Emily Vance Ferris State University

What

is Dementia? Treatments
Medications/Side Effects Non-pharmacological
Doll
The

Therapy

purpose of this assignment is to practice collaborative leadership to advocate for quality nursing practice using evidence based knowledge

Nursing Problem
Is

this therapy effective in treating distress in dementia patients? Is it ethical to use?

Nursing

Theory

Katharine Kolcaba Comfort Theory John Bowlby Attachment Theory

Methods
1st

study

3rd study
Bradford Dementia Group Wellbeing Profiling too

Mixed methods design to

collect observational data Used Likert Scale 14 residents

4th study
Questionnaires to 46 care staff 37 residents

2nd

study

66 residents Examined case notes

Results
All showed some decrease in agitation

and wandering However, some caregivers found it demeaningpatronisingbabish

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

 Nurse

Leader

Nursing staff In-services and other training options Family Counseling, support groups Social Worker Behavioral Therapists

Physical/Speech Therapy

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 mothers 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.

1.Identify
78 year old female

2. Relate
Primary Proposition: Pt is agitated because family left her in a nursing home. Possible Assumptions: Pt doesnt participate in regular social activities.

3. Understand
Proposition: If the pts agitation is not controlled she could injure herself or others. Significance of Assumptions: If pt is unaware of why she is here and doesnt 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.

Dementia/confused
New admit Easily agitated Wandering Looking for young daughter

Possible Confounding Variables: Pt has moderate dementia and is difficult to redirect.

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.

Nursing Diagnosis Risk for injury: Risk Factors: confusion, agitation.

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)

 Educate

Staff/family/patients Treat patients with dignity More Research Significance to Nursing Practice
Better patient compliance Holistic nursing

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. & ODonnell, 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.