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Patient Aggression Analysis

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Patient aggression is defined as behavior that harms others or causes them to repel away from the situation. It can be verbal or physical. Patient aggression occurs commonly among patients with dementia. In the United States, there were 4 million people with dementia in 2009. That number was expected to increase to 14 million with the next 40 years. As half of the people with dementia have incidents of aggression, it is important to attempt to define methods of diffusing situations where the patient with dementia is agitated and may act out. Two models addressing aggressive behavior are Need-driven Dementia-compromised Behavior (NDB) and the Progressively Lowered Stress Threshold (PLST). These models each help caregivers to identify triggers …show more content…
When these needs are unmet, patients get frustrated, but the patient with dementia has less tolerance for frustration, and their brain does not send message to be kind. They are unable to consider the consequences of their actions. Frustration may stem from poor eyesight in low light conditions. It can also can stem from boredom. There are an endless supply of triggers, and each patient has a unique situation. With caregivers, aggression often happens when patients feel a loss of control or feel that they are overly exposed, such as during bath times (Alzheimer’s Association, 2014). It is important that a nurse first address safety when confronted with an aggressive situation. At times, physical intervention must take place to ensure the safety of the patient and the caregiver. If the situation is not dire, a consideration of the cause of the aggression can be an effective, noninvasive way to intervene (Dettmore et al., …show more content…
Physiological triggers can be alleviated by addressing the activity that is the source of frustration. In patients with dementia, it may be activities of daily living such as dressing, bathing or eating. Assistance should be provided, but it is important that the patient is able to preserve any independence possible, as loss of independence is a trigger. Psychosocial triggers, such as boredom, can be mitigated with music therapy or recreational activities. Physical environments can be proactively less trigger-filled by reducing noise and being properly lit. Social environments shouldn’t be overcrowded, as frustration with overcrowding can trigger aggression (Dettmore et al., 2009). If safety is a concern, pharmacological intervention may be necessary. Cholinesterase inhibitors, memantine, anti-convulsants and anti-psychotics may be appropriate depending on the patient. In severe cases, short-term sedation may be required, and this can be done with short-acting benzodiazepines such as lorazepam (Dettmore et al.,

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