Understanding the Process and Experience of Dementia
Outcome 1 Understand the Neurology of Dementia
1) Dementia is a wide term used to describe a brain disorder with a number of different causes. Alzheimer’s disease is the most common form of dementia making up well over half of all dementia cases. With the use of a microscope you are able to see how the brains structure changes significantly which includes, the loss of braincells and the shrinking of the brain tissue.
The second most common form of dementia is Vascular dementia, this occurs when the brain is starved of oxygen. For the brain to function it needs a constant supply of oxygenated blood to maintain its vascular system, if blood vessels become blocked e.g by a blood clot this starves the brain of oxygen causing the death of brain cells leading to dementia.
Dementia with Lewy Bodies is an abnormality found within the brain, the Lewy Body is a sphere shaped structure of protein which builds up inside nerve cells and displace cell components causing the death of brain cells. Other causes of dementia are, Parkinsons Disease and Huntingtons Disease.
2)There are different types of memory impairment dependant on the type of dementia the patient suffers from, for example a sufferer of Alzheimer’s disease may show speech, thinking or memory impairments. Where as vascular dementia suffer may experience issues concentrating, confusion, epilepsy and delusional impairment depending on what area of the brains blood vessels are damaged by disease or a stroke. Fronto-temporal dementia suffer aggression, compulsion, distraction, lack insight and may come across as being unfeeling.
3)How the brain works is extremely complicated, the brain of a human is made up of billions of cells called neurons. If these neurons aren’t firing then the brain is at rest, when active and the neurons are firing electrical impulses around the brain. People with dementia can confuse things which may become very upsetting for family and carers but could be looked at as natural memory loss due to age. A sufferer of dementia could be trying to decipher a place that they can no longer interpret as nothing makes sense to them any more due to the brain incorrectly processing what the person may see, feel or hear for example. A person with dementia should be given care continuity so they can get know to some extent the person caring for them and learn to trust that person and the carer can familiarise themselves with the daily routine of the dementia sufferer but this isn’t always the case. Other aspects such as UTI,s, a change of the persons environment or stress could affect a dementia sufferers understanding of what is happening.
4)Some of the other factors that might have a affect on a persons condition could be a change in medicine to changing the food they eat. The fact that the person is suffering a loss of memory may not be due to dementia, there are many other illnesses and conditions which could affect the persons health such as depression. Changes that naturally come due to old age such as cataracts or continuous tinnitus eventually start to affect sight and the balance of the old person. It is all dependant on which part of the brain has been affected. Brain injury, Poor diet, medications and tumours can all lead to a persons memory and health being affected.
5)Every person that suffers dementia experiences it in a different way to the next, there is no exact route dementia will take and the time scale isn’t definitive as to how quickly or slowly the sufferer will deteriorate. A suffer of dementia can have both good and bad days but there is nothing set in stone as to why these good and bad days occur, it is just assumed that a poor nights sleep or how the suffere is feeling on that defined day.
Outcome 2 Understand the impact of recognition and diagnosis of dementia
1)Most people diagnosed with dementia when receiving the news find it very upsetting and distressing these feelings may also be experienced by their family members. There are still a considerable amount of people that think dementia causes a person to loopy or crazy. If its suspected that a family member is showing signs of forgetfulness or struggling to string together a sentence you should take them to see a doctor as soon as possible. Diagnosing dementia in its early stage may be hard depending on the speed of its development and symptoms may mimic other health conditions. Early diagnosis may give the affected person time to plan for health care in the future, have a say in how they want their needs met and maybe choose a care home they’d like to go to during the later stages of their dementia. There is no cure for dementia but medication is available to slow the progression down and improve a sufferers quality of life. While a sufferer is still in the early stages the person my want to remain as independent as possible still maintaining their dignity and self worth.
2)Being able to monitor and record the signs and symptoms of a person suffering dementia during day to day activities may be taken all dependant on policies, procedures which may or may not allow the recordings to be confidentially made. While recording the behaviour, day to day skills, hygiene needs and memory of a person with dementia all findings must be documented with in the policies and procedures guide lines.
3)The first visit to the doctor may not have an outcome of dementia, there is a process that the patient has to go through to get a definite yes or no diagnosis. There are advertised guidelines to help support a person with early signs of dementia and some of these are, personal history, medication review and a physical examination. If a concern is wanting to be reported the guidelines still have to be followed and the reports made give to either, a manager, supervisor or other designated member of staff. There are many agreed ways of working such as, profiling, referral, care planning and reviews.
4) The impact a diagnosis of dementia may have on a person or their family differ from one to the other, some see it as a blessing and others a curse and deny the fact they have it.
Impact on Person Impact on family and friends
Shock Feeling guilty
Early retirement Loss of social life
Financial difficulty Embarrassment
Shock Financial difficulties
Outcome 3 Understand how dementia care must be underpinned by a person centred approach
1)When a person is diagnosed with dementia it is important to remember they are still a person and an individual first and foremost, the fact they have dementia isn’t as important and comes second. Also taken into consideration is the fact they are possibly somebody’s dad, mum, aunty, uncle, son or daughter so it is important a person centred approach in their care is taken. This is care bespoke to that individual based around likes, wishes, beliefs and needs. This also prevents to a degree stress, agitation and frustration of the person not being able to truly express what they are feeling. Person centred care also promotes choice, inclusion, social participation and self worth. A non person centred care environment is more regimented, where all dementia sufferers are treated the same all eat the same, choice is taken away and every thing is set by time e.g staff bringing round a tea trolley at 9am, 12pm and 3pm instead of when the patient requests a cup of tea. This also dictates as to what can be done by the person like set activities that the patient doesn’t want to promoting exclusion.
2)There are many sufferers of dementia that are more than capable of living in their own homes with little care given by their family. Being able to support or care for a dementia sufferer the focus should be on the what the person is capable of doing rather than what they cant. Its important that they are aware of and likes, dislikes taken into consideration.
3)Before the 1900s there was a model that dominated the way dementia was looked at. When a model came to light based more on a social aspect of dementia it also became part of a civil rights movement which aimed to change the way people with disabilities were looked at. This was used to help people with disabilities access a better view and understanding of their conditions and to see how they were being discriminated.
4) looking at dementia as a disability is very important because health and social care staff are challenged in ways where they have to adapt their approach to care and promote a persons abilities and strengths the patients are still capable of.