Management of person with dementia with aggressive and violent behaviour: a systematic literature review

Abstract

To communicate with people with dementia provides a challenge for nurses and other health caregivers. To satisfy the needs of good nursing care, an important aspect is therefore to get knowledge and understanding about aggressive and violent behaviour and its management.

What Is Known About Dementia Care Recipient Violence and Aggression Against Caregivers?

“…Assault may include being hit, kicked, pinched, shoved, grabbed, or bitten. Assaults in this context may also include believable threats to the caregiver(s), or physical aggression against property which could induce fear of assault or danger to the caregiver (Galinsky et al, 2010; Shah, 1995; Ryden, 1988; Enmarker, Olsen, & Hellzen, 2011; Kunik et al, 2010). Note that “agitation” is not necessarily “aggression.” These two concepts are not always clearly separated in the literature, but while agitation generally implies verbal or physical behaviors related to discomfort or confusion, aggression clearly implies hostile physical motion, regardless of the trigger or intent.…”

“…There are a number of things which have been correlated in the literature as triggers for violence, including: pain, reduced vision and/or hearing, changes in the environment, excessive noise or activity, locked doors, limited privacy or space, and quality of relationship with caregivers (Enmarker, Olsen, & Hellzen, 2011; Kunik et al, 2010). Depression and premorbid aggressive personality traits may also be related to aggressive or violent behavior (Enmarker, Olsen, & Hellzen, 2011; Kunik et al, 2010; O'leary, Jyringi & Sedler, 2005).…”

“…Despite this well documented fact, there is not much in the literature about the impact and experience for caregivers (Enmarker et al, 2011; Kunik, 2010a; Mega et al, 1996; Orengo et al, 2008; Shah, 1995). While there has been some investigation of intervention models in nursing home settings for disruption of violent behavior by care recipients against nursing home staff, home-based caregiving remains largely outside of the purview of the current state of knowledge on this topic.…”

Staff-reported strategies for prevention and management of resident-to-resident elder mistreatment in long-term care facilities

“…Limited literature exists examining staff responses to aggressive resident behavior in long-term care facilities (Enmarker, Olsen, & Hellzen, 2011), but we know of no research evaluating the relative frequency of staff-reported actions and strategies to manage R-REM. The goal of our research was to more completely describe and characterize current nursing home staff experience with and responses to R-REM.…”

Violence in the Nursing Homes: Understandings, Management, Documentation and Impact of Resident to Resident Aggression

“…(Cohen-Mansfield et al , 1990;Enmarker et al, 2011;Soreff & Siddle, 2003,) Enmarker et al in the landmark article, Management of person with dementia with aggressive and violent behaviour: a systematic literature review wrote "The results could be summarized in two themes: 'origins that may trigger violence' and 'activities that decrease the amount of violent behaviour'. Together, the themes showed that violence was a phenomenon that could be described as being connected to a premorbid personality …" (Enmarker et al, 2011, pp.…”