Activity kits could calm people with dementia in ED
A trial will test whether emergency department activity kits can reduce the need for medication, sedation and restraints for people with dementia.
For people with dementia, a busy hospital emergency waiting area can trigger stress and trauma, but a trial is underway to explore whether therapeutic activity kits could help calm those behaviours.
Conducted at Royal Brisbane and Women’s Hospital (RBWH) with QUT Nurse Dr James Hughes, the trial aims to determine whether the kits could reduce the need for medication, sedation and restraints.
Around a third of all patients aged over 70 who arrive at emergency departments have a cognitive impairment, the majority of those dementia-related, said Dr Hughes. People with dementia and cognitive impairment are almost twice as likely to present at emergency departments compared to the general population.
“For people with dementia, a sudden change in the environment such as a busy hospital waiting area, coupled with their immediate medical problem, can quickly cause disorientation and behaviours such as wandering, agitation and aggression,” said Dr Hughes.
The kits designed to soothe them will include reminiscence cards, playing cards, towels to fold, a music player, as well as puzzles, doodling pads and colouring packs.
Potential to free hospital resources
The trial will recruit 112 patients on presentation to RBWH Emergency and Trauma Centre that are identified as at risk of developing behaviours that can complicate and delay treatment.
A seven-member team of nurses, doctors and academics will then assess how successful the kits are in preventing agitation or aggression, by studying the behaviour, care and treatment times of people with dementia who are given the kits compared to those who are left to their own devices.
Dr Hughes says the kits have the potential to not only improve care for patients and their carers, but also free up hospital resources.
“If we can prevent the unwanted behaviours, we can avoid resorting to measures such as psychoactive medication, sedation, physical restraint or one-on-one nursing care,” he said.
“Many of the interventions can be implemented in any setting quite swiftly, which could make a big difference to the care being provided to Australians affected by dementia.”
Results of the study are expected to be available from August 2020 and if successful, the kits could become a permanent fixture in hospital emergency departments in years to come.
The research is being funded by the Rosemary Bryant Foundation in partnership with HESTA.
Chair of the Rosemary Bryant Foundation, Dr Rosemary Bryant, said the benefits of the trial could be wide-reaching.
“It has the potential to improve clinical practice and health outcomes in a very cost-effective way,” she said.
HESTA CEO Debby Blakey said the research could positively impact a significant number of Australians living with dementia as well as people who care for them.
“By supporting this project, we want to make a difference, while also having a long-term impact on the world in which our members work and live.”
I have had cause to be admitted to as a patient to an emergency department of a hospital on two occasions. On each occasion I have observed that elderly patients seem to be confused about the isolation they experince. The atmosphere in an emergency unit, the isolation , the dim lighting and the unusual hustle and bussle . On each occassion the older patient kept canning for attention and became very distresed when left alone. There constant shouting distressed other patients and did not bring them any rleif either . I am sure they would not be able to deal with a an activity kit.