Rehabilitating Patients With Dementia Who Have Had a Hip Fracture Part I: Behavioral Symptoms That Influence Care

Objective: Although evidence suggests that patients with cognitive impairment can benefit from rehabilitation, healthcare professionals (HCPs) on geriatric rehabilitation units (GRUs) often find that providing care to these patients following a hip fracture can be challenging. The objective of this study was to identify the behavioral symptoms that HCPs find difficult to manage in patients with dementia who have had a hip fracture and the strategies that they report using when patients exhibit these symptoms. Subjects and Methods: One hundred thirtythree HCPs responsible for providing direct rehabilitation care in 7 GRUs in Ontario, Canada, completed a questionnaire. The questionnaire collected data on the frequency of behavioral symptoms that persons with dementia experienced after hip fracture surgery and on the strategies HCPs used to manage these symptoms. Results: The data collected indicate that HCPs perceived patients’ anxiety, agitation, and irritability to be the main behavioral symptoms that interfere with their ability to deliver rehabilitation care. HCPs perceived that patients’ behaviors occurred frequently enough to influence rehabilitation care, however, only 51% of nursing staff listed strategies they used when patients exhibited behavioral symptoms, whereas as many as 96% of allied HCPs listed strategies. When clients had symptoms, staff used assessment and intervention strategies, which included both nonpharmacological and pharmacological ones. Conclusions: The findings from this study indicate that HCPs caring for persons with dementia who are rehabilitated after a hip fracture surgery on GRUs, frequently encounter behavioral symptoms that hinder their care delivery.