Knowledge & Understanding questions Essay

1.1 Describe a range of causes of dementia syndrome

ANSWER

Neurodegenerative diseases is a common cause of dementia which mean that the brain cells known at the neurons either are degenerating therefore the neuron die off quicker which will lead to a more decline in the person mental health such as memory, language and sometimes their physical abilities all depending on which area of the brain is infected. Dementia affects the brain and the loss of function of the brain in such a way that the things we normally take for granted, for example our ability to remember things (time, date, events, to use language all of these things begin to disappear.

Also there are more causes of dementia caused by depression, brain tumours, thyroid hormone, and head injuries. Some of these causes of dementia can also be dementia-like conditions which may be treatable or non-progressive. These neurodegenerative diseases are known to us as Alzheimer’s fronto temporal dementia, and Lewy bodies are where over time a build up of abnormal protein deposits in the brain cause the gradual change and damage to the neurons which will cause the shrinkage of the brain.

1.2 Describe the types of memory impairment commonly experienced by individuals with dementia

ANSWER

Dementia is a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal ageing and are severe enough to impact daily living skills, independence, and relationships, while Alzheimer’s disease is the most common type of dementia, there are also many other forms, including vascular and mixed dementia. Common signs and symptoms of dementia may include:

• Memory loss
• Impaired judgement
• Difficulties with abstract thinking
• Faulty reasoning
• Inappropriate behaviour
• Loss or communication skills
• Disorientation to time and place
• Gait, motor and balance problems
• Neglect of personal care and safety
• Hallucinations, paranoia, agitation.

The most common forms of mental decline associated with ageing are:

• Slower thinking and problem solving
• Decreased attention and concentration
• Slower recall

As the dementia progresses the individual ability to look after themselves from day to day may also become affected.

1.3 Explain the way that individuals process information with reference to the abilities and limitations of individuals with dementia

ANSWER

The working of the brain are very complex, the human brain is made up of around 100 billion cells, main these cells are called neurons. If the neurons is switched off is resting when it is switched on it fires electrical impulses along its body known as the axon. Some people with dementia often confuse things, this may be very distressing for their family or carers, but can be called as a natural aspect of their memory loss. An individual with dementia may be trying to interpret a world that no longer makes sense to them that because them brain is processing the information incorrectly.

An individual with dementia may receive care from a provider who does not maintain a good standard of continuity with their staff, for a person with dementia it is very important as they must become familiar with the people who care for them to gain trust and familiarity with their daily routine. Communication could not be structured correctly for the person who causes confusion and lack of understanding as they are unable to comprehend what is expected of them. Infections, change of medication, change of environment, pain and stress, social skills, understanding and interaction levels may decrease or fluctuate. However an individual process the information in different ways therefore depending on their abilities will depend on their limitations as suffering with Dementia.

1.4 Explain how other factors can cause changes in an individual’s condition that may not be attributable to dementia

ANSWER

Change of diet, environment, and medication can cause changes in an individual condition; in spite of the fact experiencing a loss of reduction in memory does not mean always indicate a form of dementia. There are many other conditions which could affect an individual health which can be a difference between dementia, depression and confusional state. Sensory changes due to age related degeneration example macular degeneration and cataracts affecting vision, loss of hearing and increase of tinnitus affecting balance, reduced metabolism causing poor appetite. The part of the brain which was affected will determine how the person will be affected. Some condition that may affect the memory are listed below:

• Brain injury- which can be caused by an external trauma such as a blow to the head or internal factors such as a result of a stroke or aneurism.
• Brain tumour – a tumour of the brain can be benign (slow growing, non cancerous) or malignant
• Medication – some prescription medication can have side effects which can affect somebody’s memory.
• Diet – some foods can have an effect on a person’s memory.
• Stress is the emotional and physical strain caused by individual’s response to pressure from the outside world. Stress can affect an individual’s health in many ways, including memory difficulties.

1.5 Explain why the abilities and needs of an individual with dementia may fluctuate

ANSWER

Each individual may experience dementia in different ways. There is no definitive direction or path that the condition will follow and there are no exact timescales in which the condition may progress. Somebody with dementia can have “good days” and “bad days”. Believed all depends on how we are feeling, how much sleep we have had, and what activity we are doing and how much we want to do that activity. On the other hand changes that may occur in their day to day life, changes of people (changes of carers on a regular basis), therefore not being consistent in a routine programme.

2.1 Describe the impact of early diagnosis and follow up to diagnosis

ANSWER

Generally speaking for most people receiving the diagnosis of dementia is very distressing, also can be very upsetting for their loves one. Many people in nowadays still think of dementia as being a condition which causes people to go “crazy”. When supporting somebody who is exhibiting any signs or symptoms of forgetfulness, confusion or the inability to find the right words when communicating, it is important that they see their GP. In the early stages diagnosis can be difficult to make as the symptoms of dementia can develop slowly, also the symptoms can be similar to symptoms of other health condition. The early diagnosis of dementia is essential in order to:

Rule out other conditions that may be treatable

Access advice, information and support

Allow the person with dementia and their family to plan and make arrangements for the future. Although there is not cure at the present, there are various medications available which can help improve symptoms and possibly to slow down the progression of disease. Following diagnosis, an individual may want to live as independently as they can. In order to aid a person to self look after themselves, the individual could place a list of important telephone numbers by their phone, labels also could be placed on cupboards doors to remind them of the contents. However the quality of life, fear, feeling lack of control, loss of dignity, loss of identity, invasion of privacy, fear or losing own home, inability to communicate needs and preferences, loss of friends, increased risk of falls, nutrition, personal hygiene all of these factors are playing a huge impact in an individual life diagnosed with dementia.

