Aggressive Incidents Towards Staff by Elderly Patients With Dementia in a Long-Stay Ward

Frequent requests to medical staff from nurses on a long-stay ward for patients with dementia and associated behavioural problems to review patients were felt to reflect a sense of dissatisfaction and isolation in managing difficult patients. In addition, the recent admission of particularly aggressive patients had heightened awareness among both medical and nursing staff of the management problems posed by these patients. The aims of this study were to review the systems of recording aggressive incidents by patients with dementia on the long-stay ward, to introduce a new reporting system and review all cases reported by this means over a 3-month period. The impact of aggressive behaviour on staff was also explored. Forty-seven incidents were reported during the study period, and all staff on the ward had been the target of aggressive behaviour while working on the unit. Aggression by patients with dementia is common on the ward although most aggressive behaviour is not of a serious nature. Staff require support and acknowledgement of their difficulties in dealing with such patients. A reporting system may assist nursing staff by highlighting factors associated with aggression, and may provide a focus for planning interventions by the multidisciplinary team.