For the past three years Joan and Bill Taylor have lived with their daughter Grace.
Joan is 81 years old and was diagnosed with dementia two years ago. Bill is 82 years old and very frail.
Grace felt unable to cope with both parents at home and as a result of this, four days ago, Joan was admitted into an aged care facility.

Since arriving at the facility, Joan has been wandering around in the facility and upsetting residents by removing personal items from their rooms. Joan left the facility unescorted this morning after a visitor let her out as they were leaving. Although she was found very quickly and was unharmed this may be an ongoing problem, as the facility does not have a specific secure area for persons with dementia who wander and there is a long waiting list for facilities with a secure dementia wing.

Joan gets very anxious and can become aggressive if she does not get her own way. On two occasions she has pushed care assistants. Joan will refuse to take medications at times when upset.

In addition to this, there is a new staff member who knows nothing about dementia and wants to know what it is and how to deal with Joan’s aggression.

Medications Metoprolol 50mg Mane Lorazepam 1-2mg PRN Maximum dose 2mg in 24 hours.

In essay format as the Registered Nurse on duty you are to provide information to the new staff member addressing the following criteria:

1. Explain what dementia is and what the new staff member can do when Joan is aggressive.

2. Provide some strategies to cope with Joan wandering into other residents rooms and leaving the facility unescorted.

3. Consider and discuss strategies for administering medications when Joan is anxious or upset.

4. Be sure to explain medications used and what they are for, including any concerns you may have.
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