Dementia Interventions And Implications Health And Social Care Essay

derangement Interventions And Implications Health And Social C atomic count 18 turn erupt lunacy is one of the in the come about causes of nonfatal disability in the genuine world and by 2030 it is predicted that frenzy every(prenominal)ow be the third in the lead cause of the years of life lost c all(prenominal)able to death and disability .Measured using the concept of disability ad on the noseed life years (DALYS) which combines a measure of the average years of life lost due to ailment with the years lived with disability Mathers and lonrail focusing car (2006). Alzheimers society describes lunacy as a considerationinus used to describe various different brain disorders that fuck off in common a conditionination of brain function that is usu totallyy forward and eventually severe on that point are over 100 different types of mania. (All Parliamentary party groups on dementia 2009) reports, in that location are most 700,000 raft in the UK at once with d ementia. That number allow double up within 30 years and the financial cost of the dementia today is more than the cost of heart unsoundness, fecescer and stroke combined. In orbicular burden unhealthiness WHO( 2003) it was estimated that disability from dementia is higher than almost all conditions with the exceptions of spinal cord injury and terminal gagecer .Dementia is a wellness and social look at challenge of scale, we can no longstanding treat it and government recognized this with national dementia strategy for England in February( 2009). Dementia is a significant life changing process affecting everyone in different ways .Different type of dementia affects individual sight differently. My faux pas study is about Mr. Roy who is diagnosed with Fronto temporal dementia who has progressive voice communion loss and cognitive decline. As he suffers from primary progressive aphasia, all discipline gained from his married woman .Jane. I have changed all names of s omebodys and lays to protect confidentiality as followed by NMC guidelines.Mr. Roy was a supervisor and driver for a come with for 35 years, use employee, he married Jane and had cardinal children. Roys mum has history of undiagnosed psychotic somebody businesss. He always had abrupt mannerism, strict with everything and always wanted to be first. Although he was dedicated to his job and never had time for his family, Jane was the main upkeepr of the family. She locomoteed as manager of a residential home .She says that he never been there for my children. Roy was a lovely person when he married her, after she had quad children, he was working as a supervisor for a company for 35 years. Roy lost his job when he could non accept the changes in work environment, when the company started to use the modern equipments. He started to behave opposedly, he collected speckle documents and kept it on the top of the attic, as he does non same(p) Changes Companys policies .He lost his job as this company locomote to another place. He lost interest in his family life he spent time in pub and always had fleeting brothel keeper friends and spends money for them, which always leaded him to have debts and borrowed from banks and building society, without fucking his wife. His wife had to face the summonses, bills and police cases for a long time. She continued to pay top .He had problems with managing accounts, immortalizes and names of children. Roy started to be very rude and argumentative pressure on his wife for money and spent it treating others in the pub. He had lots of temporary lady friends his personality changed, he threatened his wife with a ordnance one day to find his way. His driving skills became measly, and he had a car crash but survived miraculously. He never mentioned with his car after this incident. Mr. Roy indeed isolated him ego .He use to visit regularly to the place where the company was and traveled several times in a bus on t he pertinacious route. He has been referred to the psychiatrist and diagnosed of anxiety, depression and he refused to undergo any intercession for 3 years. His condition start worse .Roys memory deteriorated. He admitted to the hospital due to his difficult deportment pneumonia Mrs. Jane had to take voluntary retirement due to financial commitment and to look after Roy. Her daughter was very supportive to her other three children despised him, and never bothered about their dad. Roy because sectioned due to his difficult behaviour admitted in mental health unit, undergone a CT scan and diagnosed of Fronto temporal dementia. He moved to an EMI breast feeding home to manage his complex needs. Roy displays physical aggression both positive and threatening. Roy says do you want twain black eyes. He will remonstrate his fist and will attempt to slap the staves faces. Roys inhibitions appears reduced which often results in socially inappropriate behaviours .Physical aggression towards fellow residents, Roy appears to have no sharpness to his own condition on others illness and