If the oxygen supply to the brain fails, brain cells may die. The symptoms of vascular dementia can occur either suddenly, following a stroke, or over time, through a series of small strokes. Describe the types of memory impairment commonly experienced by individuals with dementia Memory problems are usually the most obvious symptom in people with dementia. Someone with dementia may not know common facts when questioned. Language problems can also develop. For example, someone with dementia may have difficulty understanding what is said to them or understanding written information. New surroundings and new people may confuse a person with dementia: they can become easily disorientated. Even clever people who develop dementia find it difficult to grasp new ideas or learn new skills. Changes in mood, behaviour and personality and problems carrying out day-to-day activities.
We have two types of memories that may be affected episodic memory where we store events in reference to time, individuals with dementia may find it hard to remember events that have happed or of which have been planned. We also have semantic memory, where we store facts; with a individual with dementia they would find it hard to store facts for day to day lives. So far, no one single factor has been identified as a cause for Alzheimer’s disease. It is likely that a combination of factors, including age, genetic inheritance, environmental factors, diet and overall general health, are responsible. In some people, the disease may develop silently for many years before symptoms appear and the onset of clinical disease may require a trigger. People with conditions such as high blood pressure, heart problems, high cholesterol and diabetes are more at risk of developing vascular dementia. It is therefore recommended that these conditions are identified and treated as soon as possible. Explain the way that individuals process information with reference to the abilities and limitations of individuals with dementia The brain is made up of billions of nerve cells that are called neurons.
The activity of these neurons is how the brain works. For example, to control movements, the brain can send messages along neurons to different areas of the brain or to parts of the body. Alzheimer’s disease changes the structure of your brain and causes your brain cells to die. It also affects the connections between brain cells, which means that nerve messages aren’t passed on properly. Over time, as more and more areas of your brain become damaged, your symptoms will get progressively worse. This is about how an individual with dementia listen to what they are being told then think about it, mull it over, work out how the feel about it. A person with dementia can find it hard to listen as their ability to concentrate can be poor, moreover the part of the brain that process words and speech can be diminished. To be able to understand and to work out how they feel about the information they have been given to them can also be difficult for a person with dementia. As even if they understand the words they may not understand what is meant by them and how they feel about what they have been told, as the individuals thought process can be hampered by the dementia.
Explain how other factors can cause changes in an individual’s condition that may not be attributable to dementia. Many people become forgetful as they become older. This is common and is often not due to dementia. There are also other disorders such as depression and an underactive thyroid that can cause memory problems. Furthermore people of any age can be affected by delirium which can be caused by urinary tract infection or other types of infections. Explain why the abilities and needs of an individual with dementia may fluctuate. An individual’s needs and abilities change over time as a result of their condition and are different for each person. All abilities involve more than one memory and dysfunction of the brain will affect a person’s abilities.
Self-awareness and identity can be lost that may affects a person’s abilities and needs. Furthermore anxiety, depression, mental health issues, loss of independence, loss of companionship, change of circumstance. Moreover Seven Stages of Alzheimer’s (2006) going from no impairment to very server cognitive decline shows the fluctuation of the needs and abilities. People with dementia have symptoms that can vary throughout the week or even day. They will have times when they perform well, and others when they will have more problems. Fatigue is the biggest enemy of the person with memory loss. People with brain diseases tire easily because they must concentrate so hard all the time. For many, the late afternoon and early evening hours can be the most challenging due to fatigue, a condition often referred to as “sundowning.”
Describe the impact of early diagnosis and follow up to diagnosis Early diagnosis helps a person and their family prepare, they may want to learn about what they about to face increase awareness of dementia, its implications and Integrated Care Pathway. They would be able to look at benefit and legal implication such any benefits entitlements and power of attorney. The person and their family would be able to find out about types of services available and how to access them, such as prediagnosis counselling. Explain the importance of recording possible signs or symptoms of dementia in an individual in line with agreed ways of working Doctors employ a number of strategies to diagnose dementia. It is important that they rule out any treatable conditions, such as depression, normal pressure hydrocephalus, vitamin B12 deficiency or infection, which can cause similar symptoms. Early, accurate diagnosis of dementia is important for patients and their families because it allows early treatment of symptoms.
