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Nursing care for people with frontal-lobe dementia – difficulties and possibilities

Published online by Cambridge University Press:  11 June 2007

A-K. Edberg  and
E. Edfors
A-K. Edberg*
Affiliation:
Department of Health Sciences and the Vårdal Institute, Lund University, Sweden Department of Health Sciences, Kristianstad University, Sweden
E. Edfors
Affiliation:
Department of Health Sciences, Kristianstad University, Sweden
*
Correspondence should be addressed to: Anna-Karin Edberg, Department of Health Sciences, Lund University, P.O. Box 157, Se-221 00 Lund, Sweden. Phone: +46 46 222 1980; Fax: +46 46 222 1934. Email: [email protected].
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Abstract

Background: Nursing care for people with dementia diseases affecting the frontal lobes places special demands on staff, but there is little information available about how best to tailor nursing care. The aim of this study was to describe nurses' experience of difficulties and possibilities in caring for people with dementia diseases with frontal-lobe dysfunction.

Method: The study was carried out as a descriptive qualitative study. Data collected during interviews with nursing staff (n = 10) were analyzed using qualitative content analysis.

Results: The difficulties experienced were related to the patients' lack of inhibition and judgment, anxiety, agitation, reduced ability to deal with physical needs, egocentricity, imbalance between rest and activity and depressed mood. The possibilities were seen in relation to the nursing staff's professional encounters, characterized as being clear and consistent, a step ahead, flexible, calm and creating a positive atmosphere, close and trusting and being and doing things together. Continuous feedback and support were prerequisites for the engagement of the staff.

Conclusion: Nursing care in this context involves ethical issues whereby the residents' integrity must be balanced against a safe and secure environment. Nursing care is a sensitive but also demanding task, where nurses' actions can reduce the negative effects of the disease. It is therefore important to support staff in nursing care so they are able to manage their work and reduce the risk of emotional exhaustion.

Keywords

dementiafrontotemporal lobar degenerationnursing carenursing staffinterviewsqualitative research
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 2 , April 2008 , pp. 361 - 374
Copyright
Copyright © International Psychogeriatric Association 2007

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References

Berg, A., Welander Hansson, U. and Hallberg, I. R. 1994. Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care: comparisons between a ward for severely demented patients and a similar control ward. Journal of Advanced Nursing, 20, 742–749.CrossRefGoogle Scholar
Berg, A., Hallberg, I. R. and Norberg, A. 1998. Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving. International Journal of Nursing Studies, 35, 271–282.CrossRefGoogle Scholar
Berg, B. L. 2001. Qualitative Research Methods for the Social Sciences. 4th edn. Boston: Allyn & Bacon.Google Scholar
Bischofberger, E. 1990. Attitudes, integrity and autonomy. In Andersson, S. O. (ed.), Suffering and Power (in Swedish: Lidandet och makten). Stockholm: Gothia.Google Scholar
Breeze, J. 1998. Can paternalism be justified in mental health care? Journal of Advanced Nursing, 28, 260–265.CrossRefGoogle ScholarPubMed
Brun, A. et al. 1994. Clinical and neuropathological criteria for frontotemporal dementia. The Lund and Manchester Groups. Journal of Neurology, Neurosurgery and Psychiatry, 57, 416–418.Google Scholar
Edberg, A. K., Hallberg, I. R. and Gustafson, L. 1996. Effects of clinical supervision on nurse–patient co-operation. Clinical Nursing Research, 5, 127–149.CrossRefGoogle Scholar
Garritson, S. H. and Davis, A. J. 1983. Least restrictive alternative. Journal of Psychosocial Nursing, 21, 17–23.Google ScholarPubMed
Graneheim, U. H. and Lundman, B. 2004. Quality content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.CrossRefGoogle Scholar
Häggström, T. and Norberg, A. 1996. Maternal thinking in dementia care. Journal of Advanced Nursing, 24, 431–438.CrossRefGoogle ScholarPubMed
Hallberg, I. R. and Norberg, A. 1993. Strain among nurses and their emotional reactions during one year of systematic clinical supervision combined with the implementation of individualized care in dementia nursing. Journal of Advanced Nursing, 18, 1860–1875.CrossRefGoogle Scholar
Kitwood, T. 1998. Dementia Reconsidered: The Person Comes First. Rethinking Ages Series. Buckingham: Open University Press.Google Scholar
Kvale, S. 1999. Interviews: An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage.Google Scholar
Lincoln, Y. S. and Guba, E. G. 1985. Naturalistic Inquiry. Beverly Hills, CA: Sage.CrossRefGoogle Scholar
Lough, S. and Hodges, J. R. 2002. Measuring and modifying abnormal social cognition in frontal variant frontotemporal dementia. Journal of Psychosomatic Research, 53, 639–646.CrossRefGoogle ScholarPubMed
Lyth, G. 2000. Clinical supervision: a concept analysis. Journal of Advanced Nursing, 31, 722–729.CrossRefGoogle ScholarPubMed
Miller, B. L., Darby, A., Benson, D. F., Cummings, J. L. and Miller, M. H. 1997. Aggressive, socially disruptive and antisocial behaviour associated with frontal-lobe dementia. British Journal of Psychiatry, 170, 150–155.CrossRefGoogle Scholar
Neary, D. et al. 1998. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 1546–1554.CrossRefGoogle ScholarPubMed
Polit, D. F. and Hungler, B. P. 1999. Nursing Research: Principles and Methods. 6th edn. Philadelphia: Lippincot Williams & Wilkins.Google Scholar
Sjögren, M., Minthon, L., Passant, U., Blennow, K. and Wallin, A. 1998. Decreased monoamine metabolities in frontotemporal dementia and Alzheimer's disease. Neurobiology of Aging, 19, 379–384.CrossRefGoogle ScholarPubMed
Skovdahl, K., Kihlgren, A. L. and Kihlgren, M. 2004. Dementia and aggressiveness: stimulated recall interviews with caregivers after video-recorded interactions. Journal of Clinical Nursing, 13, 515–525.CrossRefGoogle ScholarPubMed
Snowden, J. S., Neary, D. and Mann, D. M. A. 2002. Frontotemporal dementia. British Journal of Psychiatry, 180, 140–143.CrossRefGoogle ScholarPubMed
Swedish Ministry of Health and Social Affairs 2003. Towards Good Dementia Care. (In Swedish: På väg mot en god demensvård). Stockholm: Swedish Government.Google Scholar
Volicer, L. and Hurley, A. C. 2003. Management of behavioural symptoms in progressive degenerative dementias. Review. Journal of Gerontology Medical Science, 58A, 837–845.CrossRefGoogle Scholar
Wallin, A., Brun, A. and Gustafson, L. 1994. Swedish consensus on dementia diseases. Acta Neurologica Scandinavica, 90 (Suppl. 157), 8–18.Google Scholar