Professor Ishii Shinya is an expert in geriatric medicine at Hiroshima University’s Graduate School and leads an organization of studies on how hospitals and long-term care facilities in Japan are dealing with the coronavirus.
In a study conducted last June, after the first wave of the virus hit Japan, the organization found that caring for other people with dementia faced a multitude of demanding situations beyond their usual obligations.
Interviewees said they struggled to keep COVID-positive patients and their close contacts from wandering around and make sure they wore masks properly, monitored the deterioration of dementia symptoms, and minimized the threat of infection.
“In some cases, other people with dementia don’t notice the infection and leave the isolation zone,” Ishii says.
In addition, he says daily restrictions that help prevent the spread of the virus can also lead to isolation and disrupt daily routines. This can exacerbate dementia-related behaviors. The infection can also lead to the risk of developing an acute state of confusion, called delirium, which includes hallucinations and delusions. Ishii says patients would possibly rip off their oxygen mask or become violent.
Last February, in order for hospitals and care facilities to cope with those unprecedented challenges, the professor and his colleagues published a consultant on how to care for dementia patients in their later years and inflamed by the coronavirus. The e-book discusses tactics to save it and manage the worsening. dementia-related behaviors and delusions. Tips include “keeping patients adequately hydrated,” “talking to them frequently,” “giving them space to move around the facility,” and “offering exercise programs. “
The Kobe City Medical Center General Hospital is considering these measures as it battles the resurgence of cases. After the outbreak began, the hospital installed intercoms in all inpatient rooms to combat COVID-19 to help medical staff communicate well with patients. The staff also works hard to keep cognitively impaired patients informed about their prestige and remedy policy.
“The spread of COVID-19 is forcing adjustments in dementia care facilities,” says Otani Kyohei, an expert in liaison psychiatry at the hospital. “I shared the consultant’s content so we can re-examine our current practices. “
Ishii worries that caregivers facing a shortage of hard work are employing physical restraints more than they should. “Without intelligent judgment, this practice can cause more harm than intelligence to patients,” he warns.
The consultant takes a transparent position: “Unless it is used in an emergency and no other functions are available, physical restraint is a violation or abuse of human rights. “It also specifies what constitutes a last resort, adding review through multiple staff members, concerted decision-making, consent from the patient and family circle after a full explanation, and triggering termination once a periodic review is deemed unnecessary.
Ishii says labor shortages in hospitals and care facilities also mean that staff who care for dementia patients may not have been trained to treat the condition.
“The consultant would possibly not be offering anything new to dementia specialists. But not all doctors and nurses are accustomed to such practices. They treat COVID-19 patients by minimizing its effects on their dementia. “