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Dementia as a Public Health Issue

Task:

1. Provide a brief description of the following types of dementia:

 Alzheimer’s disease

Alzheimer’s disease is characterized by two abnormalities in the brain-amyloid plaques and neurofibrillary tangles. They stop communication between nerve cells and cause them to die.

Dementia with lewy bodies

Vasular  dementia

Frontotemporal dementia

Alcoholrelated dementia

2. What is a “person-centered approach to care”?

Often the person with dementia moves from one environment to another as their level of care changes. Each environment will impact on the person with dementia as their ability to make sense of their changing world.

3. What are some signs of abuse or neglect?

Abuse can take many different forms. It can include both mistreatment and neglect. Elder abuse is not random attacks of violence. It may not always be an intentional action, but may be due to factors such as ignorance, stress.

  1. Explain how you can encourage and assist the person with dementia to maintain some independence.
  2. Use of gestures 
  3. Voice tone 
  4. Eye contact
  5. Body language

5. Provide a brief description of five behaviors of concern

  1. Social withdrawal
  2. Verbal disruption
  3. Repetitive actions or questions
  4. Resistance to personal care
  5. Sexually inappropriate


Answer

Introduction

Dementia is a health issue of overwhelming concern for not only the people who are suffering from the disease but also for the caregivers and their families. Dementia, as opined by the health experts is one of the major causes of dependency and disability of the older people all over the world. The growing rate of dementia indicates that it needs to be considered as one of the public health agendas in all countries. In this paper different types of dementia have been discussed along with the procedures of care for the people suffering from dementia.

Types of Dementia

Dementia indicates a set of symptoms which are identified when the brain is affected by a disease. Dementia includes memory loss, rapid changes of mood, difficulties in thinking, decreasing problem solving abilities and assessing language and change in perception and behavior (Jones  & Miesen, 2014). Dementia can be segregated in various types based on the characteristics. 

Alzheimer’s disease

Alzheimer’s disease is the most common form of dementia. Alzheimer’s disease is identified when brain cells die because of certain abnormal proteins. Some of the early symptoms of dementia are related to memory loss (Lim, 2015).

Dementia with lewy bodies

The tiny spherical structured developed inside the nerve cells are known as lewy bodies. Because of such lewy bodies causes this particular type of dementia (Lim, 2015). The symptoms of this particular dementia include the fluctuation of alertness, problems regarding movement and hallucination.

Vascular dementia

Vascular dementia in second most common in this list. If the blood supply to the brain is interrupted then a person is diagnosed with this type of dementia (Lim, 2015). It is mainly found after a stroke or cerebral attack. In this disease the planning and thinking ability of a person is hampered. 

Front temporal dementia

In this particular type of dementia the front and the sides of the brain are initially affected or damaged. Rather than memory, language, personality and behaviour are more affected in this case (Lim, 2015).

Alcohol related dementia

Heavy drinking over a long period of time causes this type of dementia. Health experts often do not consider it to be a type of dementia but it has similar symptoms of dementia (Lim, 2015).

Person centered approach to care

Person centered care indicates providing care to a person keeping in mind their abilities, history, personality, interests and needs (Cipriani, Vedovello, Ulivi, Nuti & Lucetti, 2013). Person centered care is effective for dementia as it helps in controlling, managing and preventing the psychological and behavioral symptoms of the disease. In the person centered care for the people with dementia involves

  • Treating the person with dementia with value, respect and dignity.
  • Understanding their history, cultural preferences, interests and medical history along with their personal history.
  • Looking at situation from the perspective of the patient.
  • Providing ample scopes to the patient to improve relationship and interaction with other people.
  • Involving the patients in activities based on their interests.

Signs of abuse and neglect

The abuse of the elderly Alzheimer’s and dementia victims are a common phenomenon in health care services. Some of the potential indicators of such abuse include:

  • The lack of personal care and signs of malnourishment which indicates chronic health problems both physical and mental (Lin, Yang,  Cheng & Wang, 2017). The abuse of such patients often leads to the degradation of their current situation as the issue itself is a sensitive one.
  • Overt signs of physical trauma and restraint trauma injuries are the physical indicators of hypothermia, pain upon being touched and repeated unexplained injuries.
  • In many cases apart from the physical abuse the elders are subjected to financial abuse by the caregivers, neighbors and the family members as well (Bawa, Thirtala, & Lippmann, 2016). In such cases the elderly people suffering from dementia because of their disability to recall or remember facts are often exploited materially.
  • Ambivalence, depression, hopelessness, disorientation, confusion and thoughts of suicide often indicate that the patients are psychologically abused.

Encouraging and assisting a person with dementia

People with dementia require to be treated with personal care and compassion. It is often noticed that they find it hard to peak or convey their needs fluently to the care providers (). It is challenging to identify their needs and requirements as they face difficulty in understanding, reading, writing or expressing emotions. Constant encouragement and support motivate such patients to cope up with their difficulties (Hallberg et al, 2016). In order to communicate with someone who is suffering from dementia one needs to understand few factors which are:

  • It is important to identify the core problem that is challenging the patient’s communication system. Communication difficulties requires to be dealt with utmost seriousness and care.
  • It is important to stay calm and patient and allow the patients enough time to respond and they often have difficulties in understanding and decoding the information.
  • It is important to use short and simple phrases in order to communicate with them effectively. Long and complex sentence often confuse the dementia affected person as they have issues with comprehension.
  • It is important for a caregiver to not argue with such patients keeping in mind their mental condition. They can be involved into memory games and asked questions that indirectly generates their power of remembrance in for the betterment of their situation. It is also important to note that the caregivers do not indulge the patients into something that can pressurize or stress their mind as it can have adverse effect on their health.
  • It is important to maintain a positive body language and consistency in order to communicate with them. It is better to avoid communicating with such patients in a noisy environment as it raises the chance of their confusion.

 Behaviors of concern

Experts have often noticed some significant changes in the behavior of the Dementia patients. The communication challenges often leads to their disturbing social behavior. Some of the behavioral changes include:

  • Social withdrawal

A dementia patient often tends to withdraw himself or herself from the social paradigm. Experts have identified that the major reason behind such withdrawal is due to their inability to connect with other people effectively (Jones  & Miesen, 2014).

  • Verbal disruption

Because they face difficulty in verbal communication they are often disrupted in the course of conversation and it affects them adversely as they lose will to communicate with others.

  • Repetitive actions or questions

As dementia is directly associated with memory loss and inability of comprehension they often perform repetitive actions ask one single question multiple times due to short time memory loss.

  • Resistance to personal care

Patients with dementia often tend to withdraw themselves from the surroundings and this results as the resistance to personal care (Jones  & Miesen, 2014).

  • Sexually inappropriate

As they are no longer in the right proportion to comprehend their surroundings. They might behave in a sexually inappropriate manner (Jones  & Miesen, 2014). Perhaps this is the outcome social abuse or for the aged patients elderly abuse that they are often subjected to.

Conclusion

In the light of the above study it is clear that it is important to demolish the social stigma which is associated with dementia. The social isolation that emerges because of such strong stigma can be fought with in order to sail for a society that is free of fear of dementia. Government has an important role to play in order to demolish the stigma. Several public awareness campaigns in different social institution can facilitate this process.  

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