Dementia

Some of these things old be symptoms of dementia but they could Just be a memory Impairment. 2. 1 The medial model of dementia feels that it is more important to treat the disease rather than the person. It focuses on the impairment as the problem and seeks to create dependency. The social model of dementia focus’ on the individual. And try’s to ensure the person’s capabilities are maintained. By learning about each person, the care and support can be designed appropriately for the individual’s needs. 2. 3 Dementia should be classed as a disability because as the disease progresses, the more support the individual needs.

They could be unaware of the medication they need to take, ensure that they are eating/drinking. Maintaining personal hygiene. Each individual with dementia is different so they needs the care and support to maintain a good life. 3. 1 Alchemist’s. Vascular dementia- when the oxygen doesn’t reach the brain. ; Eely Bodies. Front-Temporal Dementia. 3. 2 & 3. 3 Signs and symptoms of Alchemist’s are: Minor memory problems Trouble saying the right words. Disorientation Mood swings Behavior changes The risk factors for Alchemist’s are: Age- most people are 65+ and likelihood doubles every 5 years. ;

Genes (heredity) Signs and symptoms of vascular dementia are: Difficulties with completing tasks. Memory loss Mental confusion Low attention p Wandering in the night Stroke like symptoms The risk factors for vascular dementia are: Increasing age History of heart attacks, strokes or mini strokes. High cholesterol and blood pressure Diabetes Smoking Signs and symptoms of dementia in the Eely bodies: Visual hallucinations Delusions Muscle stiffness Slower movements Shaking and trembling Problems sleeping Risk factors for dementia in the Eely bodies are: Dementia in the Family history your risk of getting it.

Signs and symptoms of Front-temporal dementia: Aggression Compulsive behavior Being easily distracted Lack of interest of washing themselves. 3. 4 Prevalence rates for dementia in the UK are: 40-64 years: 1 in 1400 65-69 years: 1 in 100 70-79 years: 1 29 80* years: 1 in 5 4. 1 Everyone who has dementia is an individual and will be at different stages of their dementia. An older person with Eely bodies’ dementia may need more assistance with everyday life tasks than an older person with Alchemist’s. This could be because how much they can do with the disease they have.

A person with Eely bodies’ mental may need assistance with eating and drinking than a person with Alchemist’s as they can’t hold cutely because their body shakes but the person with Alchemist’s will be fine eating and drinking. A younger person with dementia may have different interests to someone who is 82 and has dementia. The support should be there to meet everyone individual needs. 4. 2 Other may act well to a person who has dementia because they know what is up with the person and has some knowledge and understanding. A person who has no understanding of dementia could have wrong Judgments and assumptions of a person with dementia.

Pl Criteria- using the case studies provided write an explanation of how you would use principles and values when planning your clients care Introduction For the first part of this assignment I will be using principles of planning wealth care in health and social care with each client differently to benefit each clients care needs. Principles are guided lines to show how to carry out the best way of care for different service users and also to inform or guide staff members on the correct way to behave when carrying out care.

Case study 1- Tom is an elderly man who has been diagnosed with dementia. Tom is a sociable man who used to enjoy his career as an art teacher and has sold some of his paintings, he also enjoys being in the garden of the Independent living unit. Whenever possible he Likes to look after the plants In the containers on the patio and the Indoor plants positioned around the home. Tom shares the Independent living unit with two other people. There are full time careers that support the service users with their activities of daily living.

Tom lacks the capacity to make informed decisions regarding his health and wellbeing. In collaboration with tom and his next of kin Staffs are able to devise a care plan that promotes his holistic wellbeing. The first principle I will be using is empowerment. In doing this it means that I will be giving each individual the correct amount of information to enable them to make informed decisions and also to make choices about their care needs and their life.

The way that I would use empowerment with tom would be giving him enough independence so that he would be able to make his own decisions , I would also be allowing tom to take responsibility for how he would Like to carry out his day such as at he wants to wear and also If he wants to make himself a drink or If he would want to help make the food then allow him to help out in doing this it ill help to build toms independence and also it will gradually help tom feel more respected and he will feel as if everyone around him has respect him.

As a staff member the main priority would be to help make sure that tom is happy about what is happening and also to include tom on decisions. One way that would make sure tom was included would be when making toms care plan and the staff could include him by asking him if what as in the plan was okay for hi or if he wanted anything changing within it to make sure that he felt as if he was involved or if he had a say In It.

I would also support tom’s preferences and would recognize his preferences In doing this It would mean that I would be asking tom what he would want to happen and In doing this It would give him some Independence. Showing tom that I am supporting his preference would be me allowing tom to continue to look after the plants indoors everyone else who was in the unit with him. In meeting tom’s physical, intellectual, social and emotional needs means that when leaning his care plan we will need to talk into account his physical needs such as if He needs to exercise.

Intellectually we would need to figure out how to build up his memory even though tom suffers with dementia this is no excuse to leave this set of needs out. Socially we could invite other members of the unit to Join in with the permission of tom with helping him in the gardening. Looking at the emotional needs for tom a lot of people with dementia have trouble expressing their feelings which normally results in frustration in this situation you would need to take into account hat tom is an individual and depending on how you react to this will be personal to him.

