The Approach Process of Visiting Nurses to Old Dementia People with Delirium-Like Symptoms

Abstract

　Purpose：This study aimed to clarify the process by which visiting nurses approach older adults with dementia and delirium-like symptoms.

　Methods：Semi-structured interviews were conducted with visiting nurses regarding the process of approaching homebound older adults with dementia and delirium-like symptoms. Interviews addressed information used, information-gathering methods, responses to symptoms, and results. A narrative analysis of 10 cases was conducted.

　Results：Three patterns were identified：（1） a pattern in which delirium was inferred and addressed before the home visit （four cases）, （2） a pattern in which the possibility of delirium and other illnesses was considered based on the symptoms （three cases）, and （3） a pattern in which cognitive decline was broadly considered （three cases）.

　Discussion：If information on delirium-like symptoms and factors associated with the onset of delirium is available from family caregivers and medical facilities before a home visit, identifying relevant factors at an early stage and appropriately approaching older adults with dementia may be possible. If the pre-visit information and symptoms indicate the possibility of delirium and other illnesses, investigating the factors for these conditions is necessary. If information prior to the visit is scarce or if behavioral or psychological symptoms of dementia are suspected, considering the symptoms as cognitive decline and exploring the factors related to these symptoms individually are necessary.