title: Managing verbal agitation in people with dementia and delirium.
abstract: Patients with dementia and delirium in acute hospitals can exhibit verbal agitation, but there is no research on rate of occurrence or how ward staff manage such behaviour. This service evaluation aimed to measure rate of occurrence of verbal agitation in confused older inpatients and understand the management strategies used by staff. An agitation inventory was completed daily by the nursing team for all verbally agitated patients on eight older person wards over two weeks. Six semi-structured interviews were conducted with staff and three hours of non-participant observations were undertaken. A mean 6% (13/223) of patients were verbally agitated each day. Management strategies included trial and error, distraction and engagement, reassurance, communication and familiarity. Staff did not adopt a systematic approach to care planning due to lack of training and support on the ward, as well as scarce resources in terms of staff, space and activities. Research is needed to develop and evaluate interventions that support staff to care for these patients.
authors.affiliation: Nottingham University Hospitals NHS Trust.
authors.forename: Francesca
authors.initials: F
authors.lastname: Inkley
authors.affiliation: Older person's care, School of Health Sciences, University of Nottingham.
authors.forename: Sarah
authors.initials: S
authors.lastname: Goldberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D003693:Delirium / Q000451:nursing* / Q000523:psychology; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D006801:Humans; D057184:Practice Patterns, Nurses'; D015995:Prevalence; D000066553:Problem Behavior; D011595:Psychomotor Agitation; D036301:Qualitative Research; D014705:Verbal Behavior
keywords: acute hospitals; cognitive impairment; delirium; dementia; older people; verbal agitation