For people with Alzheimer’s disease or other progressive dementias, early diagnosis may allow them to plan for the future while they can still help to make decisions. These people also may benefit from drug treatment. By using the SMART model (Specific, Measurable, Realistic and Time based) to record signs and symptoms it is easier to ensure the individuals, family and carers have their needs met. With this model it is easier to obtain specific facts about health, personal matters, cognitive abilities, functional abilities. Decisions can be made with the individual, relatives and carers and measure accurately the individual’s needs. Moreover to ensure health and safety, hygiene and nutritional needs are met.
Explain the process of reporting possible signs of dementia within agreed ways of working The process of reporting possible signs of dementia has pre diagnosis, where a person who may have symptoms would go to the first to the GPs and receive a medical diagnosis, who if appropriate they would refer to specialist where they would have diagnostic tests and get the results. That would continue with post diagnosis, involving observing the needs of the individual, creating a care plan to ensure the individual’s needs are met. Reviews and follow ups would be needed periodically to ensure that continuation of care that is always involving with the individual’s needs. Describe the possible impact of receiving a diagnosis of dementia on • The individual
The Individual may go through a range of emotions including confusion, shock, fright, sorrow, loss of hope and disorientation. They may find it hard to find sense in the situation and may feel they have lost the chance to reach all their goals. There may also be a financial impact, as the individual may have to take early retirement. Lastly there would be a social impact as the individual may have to stop driving and would not be able to get out seeing friends and socialising. Their family and friends
The friends and family will also go through a range of emotions including high levels of stress, guilt, anger fear and embarrassment. They won’t be able to socialise as much as the friend or family member may be the individuals main carer, moreover the relationship between the two would change. Furthermore a change of dynamics between the two as the friend or family member may now be the main bread winner changing the financial impact.
Compare a person centred and a non-person centred approach to dementia care In person centred care individuality is recognised, enabling choice, empowerment, inclusion and social relationships. It looks at the individual as a unified whole, valuing individuality, and providing opportunity for stimulation. Whereas non-person centred care is dictated and individual’s uniqueness and needs are not recognised. Rather than being included the individual is excluded, have no choice and no empowerment. The individual would not be to participate in the decisions in the care and won’t be able to exercise their rights. Comparing the two types of care person centred care would be more benefited to the individual as this would stop internationalised, the individual would be more happy and interested in the world around where as non-person centred care the individual would become less interested in the world around them and slowly become internationalised.
Describe a range of different techniques that can be used to meet the fluctuating abilities and needs of the individual with dementia There are many different techniques that meet the fluctuating needs and abilities of the individual with dementia. Such as profiling about the person if the person with dementia has the capacity, for instance profiling about health, cognitive ability, life story, carrying out a life at the moment, and personality profiling. There are also many types of therapies that could be carried out to help the needs and abilities of the individual with dementia, such as reminiscence therapy, complementary therapy and creative activities. Furthermore communicating appropriately and monitoring the behaviour of the individual with dementia helps evaluate and meet the fluctuating needs and abilities of the individual. If you are caring for someone with dementia, it’s important to help them remain as fit and healthy as possible – both physically and mentally. The better they feel, the more they can enjoy life, making life more pleasurable for both of you. The way we dress says a lot about who we are. But as dementia progresses people increasingly need more help with dressing.
As a carer, if you help the person with dementia to retain their own individual style, you can help them to preserve their identity. For most adults, washing is a personal and private activity. When you are helping someone with dementia to wash it’s important to be sensitive and tactful, and to respect their dignity. Dementia can greatly affect a person’s relationship to food and eating. It is important to do what you can to make sure that the person you are caring for enjoys their food and eats a healthy, balanced diet. Describe how myths and stereotypes related to dementia may affect the individual and their carers People with dementia may view themselves and may be viewed by others as unfortunate victims, needing pity and a ‘burden on care’. Because of this the individual with dementia and their carers may feel they have been discriminated against.
The effects of this on the individual and theirs carers are that they may feel stigmatised, discriminated, inadequate and isolated. In turn this would cause the individual and their carers to have a low self-esteem, which could lead to depression. Describe ways in which individuals and carers can be supported to overcome their fears Many individuals with dementia are cared for by their partners, family, friends, and sometimes even their neighbours. But carers and their individuals they look after need support such as information and advice sheets, booklets and leaflets. The Alzheimer’s Society East Anglia gives telephone and internet support as well as Age UK who also give support within their high street shops. There are also on line support and local carers support groups such as the Alzheimer’s Society Kesgrave that meet every first Friday of the month for people with dementia and their careers. Furthermore the individual and their carers should be able to rely on the support of family and friends. And lastly where care centres such as the one I work in provide respite care for the individual giving the care giver a rest without worrying about the individual.