Due to his dementia arranging social outings may be difficult as he could forget where he is and what was planned in doing this he may get frustrated and could lash out. But instead we could encourage tom to take part in activities in small groups with other service users in the unit this will also help with toms intellectual needs as well in doing this it would also help hi to socialism with the other members in the unit, it will help tom to become friends with the service users and ill also build trust tit them.

Emotionally e could ask toms family to visit 2-3 ties a week in doing this it will help tom to see the progress within his family and it will also build his social needs to as he will be interacting with different groups of people and conversation will also change. Staff members could ask tom how he is feeling and how he feels about his activities this would give tom someone to talk to if he was having a bad day and it would help him to trust others with tom telling the staff how he is feeling it may also give them an incite to how he would like to be treat and also how they could make his ATA more enjoyable . N inviting his family around it will give him something to look forward to even if tom wasn’t in the best of moods during the week reminding him that his family are coming to visit him Taking his physical needs into account we would need to make sure that tom would be taking his medication at the right times and making sure that he actually takes them due to his dementia he may forget that he needs to take any sort of medication, to make sure that tom is taking all of his necessary medication I would suggest that a member of staff supervises him.

Working in partnership would mean that staff would be working towards contribution off the support that tom would need.

Working with his family, gap’s and the current careers working within the independent living unit the staff would also be working with tom, in doing this it would mean that we would sit down with tom and his family as well as other health care professionals and making a care plan for him that would care plan that has been made for him is important as his family would need to check if what was in the care plan was best for him and would be the best way to carry out is care needs it is important that tom is included in making decisions for his care plan as he may have suggestion and including him would make him feel valued and respected.

Carrying out holistic care means looking at the whole care of the individual and focusing mainly on them in doing this it means that the staff would be focusing mainly on tom in doing this it would mean that tom would feel more valued because the staff members would have more time to carry out his care and it would also mean that his care needs would be carried out fully, they would be focusing on his dedication needs, and they would be focusing on dietary and exercise needs Just because tom has dementia does not mean that he shouldn’t exercise if tom did not exercise it may mean that he would become unhealthy and his health would also deteriorate. They should also take into account his past and current hobbies in doing this it would show that the staff where paying attention to him. Case study 2 Sue is a 43 year old woman who has had a stroke. She lives in oak ridge care home.

She has lost the use of her right arm and leg she has difficulty speaking clearly. Fortunately sue is left handed. Sue is an intelligent woman who until she had her stroke ran her own business and had 23 employed people. Sue likes to listen to music and socialism with other residents in the home. She especially enjoys craft sessions as she used to complete cross stitch embroidery as a hobby Sue is also taking part in physiotherapy to help strengthen her right arm and has learnt to use a walking stick for support, she also has speech therapy. Since sue has had her stroke I believe that her physical needs have lowered but are still quite high due to her stroke.

I would then promote sues needs rights and choices by giving sue anything that she had requested such as something specific within her care plan. I would also need to respect sues opinion in doing this it would build trust and also start to build a good relationship, it would also help sue to feel respected and it may also build her confidence as well. Also respecting sues privacy when she wants it is important as she may feel disrespected if a staff member didn’t allow her any privacy. Allowing sue to chose activities which she wants to take part in would build her independence another way that would show staff would be respecting her references is by allowing her to choose what she would want to wear or if she would want to go out somewhere asking her where she should want to go .

My next principle is confidentiality, maintaining confidentiality wit sue is important to make sure that sue trusts you if sue did not trust the staff then it may make it difficult to carry out her care needs. By maintaining sues confidentiality it would mean that if sue had confided in you and said that she does not feel happy or if it was something that may cause concern or could cause harm to sue then this is the only time that his could break the trust between sue and the career. If sue had told you something that may concern you FRR her safety then you would need to alert a higher member of staff and her family to make sure that she is kept safe and out of danger .

When planning sues heath care plan her family should also be involved as well as other health care professionals such as physiotherapists, speech therapists it is important to involve other health care professionals with sues case study because there are many ways that would help so return to how she was before she had her trope, in her care plan there would need to be some sort of routine that would regularly have physiotherapy and speech therapy in it having regular sessions would make sues development of speech a lot quicker and also regular physiotherapy sessions will help her to develop the feeling back in bother her arm and leg in doing this it will boost her confidence and self esteem. To support sues values and cultures the staff should let her do things that she enjoys even if the staff members do not agree.

Listening to sues lifestyle and how she looks at things is important to know exactly how to treat her, allowing sue to socialism with there residents and take part in her hobbies will show sue that you respect her and also will also build up trust and it ill give the staff members a wider range of knowledge about sues views and how she lives her life. If sue was quite a religious person and prayed quite a lot then a staff member could assign certain times through the day or even night where she could have some alone time and some privacy to carry out her prayers and anything else that she needed to do, if the staff did not allow sue to carry out her religious practices then they would be discriminating against her and this would be unprofessional

Supporting sues preferences is also important as it is what she wants. Respecting sues preferences would mean allowing her to listen to the music which she wanted at a reasonable time and also volume, to help with this you could by sue a music player that was for sues use only this would help sue to feel respected, valued and also independent. Sue also likes socializing so she could ask a few of the other service users in the home that she is friendly with to sit and have dinner with her in a small group , some of the other service users have similar health issues so with sue Ewing friends with them means that she has someone that she could relate to.

