[Electroencephalographic examination of the cerebral activity of elderly people living in a nursing home after postural change from supine to sitting positions].

AIM: We investigated the cerebral activity of elderly persons living in a nursing home in the sitting position by analyzing the electroencephalography findings of postural changes in the supine and sitting positions. METHODS: This study was approved by the Health Ethics Committee of Osaka University. The subjects were 17 elderly people (4 men and 13 women, average age 85.35 ± 8.26 years) living in a nursing home. Electroencephalograms were obtained in 8 cerebral regions (the left front-polar (Fp(1)); right front-polar (Fp(2)); left frontal (F(3)); right frontal (F(4)); left central (C(3)); right central (C(4)); left occipital (O(1)) and right occipital (O(2))) while subjects sat in a head-up position in bed, or in a chair or wheelchair. Measurement was obtained over 5-minute supine, 15-minute sitting, and 5-minute conversation periods. We performed the fast Fourier transform on measured electroencephalograms to calculate the average power values of alpha band components (8-13 Hz) and beta band components (13-30 Hz) for each cerebral section. RESULTS: Compared with the supine position, the sitting position in bed did not show a significant increase in power values, whereas the sitting position in a chair showed significant increases in power values in all regions. Most of the time, the findings of patients sitting position in a chair showed significantly higher power values than those of patients sitting in bed in all regions. CONCLUSIONS: During the 20 minutes after postural change from the supine to sitting positions, the cerebral activity of subjects sitting in a chair was higher than that of subjects sitting in bed.

Placing physical restraints on older people with dementia.

This study aimed to clarify the coping strategies of nurses working in general wards who face the ethical dilemma of restraining older people with dementia. The participants were 272 nurses working in general wards in the Kansai region of Japan. Coping strategies were measured using a questionnaire consisting of 16 items. A low score of 1-4 points suggested good coping strategies. Factors were difficult to interpret for three of the 16 coping items identified; these items were therefore deleted. Eleven of the remaining 13 items were used for analysis. An explanatory factor analysis revealed three factors concerning coping with ethical dilemma: (1) self-initiated positive cognition and action; (2) negative cognition and action; and (3) choosing not to act, or maintaining the status quo. These findings highlight the need for programs that could disseminate effective coping strategies among nurses faced with the ethical dilemma of restraining older people with dementia.