Understanding Dementia in Senior Adults: Challenges and Best Practices in Nursing Care

In this document we will discuss about Understanding Dementia in Senior Adults and below are the summary points of this document:- Senior adults in Australia account for a significant portion of the population, with a high prevalence of dementia. The treatment and management of dementia in residential care facilities pose challenges due to the manifestation of challenging symptoms. Dementia is characterized by a range of symptoms, including deterioration in mental ability, memory loss, communication difficulties, and behavioral problems.

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Background:
Senior adults make up a significant proportion of the entire Australian population.
According to a report published by the Australian Institute of Health and Welfare, it has been
mentioned that 1 out of 7 Australian citizens are aged 65 years and above (Australian Institute of
Health and Welfare, 2019). The most prevalent disorder in old age patients residing within the
care facility is Dementia (LoGiudice & Watson, 2014). Statistical figure reveals that
approximately more than 400,000 elderly people in Australia suffer from Dementia (Bunn et al.,
2014). In addition to this, research report suggests that Dementia is the largest cause leading to
disability in the Australian citizens. It has been mentioned that 50% of the old age care facility
residents suffer from Dementia in Australia (Robinson et al., 2014). Dementia accounts for the
second largest reason responsible for the death of the elderly (Armari, Jarmolowicz & Panegyres,
2013). The rationale for the choice of topic can be mentioned as the complicated treatment and
management of Dementia in the elderly pertaining to the manifestation of challenging symptoms.
Search Methods:
In order to evaluate the best practice for the treatment of dementia in residential old
adults the electronic databases of PubMed and Google Scholar were scanned using relevant key
terms and specific exclusion and inclusion criteria. The key terms that were used included: best
practice, dementia, dementia care, aged, residential facility and nursing practice. The exclusion
criteria were used to eliminate the irrelevant research papers and included papers that were
published prior to 2013 and papers published in foreign languages other than English. The
inclusion criteria on the other hand included papers published between 2013-2019 and papers
that were only published in English.

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Findings:
Dementia can be defined as a condition of collective symptoms that include deterioration
in the mental ability and subsequently interfere the individual’s ability to manage activities of
daily living. Vascular dementia is the second most common type of Dementia which occurs after
a stroke (Miller & Boeve 2016). In addition to this, vitamin deficiencies and thyroid related
problems could also lead to Dementia however the condition is reversible in such cases (Wand et
al., 2014). It should be noted in this context that the symptoms of Dementia vary from one
person to another. The most common symptoms cover poor functioning of the memory, poor
communication and language, poor ability to focus and pay attention, poor ability of reasoning
and judgment and poor visual perception (Jones et al., 2013 The damage to brain cells impede
with the normal functioning of the brain to communicate with other cells (Bunn et al., 2014. This
directly affects the distinct areas present within the brain that deal with memory, decision
making or movement.
According to Bunn et al. (2014), Dementia in residential patients is characterized with a
number of challenging symptoms that include, behavioral problems, depression, disruptive
behaviors, difficult behaviors, inappropriate behaviors, acting out and unusual behavioral
symptoms. Another study conducted by Dyer et al. (2016), suggested that the most common
examples of behavioral problems presented by Dementia patients included verbal aggression,
obsessive-compulsive behaviors, social withdrawal, anger, suspicion, apathy, hoarding and
wandering. In order to effectively manage the challenging symptoms of the patient, it is
important for care professionals to understand the underlying reason for the challenging
behaviors. Illness and discomfort can be identified as the physical causes that lead to challenging
behavior. Presence of an over-stimulating environment also triggers challenging behavior in