With sues hobbies are most loved hobby is cross stitch embroidery , if sue wanted to she could set up a little group activity for herself and some of the other service users , the only issue with this is that it may need two hands to take part in this hobby if sue sees that other service users are capable of doing the activity but she is not so capable then she may get upset and frustrated resulting in her being also gives her more of the independence and if she sees sue struggling she could hen ask sue if she would like any help and if she says yes then continue to help but if she says no then respect her wishes and allow her to continue by herself. The type of care that sue is receiving is holistic care , holistic care means that the staff look at the whole care for sue such as exercise dietary needs etc having holistic care means that the staff will be able to focus mainly on sue and will take more time to plan her care plan making sure that sue is involved to make her feel valued they could suggest some care ways which they think would be best for her and sue could ay if she agrees and also have some input on what she wants.

Ml- review benefits to the individuals and professional staff or taking a holistic approach to planning support. Health and social care is about making the best decisions to improve the service user’s care. Within this I will be writing a review on how multi agency working within health and social care and also the holistic care approach benefits certain service user’s care needs I think that the benefit of a individual choosing the holistic care approach is that it is more focused on them and no one else, their care needs are concentrated on more of hat they need and also want.. With tom and sue both living in independent living or being there it helps them to socialism with other residents that live there with them.

With other service users living in the same buildings as them it will also help them to build a relationship with the other residents and this will then help them to feel as if they aren’t alone and it will also give them a higher self esteem and confidence. In sues case with her speech being limited with holistic care she would be getting regular speech therapy and this would be in with her care plan if she sits down with member of staff and organisms a meeting here they can discuss or write down what sue may want then if speech therapy was to become part of the routine care plan then the speech lessons would be a lot more regular and the more times that these sessions occur the quicker that sues speech and communication skills will improve by doing this it will help build sues confidence to communicate with others without feeling embarrassed about her speech skills.

With the careers taking the holistic care approach getting an advocate for each service user, if say a service user was UN happy with the care that they were receiving or ere Just feeling bait down or even they felt as if they aren’t being understood by the career then they would be able to talk to the advocate and then the advocate would take each problem into consideration and would try and solve it straight away, service users means that they have someone to talk to if they ever feel alone in doing this and having an advocate in place it will make them more confident and also in social situations. With careers following the holistic approach for each service user they are taking into consideration the physical, intellectual, social, emotional and also language needs of he individual, each health and social care professional taking each specific need into account this enables them to carry out the best care for the individual service user each need will be different for all service users as each service user has diverse care needs.

When the holistic care approach looks at physical needs it looks at thing such as medication how much of a certain medication an individual needs to take per day and also sometimes whether or not they could ease the service user off of the medication to possibly improve their health , they would also look at dietary and exercise needs to , when looking at the dietary needs they would take into consideration whether they are vegetarian or if their religion only eat specific foods at certain times. Coming to the exercise needs wouldn’t always be looking at if they need to lose any weight but it would also be looking at whether or not their fitness is at a good point and if not then an exercise plan would be made to help improve their fitness Just by doing small little exercises during the day.

Intellectually the service users would also improve , taking part in activities such as eating and also taking part in puzzles and crosswords, this will intellectually stimulate them and will be training their mind and will give them many intellectual skills such as problem solving , they will also start to take into account when they need to take their medication as well as how much they need to take and what they need to take. The holistic approach also shows progress and capability of the service user , if each individual was to follow the holistic approach to care then it will make them feel more confident, valued and also loved they may also feel happier about their self if they e improvement with their self.

With the holistic care approach it helps the individual feel more free and valued , to be able to do hat they would like to instead of being told what to do they are also able to do it when they want and not feel as if they are being controlled this will give each service user freedom. Each career using the holistic approach will feel as if they can allow the service user approach it means that all legislations and procedures are in place to help the careers make sure that careers can carry out their Job as best they can, it will also mean that hey will build trust with service users that they are supporting and also looking after. They ill have a sense of pride knowing that they have helped the service user.

When the holistic approach works with multi- agencies this will improve the level at which the individuals care and health improves helping service users using various care professionals can help physically as well as emotionally and socially. It will help each individual emotionally would be to talk to an advocate if they were having any problems or maybe a gap. Physically their fitness improves and in this happening it ill make them more confident. Socially with the physical and emotional needs tied in within the social part it will give them confident and will raise their self esteem so that when they are in small social groups they will have the confident to speak without feeling embarrassed. ODL- analyses reasons for working with professionals from more than one agency when planning support for individuals . Multi disciplinary team- a team of professionals drawn from a range of disciplines or services, e. G health care, education and social services, all working together towards a common goal” (stretch and Whitehorse 2010) When working within health and social care there are plenty of care professions That can help the individuals care needs to improve such as GAPS, social workers, nurses, doctors etc. Professionals working in health and social care involve other members form different organizations so that they can give the service user the best care that the service user’s needs. It will benefit the service user as it will build strong relationships with their care provider.

