McDonald, T. A., 2008
19th International Nursing Research Conference, Singapore
Background: Studies of veterans of Vietnam estimate that 15% to 30% of active service personnel experience some post-war experience of PTSD. While not all exposed to traumatic events develop PTSD, it seems more likely to develop within those exposed to war. In later life, effects of PTSD can be further compounded by mental confusion related to organic brain syndromes which can conflate flashbacks with normal memories.
Objective: In this research the development of this clinical pathway was investigated along with the outcomes of its implementation.
Methods: The elderly veteran population with dementing illness, and active PTSD, can exhibit challenging behaviours that 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. The approach has been thorough assessment based on DSM-IV for PTSD and establishment of a clinical pathway for PTSD in parallel with the general aged care approach.
Results: Aged care nurses and care staff can differentiate between dementing behaviours and those associated with PTSD the clinical pathway for these residents provides greater certainty and understanding of te issues confronting people receiving care. Clear identification of those with PTSD makes it possible for appropriate interventions in both care and pharmacological treatment.
Conclusions: Therapeutic interventions informed by clear indications of PTSD despite advanced dementia are enhanced through implementation of a PTSD Clinical Pathway for veterans. Challenging behaviours as a result of PTSD, when compounded by dementia, create considerable difficulty for the resident and all involved in ensuring safety and care. Yet this research shows that a restraint-free environment combined with a specific clinical pathway for PTSD has significant benefits for older veterans with dementia symptoms.
CITATION McDonald, T. A. (2008) Providing for the safe care and treatment of veterans whose post-traumatic stress disorder manifests with the onset of dementia symptoms. 19th International Nursing Research Congress Focusing on Evidence-based Practice: Research Sessions. Suntec Singapore International Exhibition and Convention Centre, July.