A care home resident is pushed by another resident and fractures his femur; a 93-year-old woman in a palliative care ward is pulled from her bed by another patient; an elderly man visiting his wife at a care home is struck by a male resident—these are just a few of the cases in BC of senior-on-senior aggression due to dementia that proved fatal in recent years.
Though the majority of such incidents do not result in death, the dangers are very real and, for many families and professional caregivers across Canada, dealing with them is a daily struggle. These challenges were recently highlighted in a front page report by the Vancouver Sun, titled Danger in the Dementia Care Home. The report calls for a more proactive approach in addressing the growing problem of aggression among seniors with dementia.
As a Dementia Consultant, I know how overwhelming it can be caring for someone with a progressive dementia. In my opinion, we need to ensure that care facilities are not short-staffed, and that care workers receive more in-depth training geared specifically towards managing challenging dementia-related behaviours. These two issues are vital and need immediate attention.
There are far too many overburdened care workers across the country. This is often as a result of the stress from insufficient staffing levels and higher risk levels. Current policies of staff-resident ratios are not favoured by many, including activist groups such as the Hospital Employee Union (HEU). As much as I would like to see industry standards improve, unfortunately, this is an area that needs the attention of the provincial government.
When it comes to staff education, having the basic knowledge about dementia is a great start but there needs to be a greater emphasis on specific approaches to dementia-related behaviours. For example, what does one do when a resident suddenly starts yelling and becomes hostile? With practice training, a staff person can become more confident in their approaches. With this specialized training, one can also staff become more mindful of their verbal and non-verbal gestures which can make a huge difference when it comes to de-escalation of aggressive behaviours.
With additional training, I feel it is also important to emphasize that professional care staff need to understand the value in looking past the label of ‘dementia’ to get to know residents as people first. Understanding a resident’s particular likes and dislikes, what puts them at ease, what stresses them out, can allow care staff to remove or reduce triggers that may be fueling aggression. For example, if you get to know that a resident used to be a soldier in the war and that hearing loud sounds puts him on edge, making sure that he’s located in a quiet area of the home could prevent a potential aggressive incident. You may also discover that a particular genre of music, classical or jazz perhaps, or a particular type of object, landscape paintings for example, can do wonders in generating positive emotions that reduce agitation.
Making changes at a provincial level is not a solution that can be implemented tomorrow. However, staff training is more easily attainable and vital in curbing the ‘aggression problem’ to better protect those with dementia and those who care for them.
To learn more about staff training to effectively manage behaviours, contact us at info@dementiasolutions.ca
