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Physical Restraint Use on People with Dementia - Essay Example

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The objective of this review was to arrive at an answer to the question "can physical restraints on dementia patients be avoided in emergency". The first aim was to determine emergency on the part of dementia patients and secondly the safety of the nursing staff who attend them.
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Physical Restraint Use on People with Dementia
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Physical Restraint Use on People with Dementia

(Koch Susan and Lyon Cheryl, 2001) Purely clinical emergency necessitating medical care on dementia patients does not pose any problem for the attending health staff and nurses. Dementia patients at this juncture are either passive or unconscious. Use of physical restraints on these types of patients does not arise. When the patients turn aggressive, the progress of medical attendance is blocked. This prompts the nursing staff to use physical restraints on the patients. Immediate attention towards reducing the aggression of the dementia patients dilutes the emergency in the atmosphere. Dementia patients suddenly turn hostile towards the attending nurses and agitate for reasons not known to the staff and not expressible by the patients. Agitation refers to a range of behaviors associated with dementia, including irritability, sleeplessness and verbal or physical aggressions. Often these types of behavior problems progress with stages of dementia, from mild to more severe. Pilot research studies designed to measure how agitation manifested, to measure the severity of agitation and to identify the nursing practices used to manage and their outcome revealed in the past that nurse actions triggered the majority of most highly rated episodes of agitated behavior in dementia patients.
Three databases CINHAL, PROQUEST, AMERICAN JOURNAL OF GERIATRIC SOCIETY and BLACKWELL SYNERGY were searched using search terms 'dementia', 'physical restraints', and 'emergency'. On viewing the guidelines for using the physical restraints a book by Noreen Cavan Frisch is also found apt.
Findings:
On pressing the contents of the papers through the sieve of two main views extracted it is found that emergency arising out of aggressions of dementia patients is differently perceived by nurses and other beholders and safety related dilemma in nursing staff is due to the double sided pressure from both statutory enforcement and clinical guidelines for procedural therapy.
EMERGENCY ARISING OUT OF AGGRESSIONS IN DEMENTIA PATIENTS:
Gerry Farrel (2005) analyzed 28 aggression management-training programs and found that use of restraints on patients of mental health department is obligatory. Since the concentration of the research was mainly on industrial and other professional fields wherein aggression management programs are conducted, the stress of the same in mental health area is minimal although the authors made a mention that many of the AMPs did not address psychological aspects.
(Gerry Farrell, Katrina Cubit, 2005)

Some of the greatest challenges of nursing staff with the dementia patients are the personality and behavior changes that often occur. The nurses are given training to meet these challenges by using creativity, flexibility, patience and compassion. Before thinking of the decision to use physical restraints on the dementia patients so that treatment can take its smooth course, it is obligatory on the part of attending nurses to tactfully handle the troubling behavior of the patients. Trying to change the person ... Read More
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