Caring for People With Dementia
Older patients suffering from dementia admitted at care facilities are not accorded the best of care because of their complex needs. This category of patients struggle with progressive cognitive decline, functional decline and challenging behaviors that impacts their quality of life. Dementia not only impacts the patients' but also their families, healthcare systems and the larger society. The patients are not accorded the best care mainly because the healthcare providers lack the understanding of the causes of cognitive impairment (Joosse, Palmer, & Lang, 2013). The care providers also appear overwhelmed because of the misperception of the problem. Cognitive impairment is categorized into chronic cognitive decline or the diagnosable dementia and acute cognitive changes that occur as a result of dementia. It is imperative that timely and accurate identification of the impairment is done because failure to do so often leads to suboptimal care. For patients with benign conditions whose compensatory abilities are compromised by impairments in multiple domains cascade iatrogenesis is ideal. An acute change in cognition is an indication of the presence of systemic illness. Difficulty in identifying cognitive status in older patients calls for coming up with a best known evidence to assess, interpret findings and treatment plan creation that can lead to improvement of quality of lives of these patients.
Delirium is a confusional state caused by an underlying physical condition. It has prevalence of 14.2% in care homes across the United Kingdom (Peacock, Hopton, Featherstone & Jill, 2012). It is however, absurd that with such high prevalence rates it is still under-recognized by nurses (Siddiqi, Clegg & Young, 2009). People with dementia are a greater risk of delirium. Acute confusion associated with delirium may be mistaken as part of their dementia. It is quite a challenge differentiating between dementia, delirium and depression. The situation has further been complicated by the fact that there is a considerable overlap of depression and delirium in older people. Depression affects at least 40% of patients admitted in care homes across the UK. When people are depressed it is more likely that caregivers will overlook symptoms like withdrawal and sleepiness that are associated with delirium (Mitchell & Kakkadasam, 2011). It is imperative that caregivers in care homes learn to distinguish between dementia, delirium and depression because delirium can actually be prevented. This can be done by identifying key changes in patients' behavior however subtle it may be. In this regard, it is important to understand residents' unpredictable behaviors. Long-term care staffs in care homes are in a unique position to recognize subtle and slight changes in a resident's usual behavior that may be associated with delirium. Their knowledge of conditions, causes and triggers enables them to capitalize on their proximity to and relationship with residents as a critical element in care delivery. Because the rate at which the staff working in this care homes come and go is very high, significant proportions of untrained and inexperienced staff cannot provide the best care to residents with complex needs because they are not technically qualified.
The two studies delve into care that should be accorded to elderly patients with dementia while giving an insight into the skills needed to identify and detect differences between delirium, dementia and depression.
Joosse, Palmer and Lang (2013) have explicitly stated why they conducted the study. They endeavor to address the challenges in providing care to hospitalized patients suffering from dementia. They are seized of the fact that despite the gains that have been made in the realms of medical care, older patients still suffer from progressive cognitive decline, functional decline and challenging behaviors that impact the quality of their lives. Because of lack of availability of evidence-based practice on how best these patients should be taken care of in healthcare facilities they still continue to receive suboptimal care. Elderly patients suffering from dementia are an at risk group because caregivers lack the understanding of the causes of cognitive impairment they suffer from. The situation is further compounded by misrepresentation of their condition. In a bid to address...
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation. Conclusion The research showed
Dementia Five important issues caregivers should be aware of when working with dementia patients. dementia is a "progressive and terminal" disease that "you can die from," according to a peer-reviewed article in BMC Medicine (van der Steen, 2013, p. 1). Van der Steen conducted a survey using 372 nursing home patients from 28 nursing facilities in the Netherlands. The initial survey reflected that just 43% of the families understood that "you can
(Transforming Care for People with Dementia across the Continuum) Dementia can be cured with a mixture of psychotherapy, environmental modifications, and medicines. Drug treatment can be problematic by forgetfulness, mainly if the advised drug is to be taken a number of times a day. Behavioral problems are due to irritation or over stimulation. Enjoyable activities, like crafts, games, and music, can give therapeutic motivation and enhance mood. Changing the environment
Care Case Study Slide 1 Footnotes There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion
The emphasis is on normal, everyday activities provided for residents. According to the authors, however, little research has been conducted to investigate the actual effect of such activities and settings upon residents. The assumption is that such settings have a better effect that traditional institutions, but there is little empirical research to support this. Hence, Verbeek et al. (2010) conducted a study to compare small-scale living with regular care in
Mental Health Treatment Approaches for Older AdultsOverview of mental health issues in the elderlyOld age is a natural occurrence for every human being, a stage in growth accompanied by several changes, which can be negative and identified as problems. Some of these problems are a rise in morbidity, mortality, hospitalization, and functional status loss. A large number of evidence associates these problems with common mental disorders to which the elderly
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