If a service user has any problems that they are concerned about then they would be able to talk to them about it I believe that if this was to happen and they only had a nurse to talk to then they may not open up as much as they would if it was someone else such as an advocate or a counselor. This would pick up on issues much quicker to solve the problem at hand. An example could be if you had worked with a certain service user for a number of months and they were always cheery and smiling but one day when you went to carry out their care needs and noticed that they weren’t their self and also that they were UN happy then this would cause you to have concerns about the individual.

As a staff member seeing this then I would suggest that staff member asks the service user what is the tater if it is something that is serious I would then need to inform other members unit. In doing this it would then build a greater trust with them, but if the situation was serious the staff member would need to tell the service user that she may need to break confidentiality as it could potentially cause harm to her and others around her , in doing this it may break a little of the trust but in turn it would also help to protect them from harm and in the long run it would mean that the relationship would be better. Another reason that multi professionals work together with an individual because it ivies the individual more support than what it would if they had one care worker working with the individual.

It will benefit the service user because all health care professionals working with one individual will be able to focus more on that individual and will be able to use more resources to help with the service users care needs within their care plan. It will also help each individual to overcome each health issue that they have. Having more than one health and social care professional working with an individual will help speed up their care and health needs it will help them to get back to normal ay to day life and will also help boost confidence and self-esteem having other service users encouraging them will make them want to help their self. The last reason that I think working with multi agency practices is beneficial for an individual is because each professional will be working to help develop each of the service users different needs which need to be developed.

When each professional doing this will help speed up the quickness of improving the individual’s health. If the individual only had one health worker providing their specific care needs it may aka a longer period of time for the individual to become well again, if the service user feels as if they are getting no further along in their progress they may want to give up and may become depressed in turn meaning that their health would not improve. But working with numerous health professionals would mean that progress would develop quicker making the individual a lot happier and confident. Staffs from multi agency groups have different skills which they could put in place to help with the care needs of the individual.

This would be both beneficial to the staff and also the service user. It would be beneficial to the staff as it would give them a wider knowledge of different care techniques meaning that they would be able to put into practice when caring for an individual, for the service user the health and other specific needs would be fulfilled and it would mean that it would get them back on track to becoming healthy again and confident when socially interacting with other individuals. It would also mean that some of the health professionals would have more experience meaning that the techniques that they had learned and have shared would be more likely to work.

Profile and presenting symptoms:

The patient is Mrs. C, an 83-year-old widowed Caucasian female. She lives alone in her apartment. Means of income come from her husband’s retirement income as well as her social security. She had no formal occupational training but formerly worked as a hairdresser at a theatre. Her 72-year-old brother brought her to a psycho-geriatric psychiatrist clinic for assessment and evaluation as she had been noted to be extremely forgetful, incapable of paying attention to simple chores and has difficulty finding words lately. Physical examination results showed good but deficits were confirmed on her mental status. Current diagnoses include osteoporosis and osteoarthritis and she had been solitary since the death of her husband of sixty years since two years ago. No history of major illness or injury as well as no prior psychiatric history. Current medications include Estrogen, Calcium with vitamin D and Multivitamins.

Full description of mental health problem:

MMSE score is 24/30. The patient was reported to be very forgetful. Reported by her brother that she had forgotten to lock her door and turn off the stove burner when he visited her. She admitted that she felt confused with episodes of not remembering things from one moment to another. She could not remember how long has this been going on and thinks of it as things attributable to normal ageing. She admitted having difficulty sleeping. Her brother reported that she had lost weight though she describes her appetite as “so-so.” She sees herself as a worthless woman who is just a burden to her family. Added to the psychiatrist that she would be happy not to be in this world. She has a 52-year-old daughter who is married and has three children but lives on another state. Next of kin nearby is her brother and his daughter.

Mental State Examination:

Mrs. C appeared somewhat untidy with uncombed hair, wore wrinkled dress and used strong perfume. She is a cooperative lady. LOC is alert and oriented to person and place (knows the year but is unsure of the month and date).  Denied having any illusions and hallucinations but was found to be delusional that her brother wanted to get rid of her. She was noted to have difficulty concentrating, easily distracted and has loose associations but can be easily redirected. Presented labile moods, superficial, irritable and intermittently very anxious. Mrs. C was noted minimizing her cognitive defects by concealing them thru confabulating, circumstantialities as well as hiding them by perseverating. She has little insight of her current situation.

Risk Assessment for Mrs. C.

The psycho-geriatric specialist should appreciate that they are attempting to predict a heterogeneous group of disease condition. As a consequence to this, there is a possibility that emergence of some risk factors may predispose to some types of dementia while having little influence on predicting the onset of other types. Physicians should also be aware that most types of dementia are preceded by an identifiable phase of mild cognitive decline. They should also be knowledgeable with the concepts of mild cognitive impairment, cognitive impairment and there differences with dementia (Chertkow et al, 2008). An accurate diagnosis is very important in diagnosing the correct subtype of dementia that is essential in the potent development of successful treatment regimen (Focht, 2009). Genetic aspects followed by vascular, lifestyle and socio-demographic risk factors should be considered.

