Assignment

QUALITATIVE STUDY

Background

The main problem that led to conduct this study is the high amount of deaths from injuries related to the falls of people older than 60 years old. To determine these cause of falls and improve the nursing care in elderly patients with dementia a research was conducted and approximately 33% of elders have been affected by injuries from falls which translates to 16,000 yearly deaths, and about $19 billion is used yearly for treatment related to falls in the United States (Overcash, Rivera &Van Schaick, 2010). The main purpose of this research study is to provide information about issues related to falls in people with dementia and to examine the similarities in the data that may be used to improve nursing care in patients with dementia. Three research questions were developing during the study to archive this purpose. What is the elderly fall rate in the nursing home? How many times a day nurses provide rounding to patients with dementia? What activities were identified that may have caused the falls? This study reviews the article Aizen (2015); Falls in older people with dementia. Dementia is the loss of mental ability so severely that it can interfere with the normal activities of life, it often lasts six months, its not present at birth and is a condition cannot be associated to alteration or loss of consciousness. The study describes the condition regarding its occurrences, causes effects and the implications for the healthcare providers. Dementia is a manifestation of some symptoms that occur as a result of the death of brain cells. It results in loss of cognitive abilities leading to impairments in reasoning, memory, behaviour and planning. While the condition mostly occurs due to ageing, it is not entirely inevitable with ageing since it is caused by a disease called Alzheimer’s disease (Aizen, 2015). The prevalence of the disease is not quite easy to determine since the disease has been defined differently in different studies and there are also normal levels of decrease in functional ability with age. It is highly prevalent for individuals aged over 60 years. About 60% of nursing home patients are affected by dementia.

Elderly people with dementia need a lot of care and medical supplies to maintain their safety, which can sometimes be very costly. Nursing care for such people can be very difficult. When a person has dementia, he loses control most of the vital body functions and personality (Aizen, 2015). Such people become increasingly dependent and unpredictable, and their loved ones and families have to cope with them. The study states that the elderly people with dementia are at higher risk of falls and the consequences of such falls. Compared to those who are old but cognitively intact, the elderly with dementia falls twice as much. The falls in older people with dementia results in increased rates of mortality, morbidity and institutionalization. The study states this area has not attracted enough studies to establish specific risk factors to the falls (Aizen, 2015). Trials that have been conducted in fall prevention programs at the community dwellings of the elderly with cognitive impairments have not been very much effective. The study largely addresses the handling of the risk of falling in among the elderly people with dementia.

Method of Study

In the study, there is evidence of the use of both qualitative studies as well as quantitative studies. For the qualitative study, the article uses other studies that have been conducted in this field of dementia. The article even notes that the area of falls in the elderly people with dementia has not attracted enough research to enable conclusive findings. It states that even the results obtained by studies in various long term care services have not obtained conclusive findings on the topic of falls among the elderly with dementia. The study tries to explore the risk of falls among the patients with dementia and the consequences of the falls among the elderly. To find out solutions of how to deal with such falls the article reviewed some attempts and frameworks that have been used in the effort to prevent falls among the elderly in long term care facility, dwellings and other care systems

The study also refers to some other articles that address the topic of dementia. In this regard, it considers the article with the most current information about the areas of interest. It has to refer to the current articles since it even considers the figures and facts about the occurrence of the condition among the elderly. It is a condition that keeps changing regarding the number affected and the experienced impacts due to the increasing number of the old population. To illustrate things like the attempts to address the risk of falling among the elderly with dementia the article critically reviews some articles and studies that have been conducted covering the area of interest.

Results of the study

The study finds out that falling is not an inevitable aspect for those living with dementia. However, some symptoms of dementia make the patients more at risk of falls. Those with dementia have some health conditions that make them more likely to fall compared to people without dementia. Even among the people with dementia, there is deference in risk to falling. Some of the factors that may lead to falls include; some experience problems with mobility, balance and weakness of muscles. They often have difficulty in finding their way around due to loss of memory. Due to loss of cognitive abilities, they get difficulties in processing information in situations when a reaction is needed after seeing something (Namioka et al.2015). Another challenge is that they take medicines that can make them drowsy thus being more susceptible to falling. Most of the patients can become so depressed and face a lot of difficulties in sharing their feelings, needs and worries.

The likelihood of falling increases as people get older. However, those with dementia have more prone to falls not only due to their age but their decline in the cognitive abilities and ability to judge distances. To avoid the falls or rather reduce the chances of falling those providing care to the elderly people with dementia can take some measures. Providing hourly rounding, avoid clusters in the living spaces, and the rooms should be adequately lit, elderly people should be provided with comfortable foot wares; the foot wares should not in any way contribute to the risk of falling. In critical areas of the house that could be most challenging for elderly people, there is a need for grab rails to aid their movement (Luxford et al. 2015). Use of distinctly contrasting colours for different objects to avoid confusions. People with dementia should be kept away from slippery surfaces. Sudden and loud sounds should be avoided since they cause someone with dementia to be disoriented and may fall. The surrounding of these people directly influences the level of risk involved, so it’s a key factor in the care of the old with dementia.

Ethical considerations

The study takes note of the ethical considerations when it comes to handling the patients with dementia or any other care providers to such people. It states that the care should obey the autonomy, the quality of life, social responsibility, capacity and competency and employ substituted judgment. For autonomy the people have right to consent, their respect and dignity should be maintained, right to information and self-determination and voluntary participation in the care. And the care should be guided by the patient's sense of the quality of life not those of the caregivers.

Conclusion

Dementia is a condition that is continually affecting a larger number of people due to the increase in the ageing population. It is a condition that interferes with the cognitive ability of an individual making the more dependent and vulnerable. The victims of this disease are often a risk of falls due to the decline in their cognitive abilities. Such falls pose a greater risk to their health and wellbeing, and the care systems should always strive to minimise the risks of falling.

References

Aizen, E. (2015). Falls in patients with dementia. Harefuah, 154(5), 323-6.

Kolanowski, A., Mogle, J., Fick, D. M., Hill, N., Mulhall, P., Nadler, J., ... & Behrens, L. (2015). Pain, delirium, and physical function in skilled nursing home patients with dementia. Journal of the American Medical Directors Association, 16(1), 37-40.

Luxford, K., Axam, A., Hasnip, F., Dobrohotoff, J., Strudwick, M., Reeve, R., ... & Viney, R. (2015). Improving clinician–carer communication for safer hospital care: a study of the ‘TOP 5’strategy in patients with dementia. International Journal for Quality in Health Care, 27(3), 175-182.

Namioka, N., Hanyu, H., Hatanaka, H., Fukasawa, R., Sakurai, H., & Iwamoto, T. (2015). Comprehensive geriatric assessment in elderly patients with dementia. Geriatrics & gerontology international, 15(1), 27-33.