2.2 Explain the importance of recording possible signs or symptoms of dementia in an individual in line with agreed ways of working

ANSWER

The recording signs or symptoms of dementia in an individual day by day life can be made, depends of the policies and procedures of the company such as verbal, written, electronic, accurate, timely, and confidential reporting.

When monitoring somebody’s condition, it is important to record any findings in line with the organisation’s policies and procedures. The following areas area those which it is very important to monitor and record in the person, as these will show what changes have occurred and over what period:

• Memory
• Behaviour
• Personality
• Ability to cope with daily living skills
• Care-giving strategies
• Activities that person enjoys
• Any medication that they have taken that day

Below are shown some key points in importance of recording:

• To obtain specific facts about health, personal matters
• To measure accurately the individual needs
• To ensure health and safety of all involved
• To accurately record the action agreed
• To ensure nutrition needs are accurately met
• To make sure hygiene needs are met

Follow the Smart model (specific, measurable, realistic and time based) to be sure the individuals family and carers have their needs met.

2.3 Explain the process of reporting possible signs of dementia within agreed ways of working

ANSWER

The diagnosis of dementia does not always occur from the first visit to GP. Generally there is a process in which the person goes through in order to receive a definitive diagnosis. National Institute for Health and Clinical Excellence has advised guidelines in supporting people with dementia, where the early diagnosis of dementia it is included.

The person historyA cognitive and mental state examinationA physical examinationA review of all medication including over the counter remedies

To report a concern, the organisation’s guidelines and procedures have to be followed, usually most reports are given to a designated member of staff, this may be line manager, supervisor or manager, always try to avoid by giving the personal opinion. Also agreed ways of working may be:

• Medical diagnosis
• Referral pathway
• Diagnosis tests
• Profiling
• Observation
• Care planning
• Review
• Follow up
• Continuation of care

2.4 Describe the possible impact of receiving a diagnosis of dementia on:A) The individualB) Their family and friends

ANSWER

The impact on the person and their family receiving a diagnosis of dementia can vary, some may see it as a relief that the cause if their difficulties has been diagnosed while others may be in disbelief, preferring not to acknowledge what they have been told.

Impact on the individual:

• Confusion
• Shock
• Feeling frightened
• Denial of failings
• Disorientation
• Trying to construct sense of meaning into the situation
• Destruction of hope
• Loss of future goals
• May have to retire early
• Financial implications
• May need to stop driving
• Loss of socialisation

Whatever feeling the diagnosis creates in the person, you should encourage and support them to talk about their feelings.

• Impact on family and friends:
• Loss of socialisation
• Increased stress levels
• Feeling of guilt
• Need to balance commitments
• Anger
• Loss of financial support/ increased financial needs
• Fear
• Feeling embarrassed
• The individual’s family and friends should respect the wishes of their loved one.

3.1 Compare a person-centred and a non-person-centred approach to dementia care

ANSWER

When an individual been diagnosed with dementia it is important to bear in mind that people with dementia are individuals first, with their condition of dementia coming second. They may also be mothers, fathers, brothers, sisters, sons or daughters. Person-centred care is a way of providing care with the person at the centre of everything you do, or another way of describing it is individualised care- care that is given to the person according their needs, wishes, beliefs and preferences. Studies have shown that a person-centred approach can help reduce agitation in the person with dementia where the agitation is often causes by the person’s frustration in not being able to express themselves .

• Recognising individuality
• Enabling choices
• Enabling social relationships
• Valuing the individual
• Providing the opportunity for stimulation
• Inclusion
• Looking at the person a s unified whole

Once a person needs have been identified, plans should be made to draw up a support plan which will describe how those needs will be met. Nothing should be planned for the individuals for them without them.

• A non person-centred approach can be identify such as:
• Dictating form of care to be used
• Not recognising the individual’s uniqueness and needs
• Exclusion
• Lack of choice
• Not allowing participation in decision making
• Not allowing the individual to exercise their rights
• Responding to behaviour rather than looking at the unified whole
• Not empowering the individual

3.2 Describe a range of different techniques that can be used to meet the fluctuating abilities and needs of the individual with dementia

ANSWER

Many people with dementia are able to live in their own homes for most their lives with care being given to them by their families. As a carer or support for those suffering with dementia, must focus on the skills and abilities that the person has, rather those that they have lost. Ensure that they are fully aware of and respect the person’s background, their history, likes and dislikes. Be prepared for changes and adapt flexible approach. Not every day may be the same in supporting people with dementia. By learning about each individual ‘history and background, can be designed the care and the type of support provided around their specific needs.

Ensure that individual’s support plan is kept as up to date as possible and shows alternative methods to use for various fluctuations in their support needs, share the information with the rest of the carers., provide a stable environment and suitable surroundings as one of the main triggers resulting in somebody with dementia becoming agitated and confused is a change in their routine. To ensure stability it is important to : Have consistent, regular staff, unfamiliar faces can cause the person great upset Maintain a familiar environment, if there some new decorations needs to be undertaken try to make the new decor similar if not the same as it was previously. Ensure that the individual is in a non stressful, constant and familiar environment Establish a regular routine regular physical activity and adequate exposure to light and improve any sleep disturbances.