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When Post Traumatic Stress Disorder is compounded by dementia…

McDonald, T. A., 2004

ICCHNR Conference presentation, Tokyo Japan

ABSTRACT

Objective: To examine the effects of nursing intervention on Post Traumatic Stress Disorder (PTSD) compounded by mental confusion related to organic brain deterioration. It is acknowledged that any prospect of successfully using established therapeutic approaches to relieve PTSD in the presence of dementia is dramatically reduced. Most therapeutic approaches to PTSD require cognition and the use of pharmacotherapy to reduce the effects of traumatic memories. In most of these approaches, the presence of dementia thwarts access to the cognitive and communicative aspects of therapy that are critical to symptom reversal. Agitation, wariness and sleeping problems combine with physiological responses to adrenalin production mean that symptoms experienced by the confused person with PTSD can be significantly exaggerated.

Methods: A series of case studies and therapeutic exemplars of nursing interventions for older veterans with mental confusion and PTSD were analysed in terms of therapeutic choices made by nurses and health outcomes for veterans in the sample. It was anticipated that by reducing long periods of physical agitation and anxiety through therapeutic interventions, physical deterioration could be halted and even reversed in the cases studied.

Results: In the confused, elderly veteran population manifestations of severe PTSD can result in challenging behaviours that often do not respond to counselling, memory re-construction approaches or relationship therapies that have been found to be effective in the non-confused PTSD population. By minimising triggers that cause this group to re-live traumatic events the potential for renewed PTSD is also reduced thus allowing physical health a chance of recovery as a consequence of rest, adequate nutrition and sleep.

Conclusions: Therapeutic approaches that reduce social isolation and reinforce patterns of trust in others can also result from structured activities that prompt memories of happy times and activities that the person enjoyed when younger. Increased interaction that is friendly and respectful can lead to a decrease in fear and anxiety in mentally confused veterans suffering PTSD.

CITATION McDonald, T. A. (2004) When Post Traumatic Stress Disorder is compounded by dementia. International Conference on Community Health Nursing Research (ICCHNR). September 30 to October 2, Tokyo, Japan

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