Preventing aggression and other secondary features of dementia in elderly persons: Three case studies

Abstract

Dementia and Alzheimer's disease are associated with behavioral symptoms that can be costly and troublesome to caregivers. Behavioral strategies to prevent aggression in people with dementia (PWDs) are necessary to decrease caregiver burden and relieve other behavioral disturbances in PWDs, such as depression. On the basis of their previous study that identified pain as a possible cause of aggression, the authors developed a behavioral in-home intervention designed to teach caregiver(s) how to recognize signs of pain and distress in PWDs. The authors present a description of the Preventing Aggression in Veterans with Dementia (PAVeD) intervention and illustrate its use and results with three case studies. Results indicate that this intervention may help prevent the development of aggression and pain in PWDs, reduce caregiver burden, and help manage other behavioral symptoms associated with dementia.

Patient Aggression in Real Time on Geriatric Inpatient Units

“…A high rate of assaults are being under-reported (Danesh, 2008;Fowler et al, 2015;Gerberich et al, 2004;Lanza & Campbell, 1991;Lion, Snyder, & Merrill, 1981). Reasons include:…”

“…Many assault victims feel that assault should only be reported if it is "sufficiently severe;" • Differential attributions made to the patient about the degree of intent to commit harm; • Staff inurement to assault: "Assaults are so common here;" • Staff attitude that assault is to be expected since they work in a high-risk environment: "Being hit is part of the job;" • Staff characteristics, such as peer pressure, not to report and differential reporting based on the gender of the person assaulted; • Invalid or incomplete information on reports due to reports being completed by persons who have not witnessed the event; • Excessive paperwork involved in reporting assault and not enough time to complete it; • Fear of blame; staff may be afraid of reporting because they may be implicated or rebuked for failing to diffuse the situation. (Danesh, 2008;Fowler et al, 2015;Gerberich et al, 2004;Lanza & Campbell, 1991;Lion et al, 1981).…”

Evidence-based clinical practice guidelines on the management of pain in older people – a summary report

“…32,36 Educational and family-centred interventions have had limited benefits in supporting carers in their pain management roles. [37][38][39] However, a more integrated approach involving co-existing and evolving care between formal and informal health systems has been suggested. As such, formal and informal carers should combine their knowledge to manage the person more effectively.…”