Using the Step Method of Hypothesis-testing Case Studies to Address Care Resistance and Wandering in a Dementia Patient

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  • 認知症高齢者の介護抵抗と徘徊への対応に関する 実証的検討
  • 認知症高齢者の介護抵抗と徘徊への対応に関する実証的検討 : ステップ式仮説検証型事例検討による実践報告
  • ニンチショウ コウレイシャ ノ カイゴテイコウ ト ハイカイ エ ノ タイオウ ニ カンスル ジッショウテキ ケントウ : ステップシキ カセツ ケンショウガタ ジレイ ケントウ ニ ヨル ジッセン ホウコク
  • ─ステップ式仮説検証型事例検討による実践報告─

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We applied the “Step Method of Hypothesis-testing Case Studies” to assess a hypothesis-based intervention for Behavioral and Psychological Symptoms of Dementia (BPSD), including care resistance and wandering behaviors in an elderly individual with severe dementia living in a community-based longterm care welfare facility. We hypothesized that care resistance resulted from increased anxiety, tension, and physical pain during toilet assistance caused by cognitive decline. As a result, we aimed to standardize responses during toilet assistance. Similarly, we attributed wandering to stress and agitation to cognitive impairment, pre-illness activity levels, and the lack of pleasant stimuli. We conducted an intervention that enhanced the living environment with pleasant stimuli and ensured a secure walking area. Results indicated that our intervention did not significantly impact care resistance. However, a notable reduction in the patient’s non-responsiveness to the staff concerning wandering and increased staff responses to wandering behaviors was observed. Additionally, the staff evaluation indicated fewer negative behaviors by the patient and a substantial ease in managing wandering and other negative behaviors, indicating some intervention’s success. We have discussed the relevance of the Step Method of Hypothesis-testing Case Studies and the potential for future research areas.

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