5. Dementia and its effects on patients, family and carers Flashcards
Common types of Dementia?
Alzheimers disease Vascular dementia Mixed dementia Dementia with Lewy bodies Fronto-temporal dementia: 45-65yrs common. Speech difficulties
Epidemiology of dementia?
850,000 inUK
Risk increases with age but not a normal part of aging
>42,000 younger people with dementia in the UK
Cost of dementia?
£26.3 billion to society (32,350 pp)
3 principals of syndrome of dementia?
Loss in ability to do day to day activities
Changes in personality and social behaviour
Intellectual function loss
What are the progressive stages of alzheimers?
Early stage
Middle stage
Later stage
Characteristics of the early ‘mlld’ stage?
Forgetful Mislaying items Struggle to find words Slower cognitive capacity Cofusion/losing track Poor judgement, hard to make plasn/decisions --> lose interest --> low mood Poor distance judging Forgetful
What are the potential issues for the person/family & HCPs at this early stage?
Denial
Frustration
Anxiety/worry
Characteristics of the middle ‘moderate’ stage?
More forgetful Fail to recognise people Time/place/events/getting lost Need help with personal care Difficulty in daily activities Safety Behaviour change
Characteristics of the late’ stage?
Usually TOTAL DEPENDANCY
Unaware of time/place Confusion/comprehension Not recognise familar faces Need assistance ineating Increased need in self care Incontinence Mobility problems Behaviour changes
What is the role of the caregiver at the early stages of dementia?
- Provide emotional support following diagnosis and when the person is depressed or anxious
- Prompt and remind the person about events, tasks and other things to help them maintain involvement and independence
- Provide assistance with instrumental activities (e.g. personal finances, shopping).
What is the role of the caregiver at the middle stages of dementia?
- Use communication strategies to aid understanding
- Provide help with carrying out personal care
- Provide help with other activities ofdaily living such as food preparation, dressing appropriately
- Respond to and manage behavioural disturbance and inappropriate behaviour.
Consequences for the psychological, physcial heath and quality of life on the CAREGIVER
“A second patient in the making”
– Depression/anxiety
– Lower quality of life/wellbeing
– Worse health outcomes: e.g., obesity, higher metabolic risk, higher levels of stress hormones, compromised immune system, cognitive decline, less preventive health behaviours
E.g. • Sleep problems • Socially isolated • Rolestrain–trying to manage multiple caring duties • Family conflict • Financial strain: providing dementia care can be a full time job. • Sense of loss/grief • Guilt/resentment/ anger
Consequences for the psychological, physcial heath and quality of life on the CAREGIVER
“A second patient in the making”
– Depression/anxiety
– Lower quality of life/wellbeing
– Worse health outcomes: e.g., obesity, higher metabolic risk, higher levels of stress hormones, compromised immune system, cognitive decline, less preventive health behaviours
E.g. • Sleep problems • Socially isolated • Rolestrain–trying to manage multiple caring duties • Family conflict • Financial strain: providing dementia care can be a full time job. • Sense of loss/grief • Guilt/resentment/ anger
How are public/professional attitudes a barrier to diagnosis of dementia and provide good-quality care?
- Stigma of dementia prevents discussion
- False belief: Normal part of ageing
- False belief: Nothing can be done
What are the different sources of support for dementia?
- Social services department of local authority/council
- Community psychiatric nurse
For long-term care plan:
• Physiotherapist: issues around mobility
• Occupational therapy:
– Helps with reminiscing and how to make a life story book – Recommending suitable exercise/changes around home – Assist with personal care training
– Improving safety at home
– Info support on accessing other support
– Advising carers
