What is Dementia?
Dementia is not a single disease but a neurological syndrome identified by a decline of
the intellectual or cognitive functions of the brain. This decline is accompanied by
changes in behavior and personality severe enough to interfere with the activities of
daily living such as interacting with others, eating, dressing and personal hygiene. While
conscious control may be clear, there is a noticeable disturbance in memory, thinking,
attention, problem solving, calculation, comprehension, language and judgment.
Dementia affects less than 1 person in 1,000 under the age of 65. Over the age of 65,
the incidence grows to 5 in 100. Of the population who reaches age 80, 1 person in 5 will
have some form of dementia [Source; Kingshill Research Centre, UK]. The condition has many
causes.
The severity of dementia varies from person to person and a sufferer's life expectancy
depends on the variety of dementia and how early it was diagnosed. For example, if the
symptoms of Alzheimer's disease, the most common form of dementia, are recognized and
treatment begins early, the person with Alzheimer's may live 10 or more years after the
diagnosis.
Restraints: What are they and how should they be used?
If your care recipient is in a hospital or institution that uses restraints, there are
a few points you should keep in mind when discussing restraints and their use in the
facility. Generally speaking, restraints are physical items/materials used as a way to
stop free movement that might hurt the person and/or others nearby. Restraints may be
required if a person becomes aggressive, combative or so confused that there is a
significant risk of injury or harm to either the person or those around them.
The use of restraints should be a joint decision between the medical staff and
families. There should be a written policy on the use of restraints clearly visible for
the family's reference. It is important to remember that the use of restraints can
sometimes be avoided by looking at other options. For example, changing how someone is
seated in a chair can remind him or her to ask for help before getting up. Allowing
uninterrupted sleep, regular toileting and good pain control can lessen the need for
restraints as they can make the care recipient more comfortable and less agitated.
Misconceptions about restraints include:
Restraints always keep the care recipient safe. People don't mind restraints.
Restraints will stop people from falling Restraints are the only way to handle aggressive,
agitated or confused people
If the family and medical staff determine and agree that restraints are necessary, then
the following procedures should be followed:
The person in the restraint should be watched carefully by all nursing staff. Continued
use of the restraint should be reviewed every 8 - 12 hours (i.e., every change of nursing
shift). Every effort should be made to reduce restraint use and prevent the risks that are
associated with the use of restraints
The risks of lengthy restraint use include:
- Loss of bladder control Constipation Bone loss and osteoporosis
- Skin breakdown and pressure sores
- Depression
- Entanglement in straps and resulting injuries
- Increased infections and blood clots
Caregivers may need to make decisions quickly about the use of restraints and the
appropriate time to remove them. If restraints are to be used, family members should be
advised of the reasons for the restraints and the anticipated length of time that the
restraints may be necessary.
