Agitation is one of the most critical issues in the long term care nursing homes across the world. Residents of such homes, due to a number of reasons, experience changes in their behavioral patterns involving agitation, distress and aggressiveness…
Agitation is one of the most critical issues in the long term care nursing homes across the world. Residents of such homes, due to a number of reasons, experience changes in their behavioral patterns involving agitation, distress and aggressiveness The second reason revolves around the resident nurse; dealing with agitated patients involves surviving verbal and sometimes physical abuse from the patients, which impacts negatively on nurse motivation and productivity (Zeller et al. 2009). According to the Nursing Times (2011), majority of nurses are not well prepared/trained to handle agitation. The overall impact is a threat to the quality of healthcare, hence underpinning the importance of the issue of agitation in the resident care setting. Background According to Zwicker and Fletcher (2009), agitated behavior in conditions such as dementia represents feelings and needs that are difficult to adequately verbalize. In frequent occasions, agitation is a result of an inability to communicate needs by the long term care patient in an unpleasant environment or due to physical discomfort (Rabinowitz et al., 2005). Statistics indicate that agitation is a serious problem, with above 50% of patients in a community dwelling and above 70% of residents in nursing homes experiencing the condition. The most common manifestations of agitated behavior include physical agitation such as pacing, nervousness and repetitive movements, and verbal agitation such as complaining, using abusive language and screaming (Zwicker and Fletcher, 2009). ...
Whereas this may cause discomfort in healthy individuals, the situation is worse among residents in nursing homes due to their underlying conditions, making it difficult for them to communicate. Hunger is another leading cause of agitation, with Erockson and Grove (2008) observing that Alzheimer’s patients may experience weight loss even with proper nutrition. Such patients may have abnormally high activity levels. Another important cause of agitation is the fear and disorientation among the residents in the long term care settings. For instance, dementia patients are often afraid while Alzheimer’s patients cannot recall the staff, facility, other patients and even themselves (DETP, 2001; Zieber et al., 2005). Medical causes of agitation also exist as most mental health patients may experience abrupt onset of delirium. Such cases may be due to infections such as urinary tract infections, pneumonia and colcystitis among others (Gerdner, Buckwalter and Hall, 2005). The external environment also plays a crucial part in triggering agitation in the long term care setting. Here, the nurse takes a central position in influencing triggers of agitation either positively or negatively. Changes in medication, creating an impersonal environment and certain aspects of care cause the patients to be agitated. Failure to adequately deal with the internal determinants of agitation also contributes to the condition (Erickson and Grove, 2008). Effects on Nurses Nurses in the long term care settings not only have to manage the causes and impacts of agitation on the patients, but also impacts on themselves. First, such patients can fall under the ...
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