Aim
The project aims to establish a dedicated pathway for assessing and managing the extreme behaviours within an appropriate environment.
Benefits
- A systematic approach for identifying persons with dementia who demonstrate refractory aggressive behaviour and whose care needs are congruent with aged care facility resources and community care.
- An appropriate assessment, management and referral guidelines.
- A dedicated environment for specialist management.
Background
The Cognitive Care Project managed by Dr Jane McLean from Central Queensland HHS, was sponsored by the Statewide Older People Health Clinical Network (SOPHCN) in 2016-17 and then extended in 2017-18.
Stage One of the project focused on engaging key stakeholders to identify existing cognitive care practices and associated service gaps and/or knowledge and skill requirements. During the 12 month project the project team developed two clinical pathways of BPSD management (a hospital inpatient pathway and a community/RACF pathway) designed to improve the quality and safety of care provision for this client group through collaborative practice and improved communication.
In Stage two from March 2017 to June 2018 they completed the work done in Stage one by consolidating local service provider relationships and simplifying the collaborative decision pathway for supporting people experiencing BPSD and/or delirium within Rockhampton and surrounding areas. Cognitive care education needs were identified and training programs subsequently developed.
Residents with extreme aggressive behaviours have proven extremely difficult to manage in our community settings. Subsequently these patients are sent to the acute care setting as a management strategy. When hospitalised these patients become difficult to discharge, because aged care facilities recognise that the care needs outweigh facility resources. Their increased care needs are often associated with a high risk of physical harm for staff and others within the same environment and pose a serious concern for management and carers. There are also notable risks for the patient with the potential of harming themselves very real and as well with the increased use of antipsychotic medication placing them at risk of deleterious outcome.
Currently within our healthcare district we would have five residents, PWD with severe aggressive behaviour: These patients have complex care needs requiring closer observation and intensive review. The aim of our project will be to provide management strategies particular to this group’s needs so they benefit from specialist management within an appropriate environment to avoid unnecessary hospitalisation.
