McDonald, T. A., 2009
IAAG Conference, Paris France
Background: Studies of veterans of war indicate that 15% to 30% of active service personnel experience some post-war experience of PTSD. In later life, effects of PTSD can be further compounded by mental confusion related to dementia which can conflate flashbacks with current experience. This research investigates the effectiveness of a clinical strategy for aged care of those with PTSD occurring concurrently with dementia.
Objective: To develop a strategy for identifying PTSD among residents living with symptoms of dementia in a residential care village.
Methods: Reviews of published findings on PTSD in older people formed the basis of an action research process undertaken with professional experts in the clinical management of people with dementia and challenging behaviours. Mixed methods including secondary analysis of care needs and management documentation identified the extent to which elderly residents may have PTSD as well as dementia symptoms.
A clinical pathway developed through this process was implemented across 6 residential care units in a large aged care facility and care staff training on dementia and identifying PTSD using DSM IV criteria implemented. Care and treatment outcomes are analysed for residents on the clinical pathway along with staff use of the tool.
Results: Differential diagnosis of older people with PTSD and dementia makes possible appropriate interventions in both care and pharmacological treatment. Aged care nurses and care staff can distinguish dementing behaviours from those associated with PTSD using the clinical pathway which also provides greater certainty and understanding of the issues confronting people receiving care.
Conclusions: Therapeutic interventions informed by clear indications of PTSD despite dementia are enhanced through implementation of appropriate psychiatric interventions for veterans. Challenging behaviours as a result of PTSD, when compounded by dementia, create considerable difficulty for the resident and others responsible for safety and care. This research shows that a restraint-free environment combined with a specific clinical pathway for PTSD has significant benefits for elderly, mentally confused war veterans.
CITATION McDonald T. (2009) Providing for the safe care and treatment of veterans whose post-traumatic stress disorder (PTSD) manifests with the onset of dementia symptoms19th International Association of Geriatrics and Gerontology (IAAG) World Congress on Gerontology and Geriatrics “Social research, policy and practice” Paris, France. 5-9 July.