safety. Roy is at high seek of absconding and has a past history of windows and absconding from the previous care settings .Roy is self heedlessness ,resistive towards personal care , his behaviour can be challenging when round onset him regarding personal care .He has no concept of risk to himself or others ,he will invade peoples personal space and can become confrontational regardless of any age groups .When people ask Roy questions he will laugh inappropriately, mimic ,or answer inappropriately ,for example dont be inconclusive .His short term memory appears impaired to the place and date .Long term memory appears impaired and muddled . Roy believes that he was in the Navy, but his wife has told that this was incorrect .Some aspects of Roys long term memory are intact and he is able to recognize family members He likes to wear coat and tie all the time .Conversational sk ills are limited and superficial in style accordingly further mental health assessment are difficult. Roy likes melody and will play loud music with no concept to others. When his mood lowers Roy has a tendency to socially isolate himself ,He is in advance long prescribed antidepressants and his mood currently appears stable ,he has a sweet tooth , can be very demanding for particularly chocolate clairs .He tends to get chest infections recurrently.Common causes of dementia are Alzheimers ailment ,vascular dementia ,Korsakoffs syndrome ,Dementia with Lewy bodies Fronto temporal dementia ,Creutzfeldt Jacob syndrome ,Aids related cognitive impairment ,other rarer causes like Progressive Supranuclear palsy, and Bins angers disease. People with multiple Sclerosis, motor neuron disease, Parkinsons disease and Huntingtons disease can also at an increased risk of go uping dementia.jr. onset of dementia is arbitrarily delimit as beginning forwards the age of 65 years. It is much ra rer than late on set of dementia (Harvey, 1998) the proportion of those with Fronto Temporal Dementia is thought to be higher in new-fashioneder-on set group than among old(a) people developing dementia. (Dale2003 Williams 2001) possibly be stresses for family members. In addition , the social and psychological context of younger people with dementia is different from that of older people (Cox and Keady,1999 Tined all and Manthrope,1997)The term Fronto temporal dementia covers a range of condition including picks disease and dementia associated with motor neuron disease all are caused by injury to the frontal lobes and the temporal parts of the brain, these are responsible for the delirious responses and diction skills Alzheimers society (factsheet404)explains the core features of FTD as defined by the Neary criteria are premature decline in social and personal bestow, mad blunting and loss of insight. selective brain degeneration is seen in dorsolateral orbital and medical frontal cerebral mantle (Neary).Personality shifts in the direction of submissiveness are typical for FTD. Although extroversion can surface in previously introverted individual s(Rankin, Kramer, Mychackand Miller(2003) points out that there is a shift from the warmth to coldness on personality scares .Changes in formal religious or political believes and patterns of dress suggesting changes in the sense of self are common, assess for personal boundaries disappears, some patient stare and become overfriendly, taking openly to the strangers(including children),Increased trust for others make these patients vulnerable to financial scams or sexual exploitation. Indiscretion causes embarrassment to the family and disinhibited verbal outbursts or socially inappropriate behaviour is common. Miller (1997) describes the symptoms are Antisocial behaviours, often reflect poor judgement and impaired impulse control. Impairment in personal conduct is a core feature .Some can be overactive with verbal and motor activities .where as others become inactive and withdrawn, some patients will fluctuate between over activity and apathy. Gregory and Hodges (1996)Kean Kalder, Hodges and young ,(2002),Rosen et al,(2004) departure of precaution for others and prominent emotional blunting tend to isolate the patient .A consolation of cognitive and emotional changes tocontributeto this emotional blunting .for example ,comprehension and expression .are deficient , and the inability to comprehend the emotions that others are tinting. That the others are feeling particularly better, negative emotions contributes to the feeling that the patient is no longer concerned about his or her loved ones, in addition, patients become self centred and tend to focus on their own particular needs and desires. In a medical crisis setting, patients may respond with inappropriate lack of concern , sometimes in a bizarre manner (Johansson Hagberg,1989Kramer et al 2003) loss of executive functions leads to impaired multi tasking , displacement abstracting , make sound judgments , planning and problem solving the executive problems can be the first manifestaon of std proceeding behavioural deficits ( lindauetal 2000) poor performance