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patients (Jones et al., 2013). Confusion and suspicion or feeling unsafe within the care
environment also leads to the portrayal of challenging behavior in patients. It is extremely
important for care professionals to be aware of the best care practice that could help in dealing
with the challenging symptoms of the patient so as to improve patient outcome.
Pharmacological interventions of administering Cholinesterase inhibitors such as Donepezil and
Galantamine has been proven to boost the levels of chemical messenger directly involved in the
process of decision making and memory. In addition to this, administration of Memantine has
been studies to control the activity of Glutamate which is a neurotransmitter involved in a
number of brain functions such as memory (Laver et al., 2016).
In addition to the discussed pharmacological intervention, a number of therapies can help
in positively dealing with the challenging symptoms of the patient. These therapies are referred
to as the non-drug approaches to manage the disease and include assisting the patient with
occupation therapy, harboring a risk-free environment and modifying the tasks. The
administration of occupational therapy typically assists patients with coping skills and self-
management skills so as to manage behavior and prevent risks from accidental falls and injuries.
Studies show that the creation of safe environment helps in preventing risks from accidental falls
and injuries. Nursing care professionals should be alert and foster a safe healthcare environment
by reducing noise and clutter. The rationale for the same can be explained as the reinforcement
of a secure environment where the patients would find it easier to focus and concentrate. In
addition to this, care professionals must also ensure ample lighting within the room and procure a
dry environment free from loosened rugs so as to avoid the risk from falls. Also, care
professionals must also keep in mind the difficult behavior of the patient and hide objects that
threaten patient safety such as knives and scissors. Also, installation of monitoring systems can

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help in keeping a check on the patient if the patient wanders aimlessly within the care facility. In
addition to this, making use of a structured routine helps in reducing the symptoms of confusion
in patients with Dementia. Nursing professionals should break tasks into simpler steps and
critically focus on the success rather than failure, so as to motivate the patients to manage the
symptoms effectively.
Research studies also suggest that the administration of certain diet supplements can
promote positive effects in Dementia patients. These medications are referred to as alternative
medications and include the administration of Vitamin E, Omega-3 fatty acid and Ginkgo.
Studies mention that administration of Vitamin E slows down the progression of Dementia and
Alzheimer’s. Also, studies suggest that the administration of Omega-3-fatty acid supplements
could help in reducing cognitive decline (Ball et al., 2015). Care professionals must therefore
customize the dietary need of the Dementia patients within residential facility and include Fish
which is a high source of Omega-3-fatty acid. Also, Ginkgo has been suggested to improve the
symptoms of Dementia (Ball et al., 2015).
The evidence base suggests that the administration of a number of psychological
therapies can help in promoting relaxation and dealing with the symptoms of agitation in
Dementia patients. These therapies include the administration of Music therapy and mindfulness
based therapies such as meditation and yoga (Blackburn & Bradshaw, 2014). In addition to this,
administration of aromatherapy and pet therapy has also been proven to yield effective outcome
and better regulation of the symptoms. Aromatherapy typically makes use of essential oils from
plants such as lavender to instill a soothing feeling among the patients (O’Connor et al., 2013).
Pet therapy, on the other hand makes use of animals such as visits from cats and dogs to alleviate
the mood in patients suffering from Dementia (Burton, 2013).

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Also, adapting a family centred approach and involving a family member in the care
delivery process has been witnessed to render positive outcomes (Robinson et al., 2013). Also,
promoting health literacy about the disease among the family members and close friends of the
patient can help in acquiring positive support which speeds up the recovery process.
Discussion:
Therefore, it can be mentioned that the senior adults constitute a significant percentage of
the Australian population. Old age individuals aged 65 and above suffer from a number of
physical health issues with Dementia being the primary reason to cause disability and the second
reason for increased mortality in patients. Dementia is characterized by a number of complicated
symptoms which include, poor memory, poor decision making ability, poor social interaction
ability and limited ability to manage activities of daily living. In addition to this Dementia
patients present a number of complicated symptoms such as difficult behavior and abnormal
behavioral interactions. It is important for care professionals to understand the reason attributing
to challenging behavior so as to design appropriate intervention. Dementia accounts for the
largest reason for hospitalization in the elderly. Care professionals must make use of appropriate
pharmacological intervention strategies so as to effectively manage the symptoms of the patient.
In addition to this, administration of a number of psychological therapies, proper nutrition and
alternative therapies can also help in dealing with the challenging symptoms of the Dementia
patients.
However, it should be mentioned here that a number of literature gaps have been
identified in the reviewed literatures. The literatures do not provide an insight into the training
requisites of care professionals to effectively care for Dementia patients. Therefore, it can be said

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that the area of imparting education and training among residential nursing provides offers area
of further promising research.

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References:
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Australian Institute of Health and Welfare (2019). Older Australia at a glance, Australia’s
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Burton, A. (2013). Dolphins, dogs, and robot seals for the treatment of neurological disease. The
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