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'Nurses need an armoury of alternative strategies'

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Various approaches have been developed to help nurses engage with people with memory loss

Around 60% of people living in care homes have dementia, which leads to challenges for staff in caring for residents who are confused or exhibit aggressive behaviour.

In the past the initial response was to reach for antipsychotic medication. However, concerns have been expressed about the inappropriate use of these drugs. People with dementia are susceptible to the side-effects including sedation, and have an increased risk of falls and cardiovascular events.

”They need to understand why memory problems occur”

While nurses working with people with dementia should regularly question prescriptions for antipsychotic medication they also need an armoury of alternative strategies to support them in their care of patients. They need to understand why memory problems occur, why memory loss is progressive and why their patients may become aggressive.

Various approaches have been developed to help staff engage with people with memory loss and you can find numerous articles in our archive that will help you develop your skills in managing this complex symptom.

I have selected one of these articles which uses a simple analogy of the “time machine” to help staff to understand memories and how these change as dementia progresses. It explores how we can make sense of what our patients are feeling and respond appropriately.

You may also like to update your knowledge of dementia by completely our Dementia, Delirium and Depression learning unit.

The majority of drugs taken by patients are via the oral route but nurses need to be up to date with other routes of administration for example if a patient is nil by mouth or receiving a drug that cannot be taken orally.

One alternative is the subcutaneous route and syringe pumps provide a means of administering drugs continuously while allowing patients to stay mobile and independent. However, like all devices there is the risk of error associated with their use.

”The rectal route also offers an alternative to oral administration but is under used in the UK”

The second article from our archive this week looks at the reasons for using these devices and how to use them safely. Although syringe pumps are easy to use, training is essential in how to set up, prepare, administer and monitor drug administration.

The rectal route also offers an alternative to oral administration but is under used in the UK despite the fact that drugs administered PR have a faster action than via the oral route and a higher bio-availability.

The third article from our archive looks at how drugs are absorbed rectally and the principles of safe administration via this route.

You can also update your knowledge of drug administration by completing our Drug Calculations in Practice learning unit. Our unit on Adverse Drug Reactions: Yellow Card Reporting Scheme is also useful on this area of practice.

Go to to access our learning units.

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