Aggression exhibited by older dementia clients toward staff in Japanese long-term care.

This study examined the experiences of staff members from seven Japanese hospitals who had been treated aggressively by older dementia clients. Altogether, 170 questionnaires were analyzed. In the past year, 75.3% and 63.5% of staff members had experienced physical and verbal aggression, respectively. Working numerous night shifts, working shifts other than 3-shifts, and being allotted assignments with clients who had a lower average level of physical capacity were the factors associated with recurrent client aggression. Those staff members who spent adequate time caring for their clients, who gained client consent before providing care, and who tried to build a trusting relationship with their clients were found to have experienced less aggression. Burnout, which is likely to enhance the risk of the staff mistreatment and neglect of older clients, was found to be higher among those who experienced aggression.

Effects of tongue and oral mucosa cleaning on oral Candida species and production of volatile sulfur compounds in the elderly in a nursing home.

The purpose of this study was to investigate the effects of oral care using simple tools and methods on the cleanliness of the oral cavity in the elderly. Enrolled were 84 elderly subjects with a mean (+/-S.D) age of 85.1+/-7.0 years in a nursing home. They were given tongue and oral mucosa cleaning (the oral care) after lunch every day or every other day for two consecutive weeks by the authors. The effect of the oral care was studied in terms of Candida scores in tongue coating, concentration of volatile sulfur compounds (VSC) which are the main causative substance of bad breath, and change in tongue coating scores. The above parameters were measured five times; just before the oral care program, weekly during, and at the end of the oral care program. The groups of patients, who were given the oral care, especially the group of patients cared with sponge brushes every day, showed a significant reduction in Candida scores but not in VSC concentration and tongue coating scores. The present method of oral care proved effective in cleaning the tongue and oral mucosa, and the Candida scores appeared to be a reliable indicator for evaluation. It is suggested that this way of oral care is simple, easy and useful not only for the elderly at a nursing home but for the house-bound elder people who will rapidly increase in the near future in Japan.