Dementia related aggression in the acute sector: Is a Code Black really the answer?

Abstract

Objective: This paper presents the findings of one facet of a larger study that explored the management of people with dementia as inpatients of acute care. The aim of the study is to provide a comprehensive multiprofessional view of the experience of providing care to people with dementia in an acute setting. Design: Descriptive exploratory study. Setting: Three acute care hospitals in South Australia. Participants: 25 health professionals who regularly provided care to people admitted to hospital with concurrent dementia. Results: The information gathered provided a rich understanding of the frailty, dependency and unpredictable behaviour of people living with some form of dementia and how that creates tensions in a place that is environmentally, culturally and resourcefully bereft of what is required for truly effective care. Conclusion: The study showed that people with dementia are increasingly being admitted to hospital across almost every specialty and that many staff are ill prepared for meeting their needs. The heavily medically dominated environment of an acute care system lends itself to increased confusion and agitation in these people that may rapidly escalate to aggression and violence. Due to various shortfalls in that system, staff will often resort to restraint in managing disruptive behaviour - which is not in the best interest of the patient or the health care system. The way forward is to foster a multifactorial approach to a 'dementia friendly' system of care supported by education.