Search

Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium. In response, a dementia toolkit was developed by nurses and implemented on the unit to improve the care of patients with dementia. Findings Comparison of pre-implementation and post-implementation audit results indicated a significant improvement in all aspects of care for patients with dementia in the trauma and orthopaedics unit, as a result of the implementation of the dementia toolkit. Education and training were provided to staff on the ward to ensure the toolkit was implemented appropriately. Conclusion It is important to consider the specific needs of patients with dementia in acute care settings, not only the primary reason for their admission. The involvement and inclusion of staff in determining what change was needed on the unit, how change would be undertaken and the positive effects of change, demonstrates how action research can inform and improve clinical practice. [ABSTRACT FROM AUTHOR]

This article examines the experiences of an older patient with, constipation to illustrate the importance of thorough assessment. The interaction between another medical condition and constipation is discussed, and indications for laxative use are outlined. The current evidence base for bowel care is limited. Tools for risk assessment are required and further research is needed to improve patient care in this area. [ABSTRACT FROM AUTHOR]

Obtaining informed consent is a fundamental part of the care-giving process. Current policy documents emphasise the importance of including patients in planning their care. This article explores the concept of consent and the challenges to this concept for older people in long-term care, where consent is not a one-off event requiring a `consent form', but just one stage in the continuum of involvement for service users. At one end of the spectrum, service users may be unaware that they have a service user plan (care plan), while at the other end they may be enabled to complete an advance statement of their wishes, thus demonstrating significant involvement in planning their care. [ABSTRACT FROM AUTHOR]