at jobs leads these patients to get fired , and they tend to work at progressively simpler occupations. Similarly, catastrophic financial loss due to poor decision making is common prior to presentation at the physicians office (miller 1995) explains that preservative and stereo typed behaviours emerge in the middle stages of FTD, simple repetitious motor or verbal acts much(prenominal) as lips making, hand guide or humming are common. More complex behaviours such as collecting (garbage, rocks, stamps, plastic figures) wandering a fixed route or counting money, evolve in patients. Hyperorality manifests in over eating and changes in food preference to a certain type of food or even conception of inedible objects. Analysing this behaviour ch aracteristics Mr Roy is exactly the same features we can see in him .Roys challenging behaviour can be the signs of affliction anger, aggression anxiety, and withdrawal .As ( Kerr and Cunningaham2004 ) states that it is difficult to determine how person respond to the behaviour or responses of a person with dementia ,if we do not know what caused it for and how person interprets it .As Roy has a rare form of dementia with primary progressive dysphasiaPatient with FTD also go on to develop speech and language problems during the evolution of disease, (Neary 1998 Pasquier, Lebert, Lavenu and Gallium, 1999).Depression occurs and many patients with FTD are diagnosed with depressive disorders before dementia is bare (miller 1991) depression has atypical features that are a clue to the real diagnosis. Loss of insight regarding behavioural changes, fall empathy for others, denial of depression, changes, diminished empathy for others, denial of depression, apathy, and blunt affect are p resent, in many patients with FTD and depressive features. Psychotic features, such as delusions and hallucination, occur but are infrequent. Deficits in working memory, set shifting and generation are evident, episodic memory deficits can be prominent, leading to misdiagnosis of AD. (Lindau 2000) (Miller, Swartz Lesser, Darby, 1997) states that excessive smoking and alcohol or drug abuse can lead to the misdiagnosis of alcohol or drug addiction, patients with FTD tend to overeat in gluttonous manner. In clinical practice because many physicians are unacquainted(predicate) with its specific features FTLD is commonly misdiagnosed as AD. Decline in social and personal conduct, emotional blunting, loss of insight and progressive speech disorder develop archaeozoic in the FLTD.(Dawn Brooker 2007) points out that understanding persons past history is important to providing person centred care, by looking at procedures for how key stories are know about and how these are communicated Person with dementia is central to this process although others such as family or professional carers can also derive abundant benefits from being involved . The process and its tangible outcomes assist communications and incite the development of positive semblanceships, Life story work therefore has a multiple benefits for various people. It is and activity that all the largely about the past, takes place in the present .it involves a series of intensive, non threatening highly personal discussions between the person disabled by dementia and responsive thankful listener .As Roys dementia has progressed and is unable to gain any information from him . Cunningham (2006) overleap of awareness and knowledge about the needs of the patients with dementia can lead to challenging behaviour and misinterpretation of their needs. The ABC analysis of behaviour is a useful thriving tool for understanding patients with Dementia. This system provides an opportunity to record all the fact ors which interact to create a challenging situation. (Wang and miller 2006) points out that many aspects of this disorder make it particularly troublesome for caregivers, including loss of empathy for others, apathy, diminished insight and inappropriate sound behaviours that characterize these patients. It can be argued that successful caring relationships are those here the person with Dementia is accepted just for what they are, not pressurised to become what they once were an impossible target for them to achieve.Kitwood was the first writer to use the term personhood in relation to people with dementia, he defined personhood as a standing or status that is bestowed upon what human being by other, in the context of the relationship and social being .It implies recognition, respect and trust. Brooker (2004) helpfully encapsulates the person -centred frame work in four areas valuing the person with dementia and those who provide care for them.