Mailbox Response

The question was submitted Tuesday, 25 September 2007

Subject: Restraints

My Mum is presently in a public hospital awaiting permanent placement into a Hostel.She had a brain scan in the hospital & from that we were told that she has vascular dementia & has had several small strokes in the past.This was not suprising as mum had progressively been getting more & more confused.Whenb I go to visit her in hospital, she seems quite ok, says some strange things at times but generally pretty good. I know that she has gotten quite aggitated in the past & it seems asthough this happens usually at night.I rang the Hospital this morning to see what sort of a night she had & was told by a nurse that she had a terrible night & they had to restrain her. When I heard this I almost passed out!! Surely to goodness in this day & age you shouldn't have to restrain a person with dementia. There must be better ways to assist an aggitated person than restraints.Can someone give me some feedback on this issue & does it happen often?

Answer from DementiaNet

Unfortunately this can be a common problem in hospitals which are really not designed to care for people with dementia. It is important for your mother that any treatable causes for her agitation are recognised and managed. A urinary tract infection, low blood oxygen levels, a change in medication, or abnormal electrolyte levels in the blood can all cause a delirium and agitation. By treating the underlying problem, the agitation may be reduced.

There are a number of alternatives to physical restraint. The use of medications such as antipsychotics can be useful to help manage agitation in people with dementia. These medications do have side effects and it is important to use them carefully. The other option is the use of “specialling”. This involves the use of a nurse who provides one on one care to your mother and is there to help reassure her, take her to the toilet and provide other assistance as necessary. This is more expensive for the hospital in terms of cost of nursing staff, but is definitely a much better way of caring for people with dementia. You may need to speak to the nurse manager of the ward that your mother is in to ask that she be considered for a nurse special.

The answer was published on DementiaNet Friday, 28 September 2007