scholarly journals ‘I Want to Go Home Now’: Restraint Decisions for Dementia Patients in Western Australia

2018 ◽  
Vol 33 (2) ◽  
Author(s):  
Judy Allen ◽  
Tamara Tulich

This article examines the current legal framework for restraint of persons with dementia in Western Australian aged care facilities and evaluates it in light of recent developments at the national and international levels. It highlights how the current legal framework fails to adequately protect people with dementia and aged care professionals, and considers options for reform. We argue that the viability of supported decision-making for restraint decisions needs to be carefully considered, and that law reform is necessary to ensure that the best decisions are made, the dignity of dementia sufferers is protected, and that there are safeguards to prevent abuse.

2020 ◽  
pp. 073346482095173
Author(s):  
Nadine Cameron ◽  
Deirdre Fetherstonhaugh ◽  
Michael Bauer ◽  
Laura Tarzia

The ways in which residential aged care staff conceptualize the identities of residents with dementia has significance for how they support them to make decisions and make decisions on their behalf. This article aims to further understand how staff in residential aged care facilities comprehend who residents “are.” Methods: This qualitative study draws on individual and group interview data with aged care staff from two Australian states concerning decision making for individuals with dementia. It identifies themes relevant to how staff refer to identity in relation to such residents. Results: Staff possess disparate ideas about what things comprise residents’ identities and, accordingly, which sources of knowledge are most relevant to learning about residents. Discussion: This article argues for the application of a multidimensional and temporally inclusive understanding of identity by those who provide care to people with dementia.


2021 ◽  
pp. bmjspcare-2020-002767
Author(s):  
Jamie Bryant ◽  
Marcus Sellars ◽  
Craig Sinclair ◽  
Karen Detering ◽  
Kimberly Buck ◽  
...  

Objectives(i) Describe the prevalence and type of advance care directives (ACDs) and other advance care planning (ACP) documentation completed by persons with dementia, healthcare providers and others on behalf of a person with dementia; (ii) identify the personal and ACP programme characteristics associated with having ACP documentation in the health record; (iii) identify the personal and ACP programme characteristics associated with having a self-completed ACD.MethodsA multicentre audit was undertaken in Australian hospitals, general practices and residential aged care facilities. Auditors extracted demographic and ACP data from the records of eligible patients. ACP programme characteristics were provided by a site representative. Logistic and multinomial regression were used respectively to examine the factors associated with completion of any ACP documentation, and self-completion of an ACD by persons with dementia.ResultsA total of 1388 people with dementia (33.2%) from 96 sites were included. Overall, 60.8% (n=844) had ACP documentation; 31.6% (n=438) had a self-completed ACD and 29.3% (n=406) had an ACP document completed by a health professional or someone else on their behalf. Older participants were more likely to have ACP documented. Multivariate analyses indicated the odds of having self-completed ACP documents, compared with no advance care plan or ACP completed by someone else, were significantly influenced by age, country of birth, setting and whether the site had ACP training, policies or guidelines.DiscussionWhile 60% of people with dementia had some form of ACP documentation, only half of the cases in which ACP was documented included an ACD completed by the person themselves.


2017 ◽  
Vol 29 (12) ◽  
pp. 2099-2103 ◽  
Author(s):  
Anita M. Y. Goh ◽  
Samantha M. Loi ◽  
Alissa Westphal ◽  
Nicola T. Lautenschlager

ABSTRACTTouchscreen technology (TT) is a resource that can improve the quality of life of residents with dementia, and care staff, in residential aged care facilities (RACF) through a person-centered care approach. To enable the use of TTs to engage and benefit people with dementia in RACFs, education is needed to explore how these devices may be used, what facilitates use, and how to address barriers. We sought to provide education and explore RACF staff views and barriers on using TT to engage their residents with dementia. An educational session on using TT with residents with dementia was given to staff from three long-term RACFs in Melbourne, Australia. A cross-sectional convenience sample of 17 staff members (personal care attendants, registered nurses, enrolled nurses, allied health clinicians, and domestic staff) who attended were administered questionnaires pre- and post-sessions. As a result of the education seminar, they were significantly more confident in their ability to use TT devices with residents. TT, and education to staff about its use with residents with dementia, is a useful strategy to enhance RACF staff knowledge and confidence, thereby enhancing the use of technology in RACFs in order to improve care standards in people with dementia.


Dementia ◽  
2020 ◽  
pp. 147130122092915
Author(s):  
Nadine Cameron ◽  
Deirdre Fetherstonhaugh ◽  
Michael Bauer

Care staff in residential aged care facilities (nursing homes) in Australia are obligated, under the Australian National Framework for Action on Dementia 2015–2019, to support residents to exercise choice and make decisions. Research indicates, however, that care staff are often given little guidance regarding which residents’ decisions should be supported or how to make decisions on their behalf. This lack of guidance can result in a denial of residents’ rights and inconsistent treatment by staff, placing residents’ wellbeing at risk. Through providing an analysis of the responses of staff at RACFs in Victoria and Queensland to two case scenarios, this study seeks to provide some understanding of the difficulties staff face in supporting residents’ self-determination and their own need for greater organisational support.


Dementia ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 344-359 ◽  
Author(s):  
Giovana Sposito ◽  
Ana Barbosa ◽  
Daniela Figueiredo ◽  
Mônica Sanches Yassuda ◽  
Alda Marques

A quasi-experimental study using a pre–posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) program, implemented by direct care workers, on the behaviors of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviors were analyzed. The frequency of engagement in task decreased significantly ( p = .002) however, its duration increased ( p = .039). The duration of gaze directed at direct care workers improved significantly ( p = .014) and the frequency of closed eyes decreased ( p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC–MSS and MS programs as they may stimulate residents’ behaviors.


2009 ◽  
Vol 5 (5) ◽  
pp. e7-e7
Author(s):  
M. Prior ◽  
S. Sacre ◽  
J. Wilson ◽  
R. Fleming ◽  
J. Abbey ◽  
...  

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