Genetic risk factors

            It is crucial to obtain an accurate family history revealing as much information as possible about the diagnosis of dementia as well as the age of its onset in all reportedly affected family members. Verification of diagnosis by reviewing clinical reports and neuropathologic findings will be a very good viable report in the confirmation of relatives’ diagnosis. Although this may be unavailable as patient’s parents’ medical history may be unknown due to distance, life circumstance like divorce or death from other causes. In Mrs. C’s case, it is helpful that her brother will be able to provide the doctor with information regarding their family history.

Vascular risk factors

            Incidence of dementia may be reduced with the reduced risk of stroke. It is important that patient’s blood pressure should be kept in good control. A target systolic blood pressure should be maintained £ 140mmHg (Patterson et al, 2008). ASA and statin therapy following MI, antithrombotic therapy for nonvalvular atrial fibrillatiob and correction of carotid artery stenosis also reduces the risk of dementia.

Lifestyle risk factors

            Although there is no available sufficient evidence for a firm results as yet, physicians recommended the following lifestyle modifications in order to reduce the risk of developing dementia: reduce the risk of serious head injuries; use of appropriate protective clothing when dealing with pesticides, fumigants, fertilizers and defoliants; ensure appropriate levels of education and strategies to retain students in appropriate learning environments as well as education on living a healthy lifestyle; lastly, the increased consumption of fish, decreased consumption of dietary fat and moderate consumption of wine (Patterson et al, 2008).

Care plan for Mrs. C:

Problems:

Alteration of cognition level due to diagnosis of dementia.
Potential safety risks and harming self due to memory problems.
Potential risk of imbalanced nutrition due to impaired mental ability to take sufficient nutrients to meet metabolic needs.
Interventions and Rational

Mrs. C should be given a caregiver to assist her activities of daily living once further assessment and evaluation proved the diagnosis (dementia). Transferring her to a dementia/ Alzheimer’s unit in a long-term care facility could also be arranged.
All her daily routines should be kept consistent as much as possible in order for her not to get confused.

Questions need to be addressed in a yes/no type to determine her needs.  It is important to use plain, simple and concrete language in order to reduce any confusion.

Due to memory problems brought about by her dementia, her safety is at risk if left alone to take care of her. Care providers should be with Mrs. C to ensure she is safe at all times. Mrs. C should be refrained from given any matches and she should be supervised when she’s cooking. Care providers should also make sure that she locks her door for her own safety.
As a result of decreased mental ability regarding the right and sufficient food intake, it is best that Mrs. C should follow a diet regimen prescribed by a dietician. Her weight loss is a sign that Mrs. C is not capable of taking care of herself anymore. Care providers should ensure that Mrs. C is eating the right food for her.
Expected outcomes:

Mrs. C will remain oriented x 3 months.
She will make basic needs known on a daily basis x 3 months.

Mrs. C will remain safe from potential harm i.e. fire in the house x 3 months.
There will be no incidence of burglary in Mrs. C’s house x 3 months.

Mrs. C’s will have no further weight loss and will remain physically healthy x 3months.

Although there is no method of curing or arresting dementia, early diagnosis is very crucial for a number of reasons. Early diagnosis will allow the patient and their family to be able to prepare, arrange and plan for the future. Identification of outside resources that will be helpful for the provision of help and assistance will also be done. Being alert for cognitive functional decline is the wisest way in recognizing dementia in its early stage (Santacruz and Swagerty, 2001).

The psycho-geriatric psychiatrist decided to admit her in the Older Adult Mental Health Unit for further assessment and investigation after the initial assessment. She was also started on Aricept 10mg mane, Mirtazapine 15mg nocte and Lorazepam 0.25mg prn. Aricept is an acetylcholine that is important for the processes of memory, thinking and processes. This medication is used in treating mild to moderate dementia. Mirtazapine is an antidepressant that influenced the chemicals in the brain that may cause depression. Lorazepam, on the other hand, is a benzodiazepine that is used to treat and manage anxiety.

It is best to start the medications with the lowest dose possible. In the case of Mrs. C, the psychiatrist prescribed her the combination of scheduled Aricept and Mirtazapine as well as a prn order of Lorazepam. Mrs. C is only taking Estrogen, Calcium with Vitamin D and Multivitamins so there is no adverse effects of drug-to-drug interactions. It is imperative that the physician will be notified of all the medications the patient is taking even if it’s only OTC drugs. The three major types of drugs used to treat and control agitation and anxiety are antianxiety, antipsychotic and antidepressant medications. Once the patient is diagnosed with dementia, the medications prescribed are used to treat the symptoms of dementia and not the dementia per se (Hay, 1999).

References:

Chertkow, H., Massoud, F., Nasrreddine, Z., Belleville, S., Joanette, Y., Bocti, C., Drolet, V.,Kirk, J.,Freedman, M. & Bergman, H. (2008) Diagnosis and treatment of dementia: 3. Mild and cognitive impairment and cognitive impairment without dementia, Canadian Medical Association Journal. Vol 178 (10), 1273-1285.

Focht, A. (2009). Differential diagnosis of dementia. Geriatrics. Vol 64 (3), 20-26.

