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Scenario: Non-Pharmacological Management of Dementia: On the neurology inpatient unit, there are increasing numbers of patients with dementia. Some of the symptoms noted in these patients include agitation, wandering and even screaming and violence. A nurse on the unit was recently injured by an elderly man who attacked and hit her while she was providing nursing care to him. Your task is to propose a plan that will address the non-pharmacological management of dementia on the unit and train the nurses to provide quality care to patients with dementia.

PICO Question: In adults with Alzheimer’s disease, what is the effect of animal-assisted therapy compared to usual care on the intensity of agitation?

P: adults with Alzheimer’s disease I: animal-assisted therapy C: usual care O: intensity of agitation.

3 Keywords: Alzheimer’s, animal-assisted therapy, agitation. 1 Synonym: dementia. 1 MeSH term: psychomotor agitation.

Paper For Above Instructions

Dementia is a growing concern in the healthcare sector, particularly as the population ages. One of the most common types of dementia is Alzheimer’s disease, which can lead to a variety of behavioral challenges, including agitation, wandering, and sometimes violent behavior (Majic et al., 2013). These symptoms can impact not only the quality of life of patients but also the safety of healthcare providers. As such, exploring non-pharmacological interventions, such as animal-assisted therapy (AAT), may provide beneficial alternatives to traditional care methods.

The proposed approach in the task is to develop a comprehensive plan that incorporates AAT as an intervention for patients with Alzheimer’s disease within the neurology inpatient unit. This method aims to address the intensity of agitation frequently observed in these patients. The PICO question guiding this exploration focuses on the effectiveness of AAT compared to usual care. In particular, it seeks to identify measurable changes in the intensity of agitation associated with these two treatment modalities.

Understanding Agitation in Alzheimer’s Patients

Agitation can manifest in various ways among individuals with Alzheimer’s disease, including restlessness, yelling, and even physical aggression. The causes of agitation can range from environmental triggers to unmet needs by the patient, such as pain or discomfort (Nordgren & Engström, 2014). A proactive approach to managing these symptoms is vital for improving both patient outcomes and the working conditions for nursing staff.

Animal-Assisted Therapy (AAT)

AAT is an intervention that incorporates animals into therapeutic settings. Research has suggested that AAT can significantly reduce behavioral and psychological symptoms, including agitation, in patients with dementia (Olsen et al., 2016). In a matched case-control trial, Majic et al. (2013) noted marked improvements in agitation levels among nursing home residents participating in AAT compared to those receiving standard care. The emotional support provided by animals can lead to a decreased stress response and can foster companionship, which is particularly important for patients who may experience isolation.

Implementation of the AAT Program

The successful implementation of an AAT program on the neurology inpatient unit will require several key steps:

• Selection of trained therapy animals: Collaborate with certified organizations to find suitable therapy animals that are well-behaved and trained to interact with patients.
• Staff training: Train nursing staff on AAT principles, including the appropriate interactions between patients and animals. This training must also cover the recognition of stress signals in both the patients and the animals involved.
• Creating a conducive environment: Ensure a safe and welcoming environment that accommodates the therapy animals and allows for therapeutic encounters without overwhelming the patients.
• Monitoring and evaluation: Establish a system for assessing the impact of AAT on patient agitation levels using quantitative measures before and after the therapy sessions.

Benefits for Patients and Staff

The potential benefits of AAT extend beyond merely reducing agitation. For patients with Alzheimer’s disease, AAT may enhance their emotional well-being, improve social interactions, and promote overall engagement (Swall et al., 2017). Furthermore, this intervention can have positive effects on the nursing staff, reducing their stress and improving job satisfaction by contributing to a more harmonious working environment.

Evidence Supporting AAT

Several studies corroborate the expectation that AAT can offer meaningful benefits for individuals with dementia:

• Majic et al. (2013) illustrate a significant decrease in agitation and depressive symptoms among nursing home residents participating in AAT.
• Nordgren and Engström (2014) report positive effects of dog-assisted interventions, noting reductions in behavioral issues among patients.
• Research conducted by Olsen et al. (2016) indicates measurable improvements in quality of life when AAT is incorporated into the standard care regimen.

Conclusion

In conclusion, integrating animal-assisted therapy into the non-pharmacological management strategies for patients with Alzheimer’s disease presents a promising alternative to typical care approaches. Emphasizing a community-oriented team approach amongst healthcare providers, including proper training and environmental modifications, can lead to better management of agitation and greater overall satisfaction for both patients and nurses. The implementation of this strategy represents a vital step towards enhancing the quality of care within the neurology inpatient unit.

References

• Majic, T., Gutzmann, H., Heinz, A., Lang, U. E., & Rapp, M. A. (2013). Animal-assisted therapy and agitation and depression in nursing home residents with dementia: A matched case-control trial. American Journal of Geriatric Psychiatry, 21(11).
• Nordgren, L., & Engström, G. (2014). Effects of dog-assisted intervention on behavioural and psychological symptoms of dementia. Nursing Older People, 26(3), 31-38.
• Olsen, C., Pedersen, I., Bergland, A., Enders-Slegers, M., Patil, G., & Ihlebæk, C. (2016). Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: A cluster randomized controlled trial. International Journal of Geriatric Psychiatry, 31(12).
• Swall, A., Ebbeskog, B., Lundh Hagelin, C., & Fagerberg, I. (2017). Stepping out of the shadows of Alzheimer’s disease: A study of older people with Alzheimer’s disease caring for a therapy dog. International Journal of Studies on Health & Well-Being, 12(1).