Excessive physical strain in dementia care is not so much related to equipment or the resident's body weight as it is due to communication problems and misunderstandings. This is shown in a new study from the Sahlgrenska Academy.
Dementia not only affects the memory and other cognitive functions, but also motor skills such as the ability to walk.
'The symptoms of dementia are very individual and can vary from one day to the next, and sometimes even from one moment to the next. This makes person transfers in dementia care very demanding for the personnel', says physiotherapist Cristina Wångblad, one of the researchers behind the study recently published in the scientific journal Scandinavian Journal of Caring Sciences.
The study investigates how nurses' aides at three dementia care facilities in western Sweden feel about person transfers in the workplace and what they do to reduce the physical strain. While the residents' body weight seems to be less relevant for how straining the personnel perceive their work to be, Wångblad found misunderstandings and communication problems to be much more important.
'A resident who is unable to read signals from the surroundings or who forgets what he or she is supposed to do reacts with anxiety, confusion and resistance. The personnel can avoid communication problems by explaining things with different words and by using body language, and thereby make person transfers much easier', says Synneve Dahlin Ivanoff, Professor of Occupational Therapy at the Sahlgrenska Academy.
Individual-specific knowledge about the residents also seems useful. For example, the personnel can make person transfers easier by giving appropriate instructions, using the right vocal pitch, assisting a resident in the way he or she prefers, and by knowing whether it is possible to ask a resident to move faster.
'The physiotherapists who train and educate dementia care personnel must be aware of the complexity of person transfers. The instructions on how residents should be moved ought to be tailored to each individual's needs and to each situation', says Wångblad.
Around seven percent of all Swedes older than 65 and twenty percent of those older than 80 suffer from dementia. Most of these receive care through community and county primary care providers. The most common symptoms are forgetfulness and reduced language skills. Problems related to reading, performing calculations and recognising one's surroundings and people and things in it are also common. Motor skills are affected as well; problems feeding oneself and getting dressed are typical.
- Cristina Wångblad, Maria Ekblad, Helle Wijk and Synneve Dahlin Ivanoff. Experiences of physical strain during person transfer situations in dementia care units. Scandinavian Journal of Caring Sciences, 2009; DOI: 10.1111/j.1471-6712.2008.00655.x
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