Hay, J. M (1997) Medical Treatment. Alzheimers and Dementia: Questions You Have … Answers You Need, 84.

Patterson, C., Feightner, J. W., Garcia, A., Hsiung, G.-Y. R., MacNight, C. & Sanovnick, D. (2008). Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. Canadian Medical Association Journal. Vol 178 (5), 548-556.

Santacruz, K. & Swagerty, D. (2001). Early Diagnosis of Dementia. American Family Physician. Vol 63. (4).

Explain what is meant by demtia: Dementia is a term that is used when the brain is affected by different diseses or conditions. Describe the key functions of the brain affected by dementia: The key functions of the brain affected by dementia are- processing information,language,memory,ability to make sound Judements. Explain why depression, delirium and age related memory impairment may be mistaken for dementia: They may be mistaken for dementia because the symtoms are simular eg ild cognitive impairment, apathy, confusion, poor memory, low concentration.

Understand key features of the theoretical models of dementia Outline the medical model of dementia: Expert control, dependency upon experts denial of personhood, not recognising the social context, distinction between normal and pathological, individualisation of behaviors, blaming the individual, tratment of the illness. Outline the social model of dementia: Interaction of biological and social factors, importance of communities and social etworks, role of socio-economic factors, political factors, recognition of personhood, effects of empowerment.

Explain why dementia should be viewed as a disability: Dementia should be viewed as a disability because people who have dementia are at risk of harm, and are vunerable Know the most common types of dementia and their causes List the most common causes of dementia+ their symptoms: Alzheimers disease: causes- changes in chemistry and structure of the brain, death of brain cells, signs and symptoms- memory loss related to recent events,familiar aces, confusion about time of day, familiar objects and faces, finding the right word.

Lewy body dementia: causes- development of lewy bodies inside the nerve cells, degeneration of brain tissue, signs and symptoms- memory loss, problem solving, confusion and delirium, servere phychotic symtoms such as persistant hallucinations. Vascular dementia: causes- effects of a stroke+a series of small strokes, signs and symptoms- memory loss dizzyness, slurred speech, effects movement, rapid+shuffing steps, leg/arm weakness, loss of bowel/bladder control.

Fronto- temporal dementia: causes- accumulation of proteins, development of pick bodies, signs and symptoms- lack of insight, inability to emphasise, changing or inappropriate behaviour, loss of inhibitions, development of compulsive rituals. Risk factors- age related eg, higher blood pressure, changes to nerve cells, DNA cell structure, body repairs itself slower. Prevalence rates : people with medical history like downs syndrome, hiv, and peoples lifestyles eg- excess alcohol, lack of exercise, inappropriate diet.

Understand tactors relating to an individuals experience ot dementia Describe now ifferent individuals may experience living with dementia depending on age, type of dementia, and level of ability and disability: Every individual with dementia are going to experience it different, because everybodys health situations are different, age, location, social networks, some may have support from friends and family and some may be alone, Behaviour of others: Behaviour of others can make a difference for someone with dementia eg, care workers, colleages, managers, speech therapists, support groups.

If having this support will make the individuals experience better than without the support.

“What Are the Social Effects of Alzheimer’s Disease? ” The growing epidemic of Alzheimer’s Disease plagues more than 4 million people nationwide, according to the National Institute for Aging. The social and financial costs associated with Alzheimer’s Disease are on the rise with no relief in sight. Alzheimer’s Disease (AD), is the most common form of Dementia. It is an irreversible disease that destroys the brain over a period of time. AD is equivalent to child development in reverse. Scientists have found that AD patients share the abnormal processing and degradation of the beta-amyloid precursor protein.

Scientists have noted that there are 2 changes in the brain cells. That is plaque and tangles. Plaques are made up of a sticky protein called beta amyloid, which builds up into small, sticky clumps in the cortex of the brain, intermingled with the functioning nerve cells. Tangles are made up of tau molecules, which normally form tiny tubes that support the structure of the brain cell. In Alzheimer’s patients, the molecules change shape so that the tubes collapse, causing the cell to shrink and die. It is still unknown how these changes occur.

Alois Alzheimer first identified this disease in 1907. Generally, a person can develop this disease anywhere from 2 to 20 years after the first warning signs appear. Both men and women can become effected by AD. The older person is more likely to have it than the younger person. Rare inherited forms of AD such as Familal AD, can develop in individuals as early as their 30’s and 40’s. Most people develop it between the ages of 65 and 75 years old. AD has no single cause, but in the last 15 years, scientists have found several risk factors that increase one’s likelihood in developing the disease.

One of the main risk factors is increasing age. According to the Multi-Institutional Research in Alzheimer’s Genetic Epidemiology (MIRAGE) project based at Boston University School of Medicine shows that at all ages a women’s risk of the disease is somewhat higher than men’s. Scientists also believe genetic predisposition plays a role to some degree. Based upon the MIRAGE project’s findings, it was found that people who’s both parents had AD had 1. 5 times the risk of people with just one affected parent and 5 times the risk of people with 2 unaffected parents.

