: if pt is unable to be redirected she could injure herself 6. Influence… Proposition: Make sure staff knows how to deal with her agitation. Assumptions: Make sure staff provides activities she likes Confounding Variables: Make sure to educate staff and family about dementia. 7. Control… - Nurses will calm pt with the use of nonpharmacologic methods such as reality orientation, aromatherapy, music therapy, or doll therapy (if allowed)

  10. Advocate Role • Educate Staff/family/patients • Treat patients with dignity • More Research • Significance to Nursing Practice • Better patient compliance • Holistic nursing

  11. References Colley, S. (2014). NURS 441 Nursing theory 3 [spring 2014 course syllabus]. Retrieved from https://fsulearn.ferris.edu/webapps/portal/fram eset.jsp?tab_group=courses&url=%2Fwebapps %2Fblackboard%2Fexecute%2Fcontent%2Ffile %3Fcmd%3Dview%26content_id%3D_510231_1 %26course_id%3D_8632_1%26framesetWrappe d%3Dtrue Comfort Theory by Katharine Kolcaba. (n.d.). Comfort Theory by Katharine Kolcaba. Retrieved January 26, 2014, from http://currentnursing.com/nursing_theory/comfort_theory_Kath y_Kolcaba.html Mitchell, G. & O’Donnell, H. (2013). The therapeutic use of doll therapy in dementia. British Journal of Nursing, 22(6), 329-334. Videbeck, S.L. (2014). Psychiatric-mental health nursing (6th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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