The manifestation and nursing management of agitation in institutionalised residents with dementia.

This participatory action research study is the first formal research study undertaken by nurses in a nursing development unit. The study emerged as the result of nurses brainstorming issues that they perceived to be problematic in their nursing practice and their unit environment. The nurses of the psycho-geriatric nursing development unit, Wallsend Aged Care Facility, New South Wales, Australia identified that the management of agitated behaviour manifested by their severely demented clients was a major challenge in their practice. As a result, a pilot participatory action research study was designed to measure how agitation manifested, to measure the severity of agitation and to identify current nursing practices used to manage it and their outcome. Results of the study demonstrated that nurse actions triggered the majority of most highly rated episodes of agitated behaviour in this group of elderly residents, and that the majority of these nurse actions related to those involved in carrying out activities of daily living for the residents.

Creating a nursing development unit in a dementia care context.

This paper describes the process through which a Nursing Development Unit (NDU) was created in a 29-bed unit in which nurses care for severely demented residents. The question about whether or not ethics clearance is required for the development phase of NDUs is discussed, and the framework in which to develop the NDU described. The benefits of using Participatory Action Research as the basis for undertaking a continuous process of reflection and change is highlighted. It is also suggested that two key elements necessary for NDUs are that they are 'owned' by the staff who work in them and that they are supported by senior management of the organisations in which they exist.