2020 Volume 25 Issue 1 Pages 45-56
The purpose of this research was to clarify the “fall behaviors” and real needs in the background of older people with cognitive impairment in an acute hospital by analysis of patients with and without the onset of delirium, focusing on the first week of admission when falls most frequently occur.
The subjects were nine older people with cognitive impairment admitted to an acute hospital. The research was conducted via the participant observation method. The real needs found to influence the background of their behaviors were identified through a hearing investigation with those in whom the “fall behaviors” were observed, and their involvement with nurses when their behaviors were calm once again, as well as their other behaviors were each analyzed by content for meaning.
As a result, seven “fall behaviors” were observed, and at the time of “non-delirium,” three categories, “physiological desire and custom,” “physical pain and discomfort,” and “mental stress”, were observed as the background needs of their behaviors. The subjects had clear intentions in the background of their behaviors and were stressed because their intentions were not reflected. At the time of delirium, five categories that could lead to fall behavior, and the needs of two further categories of “uneasiness caused by the difficulty of recognition of their current situation” and “physical pain and discomfort” were recognized. Individuals felt uneasy about being left alone and about several pains caused via disease and treatment.
This suggested that livelihood support respecting intention, and early intervention to their physical pain, unpleasant feelings, and anxiety can possibly prevent such a fall behavior.