It was also found that most people with one affected parent do not develop AD themselves. Scientists have also found that genetic mutations on chromosomes 1, 14, 12 and 21greatly increase the risk of this disease in some families. Specifically chromosome 21 cause AD in people with down syndrome. A gene on chromosomes 12 and 19 play a significant role in late on-set AD, the most common type of AD. Scientists believe that ethnicity and environmental  factors play a role in the development in this disease.

It has also been founded that high fat/low fiber diets have been linked to increase the risk of AD, as well as strokes, heart disease, hypertension and diabetes. It is believed that regular, moderate exercise also helps to prevent AD too. In 1998, AD researchers Erasmus University in Rotterdam found that women smokers are 2 times as likely to develop AD and men who smoke have 6 times the risk. More research is needed, as there is still no clear answer to the cause of this disease. There are 7 stages of Alzheimer’s Disease.

The first stage is when the patient is cognitively normal. This is when there are no complaints or indication of any memory problems. The second stage is when the patient is very mild and cognitive deficit. In this stage, there is forgetfulness of new names or where they put things such as glasses or keys. The third stage is when the patient has a mild cognitive decline. This is when there is trouble remembering the names of objects and material they just read. The fourth stage is when the patient has a moderate cognitive decline.

This is when the patient gets lost going to familiar places and having difficulty counting and recognizing familiar people. The fifth stage is when the patient has a moderately severe cognitive decline. This is when the patient has early dementia. It is when the patient needs assistance to survive. They forget their address, phone number and where they are. The sixth stage is when the patient has a severe cognitive decline. This is when the patient has middle dementia. In this stage, they forget relatives names but not their own. They have no idea of where they are or what the date is.

They seem nervous and paranoid and usually lash out. Other times they are peaceful. They also lose bladder and bowel control. Finally, in the seventh stage, the patient has a very severe cognitive decline. It is the final stage of dementia. They later cannot feed themselves, and eventually lose the ability to walk and talk. The 10 Warnings signs generally associated with AD are: memory loss, difficulty performing familiar tasks, problems with language, disorientation with regard to time and place, poor or decreased judgment, problems with abstract thinking, misplacing things, hanges in mood or behavior, changes in personality and loss of initiative. A diagnosis of Alzheimer’s Disease with 100% accuracy requires an examination of the brain tissue. This is typically done with an autopsy after a person dies. An autopsy of a person with Alzheimer’s shows their brains literally tangled and deteriorated. Although a diagnosis of probable Alzheimer’s is very accurate without autopsy with a complete physical examination of the patient. The diagnosis of AD is through a process of elimination after all possible causes of the symptoms are ruled out.

Early diagnosis of this horrible disease is very important, as it will give time to the patient to make plans for the care of themselves and their finances. There are no cures for AD. Only 5 prescription drugs to treat AD have been approved by the FDA. Unfortunately, none of these drugs stops the disease itself, but it slows down the process for a limited time and helps control some of the behavioral symptoms. There is no way of preventing AD. There is some indication that antioxidants such as Vitamin E and some anti-inflammatory drugs such as ibuprofen may reduce the risk of starting it.

It is believed that approximately 2-4 million Americans have AD. More than 70% of Alzheimer’s sufferers live in their own home and the average out of pocket cost is $12,500 a year. For Alzheimer’s patients in residential care centers or nursing homes, the average cost is $42,000-$70,000 per person per year depending upon where they live. The average cost of Alzheimer’s care from diagnosis until death is $174,000. AD is very costly. Most assistant living facilities are self-financed. Unfortunately, most people cannot afford it. V. A. benefits maybe an option for veterans.

Medicare pays for up to 150 days of nursing home care, but AD does not qualify because there is no possibility of rehabilitation. Medicaid is a federal program administered by individual states that pay for long term care. Unfortunately, there are many restrictions and depending upon the state and or the stage of AD, the sufferer is in dictates whether or not they qualify for such a benefit. That is why this is a health crisis facing our nation. The government must be willing to provide more money towards research, and until a cure is found the restrictions of Medicaid must be reorganized to aid those in need.

Challenges for professional care of advanced dementia The research purpose of this study was clear, as it was intended to report on the challenges for health professionals in caring for people with advanced dementia living in long term care facilities. This study used a qualitative methodology based on action research. “Action research collects information from key stakeholders and provides ongoing feedback to participants, thereby facilitating change that improves practice. ” (Chang et al. , 2009, p. 42).

The essence of the study aimed to expose the challenges for key professional providers of care for people with advanced dementia. “Descriptions of these challenges provide professional carers and policy makers with insights into the unique needs of the person with advanced dementia”. (Chang et al. , 2009, p. 42) Participants were selected from professional providers in Australia from 2003-2006. All of the participants cared for patients with advanced dementia in their profession. They brought a comparative perspective to the success of the study.

There were several focus groups compiled that included general practitioners, palliative care speciality staff, palliative care volunteer managers and volunteers, aged or dementia specialist health care professionals, and residential aged care facility staff. All participants were highly qualified with all having more than ten years experience in their field. The sample was non-random, interviewing 13 participants that were recruited from staff of 10 residential aged care facilities.

