Dementia is not a single disease but a neurological syndrome identified by a decline of the intellectual or cognitive functions of the brain. This decline is accompanied by changes in behavior and personality severe enough to interfere with the activities of daily living such as interacting with others, eating, dressing and personal hygiene. While conscious control may be clear, there is a noticeable disturbance in memory, thinking, attention, problem solving, calculation, comprehension, language and judgment.
Dementia affects less than 1 person in 1,000 under the age of 65. Over the age of 65, the incidence grows to 5 in 100. Of the population who reaches age 80, 1 person in 5 will have some form of dementia [Source; Kingshill Research Centre, UK]. The condition has many causes.
The severity of dementia varies from person to person and a sufferer's life expectancy depends on the variety of dementia and how early it was diagnosed. For example, if the symptoms of Alzheimer's disease, the most common form of dementia, are recognized and treatment begins early, the person with Alzheimer's may live 10 or more years after the diagnosis.
If your care recipient is in a hospital or institution that uses restraints, there are a few points you should keep in mind when discussing restraints and their use in the facility. Generally speaking, restraints are physical items/materials used as a way to stop free movement that might hurt the person and/or others nearby. Restraints may be required if a person becomes aggressive, combative or so confused that there is a significant risk of injury or harm to either the person or those around them.
The use of restraints should be a joint decision between the medical staff and families. There should be a written policy on the use of restraints clearly visible for the family's reference. It is important to remember that the use of restraints can sometimes be avoided by looking at other options. For example, changing how someone is seated in a chair can remind them to ask for help before getting up. Allowing uninterrupted sleep, regular toileting and good pain control can lessen the need for restraints as they can make the care recipient more comfortable and less agitated.
Misconceptions about restraints include:
If the family and medical staff determine and agree that restraints are necessary, then the following procedures should be followed:
The risks of lengthy restraint use include:
Caregivers may need to make decisions quickly about the use of restraints and the appropriate time to remove them. If restraints are to be used, family members should be advised of the reasons for the restraints and the anticipated length of time that the restraints may be necessary.