(V)The individuality of each person wi th dementia ,(I),The important perspective of person with dementia (P) and the key role compete by persons social environment person centred care involves the integration of these four elements. So the people with dementia and those who care for then truly seen as VIPs.A senses frame work has been proposed by Nolan as a of understanding these triangular relationship between the person with dementia ,the coitus and the care home staff .Six senses are highlighted .those are sense of protection ,sense of belongings ,sense of continuity ,sense of purpose ,sense of achievement and sense of significance .For person with dementia living in a care home the two key sets of triangle relationship are first ,with family members and friends and second, with various members of staff provide care .the relationship with family and friends is vital in the context of the persons move through life the relationship with staff is vital in relation day to day comfort and satisfactions needs .Nolan e t al argues (20032006) argue that these sextuplet senses are essential for the relationship that are mutually satisfied for all concerned .for each of six areas ,the person with dementia ,family member and care worker may experience this differently ,yet a gap in any of these areas will unbecomingly affect the whole step of relationship.(Woods Keady bseddonch Diane 2007)explains that the person with dementia may feel secure and safe when he or she has a friendly smiling faces around, and physical needs are responding to promptly and quietly (the family member may feel secure when she or he feel confident that the person is in corking hands . and receiving good care .the care worker may feel secure when their job is not under threat . when they do not feel criticised and scrutinised for every action, and when they do not feel under threat or attack, whether physical or verbal. A study by CSCI (2008) of care homes has shown the quality of care staff, communication with people wit h dementia has a major impact on their quality of life .leadership ethos, of care home staff training support and good development are crucial factors in supporting good practice.Jane hated Roy because his difficult behaviour and the stress she had before diagnosis. G.Ps were not aware of this dementia as it is rare form of dementia ,.A fundamental way facilitating carers involvement, is for the nurses and the carers to negotiate a relationship within which involvement can keep in line in a way that endorses the principles of good practice is already open .Walker. E and Jane, B (2001)Fronto temporal lobe degeneration strikes at relatively young age, so the disease often causes dramatic economic and social consequences before patients arrive in the clinic. The UK National service frame work for older people states that there should be specialist services for the younger people with dementiaDOH,(2001)National service frame work for long term Neurological Conditions advices that ther e should be person centred services ,early recognition ,prompt diagnosis treatment and early rehabilitation(DoH,2005)When Jane had to face the consequences of the challenging behaviours financially and emotionally for long periods as she was not getting enough help from the health professionals ,and lack of diagnosis and oblivious(predicate) of his type of dementia .the person with dementia will adjust with this by nature ,but it can be much more difficult for their loved ones, since they are distressed by what they lost .Miller and Wang (2003) Typical and Atypical antipsychotics have been used for controlling aggressive and psychotic symptoms. However considering the possible adverse response with deteriorating motor symptoms and dysphasia, antipsychotics should only be used as a last resort.An increasing number of structured or therapeutic activity-based interventions constitute for people with dementia. Examples include reality orientation cognitive stimulation therapy music t herapy art, writing, dance and movement drama aromatherapy and sensory stimulation intergenerational programmes Montessori-based methods doll therapy the SPECAL approach emotion-oriented care horticultural therapy and woodlands therapy. Reviews have revealed that the research state for most of these activities appears weak, yet the visible positive effect they have on individuals and anecdotal evidence indicates that they are worthwhile and haveReferancesKerr D. Cunningham c(2004)Finding the right response to people with Dementia .breast feeding and residential care .6,11, 539-542.Harvey R.J (1998) Family Burden young onset of dementia Epidemiology, clinical symptoms, support and outcome London Imperial College.Walker E. Devar B.J. (2001) issues and innovations in Nursing Practice .How do we facilitate carer involvement in decision making? Journal of advanced Nursing 34(3) , 329-337.ConclusionThe above study and so explains the severity of Dementia and its consequences if left un attended. As stated above the number of people getting affected by this disease is increasing at a very high rate. Thus this disease seems to pose a serious threat to mankind and its social existence. The time has come to buzz off large scale studies and experiments on this disease and thereby device a methodology/cure for this. Also WHO should promote awareness about this disease among common public to ensure early detection and thereby cut back further health risks.