Hospitalized Elders with Dementia

I have recently taken a position as one of the nurse educators in psychiatry at a Boston hospital. I'm glad to be back in the thick of it and notice once again what a therapeutic milieu is for people with dementia. Research shows that it isn't really the ratio of staff to patients but the number of contacts the patient has with staff on any given day. This cements the practice of frequent connection with a confused and frightened elder reduces the likelihood of agitation and/or aggression. We've seen that aggression is most often the result of not understanding what is going on around them or misperceiving the intent of the caregiver. Smiling, connecting by calling him or her by their name, asking, "how are you today?'(the only open ended questions that is OK),making a positive comment about the person all go towards creating a therapeutic milieu (environment). Therapeutic communication is the practice of being clear, keeping eye contact, speaking slowly, simply and concretely. One patient who recently returned to the hospital after an outburst at the assisted living residence he had been discharged to,recognized staff's faces and voices but thought he had been on a cruise last time he was hospitalized. Sometimes delusions can be helpful I guess. Happily with the right dose of medication he was able to be returned to his new home at the residence.