Gerontological Nursing & Dementia

As the population ages, there is a growing need for experienced gerontological nurses. However, this type of nursing presents serious challenges, especially when caring for patients with dementia. Because individuals with dementia experience deteriorating mental capacities, they also become less and less able to help with their own care. Understanding the special needs of elderly patients with dementia can help you prepare to offer the best care possible.

Common Symptoms of Dementia

• As a gerontology nurse, you will need to be on the lookout for the early signs of dementia in your patients. Depending on the patient's level of regular interaction with family members and physicians, signs of dementia may otherwise go unnoticed. Symptoms of dementia can include memory loss, problems with coordination, inappropriate outbursts, paranoia, agitation, inability to learn to new information or even hallucinations. It is essential to catch symptoms early so the patient can make important decisions while he is still capable.

Nursing Challenges for Dementia Patients

• Caring for a patient with dementia will present a host of additional challenges for a nurse. Develop a specific routine for daily management of dementia patients, as this has a calming influence and reduces confusion for the patient. Since the symptoms of dementia tend to get worse in the evening when the patient is tired, try to arrange strenuous activities such as bathing early in the day to prevent problems.

Risk of Abuse

• Because elderly patients are often unable to defend themselves, they are at high risk for physical and emotional abuse and neglect. According to Helpguide.org, "the 500,000 to 1,000,000 reports of elder abuse recorded by authorities every year, the vast majority of which are proven to be true, are only the tip of the iceberg." Patients with mental deterioration caused by conditions such as dementia are at especially high risk because they may be unable to identify their attackers. As a gerontological nurse caring for dementia patients, you will need to be aware of the prevalence of elder abuse.

Recognizing Signs of Abuse

• When bathing or examining an elderly dementia patient, always be alert for signs of abuse. Common signs to watch for include unexplained bruises, burns, welts, sprains or dislocations, restraint marks and skin infections that indicate your patient is being left in soiled undergarments for long periods of time. You should also investigate reports of an overdose of medication, and watch for emotional changes such as refusal to eat or sudden withdrawal. Always report signs of abuse to hospital or nursing facility administrators and the police.

Additional Considerations

• Dementia patients may forget who you are, or think you are trying to harm them. Your patient may lash out verbally or even physically, making your job much more stressful. Make sure you have a support network in place to protect your own mental health. Most elder care facilities have support networks available to nurses and other health professionals to help you cope with the stress of caring for dementia patients.