Interventions used by nursing staff members with psychogeriatric patients resisting care

Cognitive Impairment, Psychiatric Disorders, and Problematic Behaviors in a Tribal Nursing Home

“…Although existing scholarship on explanatory models has focused largely on diagnosis and help seeking, illness conceptualizations no doubt also influence how disorders are managed in long-term care settings-especially true as much of the psychotherapeutic care provided in NHs is informal in nature. One area of special interest is that of care resistance given the lack of conceptual clarity and research on the topic (Werner, Tabak, Alpert, & Bergman, 2002), not to mention its detrimental impact on caregiving staff.…”

Organizational risk management of resistance to care episodes in health facilities

“…The second stage included a search of relevant literature and associated instruments for relevant items that could be included or modified for use in the questionnaire and a draft instrument was constructed using these resources (Lanza 1983, Yudofsky et al 1986, Bridges-Parlet et al 1994, Poster 1996, Potts et al 1996, Levin et al 1998, Mahoney et al 1999, Segatore & Adams 2001b, Quintal 2002, Werner et al 2002, Hegney et al 2003, NSW Department of Health 2003, Volicer & Hurley 2003, Badger & Mullan 2004, Gerberich et al 2004, Needham et al 2005, Farrell et al 2006, Ryan & Maguire 2006, Phillips 2007, Rennie & Brady 2007, Estryn-Behar et al 2008, Mckinnon & Cross 2008.…”

“…Resistance to care is reported to increase as the ability to understand decreases (cognitive impairment) (Roper et al. 1991, Cody & Grealy 2001, Werner et al. 2002, Volicer et al.…”

“…'Resistiveness to care' includes pulling away from staff, tightening limbs, stiffening of the body, deliberately ceasing or refusing to weight bear during care, waving arms and legs and verbally objecting to care using words and/ or sounds (Newhouse 1995). Physically aggressive resistive behaviours are most likely to occur in response to invasion of patients' personal space, usually associated with care-giving, and due in part to patients' feeling vulnerable and fearful (Burgener et al 1992, Bridges-Parlet et al 1994, Potts et al 1996, Gates et al 1999, Mahoney et al 1999, Werner et al 2002, Volicer et al 2007, and are in many cases preceded by verbal aggression or non-compliance (Bridges-Parlet et al 1994). It is often difficult to distinguish between exhibited patient behaviours or responses that are aggressive or resistive (Gibson 1997) and some research reports nurses perceptions of the patient's actions as 'intentional' , however, other studies report that behaviour displayed by patients suffering dementia is acknowledged as a defensive response to intrusion into their personal space (Bridges-Parlet et al 1994.…”

“…Resistance to care is reported to increase as the ability to understand decreases (cognitive impairment) (Roper et al 1991, Cody & Grealy 2001, Werner et al 2002, Volicer et al 2007). Volicer et al reported that there are two main reasons why RTC occurs in these patients: communication problems due to lack of comprehension and presence of delusions.…”