Assignment Task:
Won Lee, a 76-year-old man, is a client in a continuing care facility. He has dementia and did not remember his wife or daughters at their last visit. Lately, he has also seemed unable to speak or understand English. The staff members at the facility where Mr. Lee resides have noticed that he becomes very agitated in the early mornings. He has fallen several times trying to get out of bed, and more recently, before his bath, he tries to pull the towels away from the staff. He has scratched several of the support workers who have tried to remove the linens from his hands. Support workers have tried toileting him more frequently, but nothing they have tried seems to decrease Mr. Lee's agitation. Mr. Lee has become so agitated that the staff members are afraid that he will hurt himself or others, so they suggest holding a client conference to discuss ways to safely care for Mr. Lee. Mr. Lee's family members, his doctor, the occupational therapist, and some of the nurses and support workers who care for him attend the family conference. Mr. Lee's family members are very concerned after hearing of his increasing agitation and wish to discuss the routines he kept when he was younger. Mrs. Lee tells the staff that waking up very early to get to work had been part of her husband's routine his entire adult life. She also informs them that they used to own a large laundry company, where he worked for over 50 years. Mrs. Lee says that when her husband was stressed at work, he would always do something physical, such as folding linens or ironing shirts. At Mrs. Lee's suggestion, it is agreed that when he wakes up the next morning, the night staff will help Mr. Lee to get out of bed and sit by the nursing station, where he will be allowed to fold linens. It is hoped that this will "settle" him. The next morning, when Mr. Lee begins to become agitated in his bed, the staff quickly toilet him and assist him to a chair by the nursing station, where a large laundry basket of freshly laundered towels and facecloths has been placed. Mr. Lee sits quietly and folds the linens. He is neither agitated nor aggressive, and he smiles while he is "working." Before lunchtime, he is given the opportunity to fold clients' clothing protectors and linen napkins in the dining room. The staff members are surprised at Mr. Lee's change in disposition and decide that they will maintain this new routine the next day as well to see if it continues to reduce Mr. Lee's agitation. Why was this outcome successful? Why was Mr. Lee so agitated? How could you use this information in other situations? Name at least three restrain alternatives that they have used in this scenario? What other alternatives to restrain can you suggest that could lessen Mr. Lee's agitation?