Managing Dementia and Anxiety
by Brad Hagen
In this video, learn to work calmly and efficiently with patients experiencing the severe agitation of dementia or anxiety. Here, two vignettes contrast the differences between inexperienced and experienced providers, including a counterintuitive method for soothing dementia patients.

Working with patients who are severely anxious, agitated, or in the throes of dementia-related delusions can trigger our own anxiety and self-doubt. In such cases, understanding the clinical underpinnings of a patient’s diagnosis, and the different communication skills they require, is key to effective treatment. In this two-part video we see contrasting scenarios featuring both ineffective and effective approaches with an elderly Alzheimer’s patient and a woman in residential treatment for anxiety. Here, you’ll witness the different skills involved in engaging each type of patient, and learn how one counterintuitive technique can dramatically improve clinical outcomes.

The first vignette features a nurse treating an elderly man with Alzheimer’s disease who believes he is still a farmer. Becoming increasingly agitated because he believes no one is attending to his farm, he pleads with his nurse to escape the facility. The novice nurse attempts to bring him to reality, which only aggravates his fears; in contrast, the proficient nurse joins with the patient by entering into his world, even adding to the story in order to bring a sense of resolution to his needs.

In the second vignette, you’ll watch a nurse work with a visibly anxious woman demanding additional medication. The novice nurse responds coolly to her distress and then becomes agitated himself, invalidating her emotional experience and avoiding eye contact. Later, you’ll see the more experienced nurse take time to speak with his patient in a quieter setting, where he engages her in therapeutic conversation and invites her to practice breathing exercises with him. After delivering gentle psychoeducation on the pros and cons of medication, he ultimately gains her trust and agreement to use inner coping skills.

This video helps demystify the challenges of working with patients who need firm, nuanced support to manage their agitation. If you’re looking to enhance your own skills in this area, add this title to your library today.
In Depth
Without proper training or experience, novice mental health practitioners risk alienating, or worse, traumatizing patients especially prone to agitation. This two-part video examines the subtle yet profound differences between inexperienced and proficient treatment for anxiety and dementia, two conditions characterized by impaired judgment and potentially high distress.

Underscoring the clinical challenges of working with patients with either condition, we are presented with two separate vignettes that feature a nurse working with an elderly Alzheimer’s patient and an anxious female patient, respectively. In the former case, an inexperienced nurse attempts to console and reassure the Alzheimer’s patient, but only serves to further disorient him by insisting upon the delusional nature of his narrative. The proficient nurse corrects this by joining with his storyline—a counterintuitive intervention that disarms and relieves the patient.

In the anxiety scenario, the novice nurse conveys disinterest in his patient by immersing himself in his paperwork, avoiding eye contact, and making only cursory mentions of relaxation exercises while trying to send her back to her room. In contrast, the proficient nurse fully acknowledges her presence and teams with her to deepen rapport and support her inner resourcing.

Although these videos are designed for mental health and psychiatric nurses, the skills demonstrated apply for any mental health care worker dealing with patients with these psychiatric conditions. If you’re a therapist, counselor, psychiatric nurse, or other helping professional working with anxiety disorders or people experiencing dementia, you’ll find a number of valuable lessons here, as well as cautionary tales to consider.
By watching this video, you will:
  • Learn about the challenges of treating anxious or demented patients.
  • Understand how novice interventions can disrupt treatment goals and exacerbate patient distress.
  • Identify proficient skills and interventions that build patient rapport and increase the likelihood of compliance.

Length of video: 00:25:00

English subtitles available

Group ISBN-10 #: 1-60124-440-1

Group ISBN-13 #: 978-1-60124-440-6

Brad Hagen, PhD, RN, is a registered nurse, a registered psychologist, and an associate professor in the faculty of health sciences, at the University of Lethbridge in Alberta, Canada, where he teaches in the nursing and addictions counseling programs. Hagen's main research and teaching interests include the broad areas of mental health, gerontology, long-term care, psychotropic drug use, and how to bring critical social theory and/or feminist approaches to these topics.

See all Brad Hagen videos.
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