There was a total of 20 in-depth interviews. Within the sample, five of them large high care facilities, two medium-sized high care (51-74 beds), one small high care (< 50 beds), one medium sized low care (hostel) facility and one small low care facility. The Director of Nurses nominated the the staff for the interviews. “The sampling was purposive, with expertise in palliative dementia care of the selection criterion”. (Chang et al. , 2009, p. 43) The data collection process was adequately described.

It may have been beneficial with respect to gaining deeper personal insight, if the researchers had sought to answer more probing questions in the approach. The researchers used semi-structured questions with focus groups that lasted 1. 5-2 hours. The role of the researcher was to find question that were critiqued by an expert panel. The questions seemed to be based on pre-defined information given to the researcher agreed on by the panel. The information was gathered by interview questions in the focus groups. The uestions seemed to be based on pre-defined information given to the researcher agreed on by the focus groups. The ethical considerations of participants were followed using standard procedures and approved by area health service ethics review committee. Informed consents were used as well as anonymity of patients and participants. “The data analysis was by constant comparative method”. (Chang et al. , 2009, p. 43). They used five focus groups (total n = 24) and 20 follow-up individual interviews (Chang et al. , 2009, p. 41).

The concepts collected were organized and compared with other ideas that emerged from the data. Regarding the background of the study, it was noted that there are many behavioural symptoms and comorbiditics associated with advanced dementia. In the last 12 months of life, it also was noted that many symptoms occur that need to be managed by decision makers such as family members. The researchers noted that during this time, the complex care decisions, such as whether to administer antibiotics and whether to place the patient in a facility or hospital are important decisions that must be validated.

There are a number of other factors that could effect the study, yet were not addressed by the researchers. The catagories, themes and findings presented a whole picture and yielded a meaningful picture of the study by attesting to the complexity of caring for people with advanced dementia living in residential aged care facilities, and the challenges of professionals. Participants did agree that assessing a verbally non-communicative person is difficult. Physicians found that examining patients also was difficult.

Skills deficit were noted. One-third of participants noted a reluctance to use appropriate amounts of analgesia regarding pain. There was a clear connection between the data and the participants regarding the management of dementia-related behaviors. The data collected did attest to the complexity of caring for patients with advanced dementia who reside in residential care facilities and the challenges that they bring to health care professionals. Researchers identified the philosophical and theoretical basis for the study. Educating aged care professionals about early palliation might improve care outcomes for residents”. Aged care staff need a strong rationale for their decisions. ” (Chang et al. , 2009, p. 45) This study highlighted the challenges in meeting the demands of caring for patients with advanced dementia who reside in residential care facilities. The researchers found there was a number of factors that could effect the aged care of residents with advanced dementia; however challenges will always remain.

All of the participants found that is was very difficult to assess patients with advanced dementia. They found that these patients were unable to report symptoms such as pain and exhibited many different behavioral issues. There were study limitations regarding the sample size and the non-random sampling. The sample size was small and not representative of a population owing to that size. Other challenges and limitations may have been noted if different questions had been asked of the patients.

In conclusion, the researchers found that it may be crucial to use continuity of care when caring for these patients. According to some of the participants, their lack of knowledge about palliative care was limited. This study did highlight the challenges that key professional care encounter when caring for patients with advanced dementia. Increase in education will provide a better understanding of the needs of patients with advanced dementia. Key professional will be able to initiate an appropriate care plan if the clinical progress of dementia is described.

Alzheimer’s In The Early Years Early-onset Alzheimer’s is an uncommon form of dementia that strikes people younger than age 65. In that case, some of the first episodes of symptoms with the early onset start as behavioral problems. The caregiver’s of the early onset patient’s experience a lot of stress in their job of taking care of patients with dementia no matter the gender. The biggest portions of people that suffer from early onset dementia tend to have shown up in family members that are very close to them.

Alzheimer’s cannot be reversed so in that case once you have been diagnosed with it, there’s no possible way to change it and all cases end in mortality. There are two types of early onset dementia. There is pre-senile dementia also classified as Alzheimer’s disease because this often happens in patients that are younger than 65 years old. This is cause by the degeneration of the front temporal lobe, progressive supranuclear palsy, and corticobasal degeneration.

The patients that tend to be older than 65 that develop dementia share the same characteristics but often nowhere near as sever but could also still be diagnosed as Alzheimer’s depending on the patient’s conditions. Cerebrovascular disorders are age-related processes. In that case VaD, or vascular cognitive diminishing, usually arises in patients older than 65 years of age, but less frequently in patients younger than 65.

The early clinical features of front temporal lobar degeneration are changes in personality and social behavior rather than impaired cognition. With progression of the disease, impairment of cognitive functions, including memory, becomes obvious and slowly increases in severity. Stereotypical speech, with prominent reduction of vocabulary, occurs in the advanced stage of illness. Sematic dementia and progressive non-fluent aphasia are characteristic clinical symptoms of front temporal dementia.

Rapid progression of cognitive impairment with neuropsychological syndromes and neurological symptoms, like spastic pyramidal signs, myoclonia, and convulsions, has been considered characteristics of early onset Alzheimer’s. However, it was reported recently that the spastic paraparesis, seizures, and myoclonic convulsions do not always occur in early onset Alzheimer’s, although language problems and visuospatial dysfunction are common.