Dementia Flashcards
Positive aspects to being old?
Freedom Travel Retirement Pension Less responsibility
Negative aspects to being old?
Illness Frailty Dependence Pension Reliance on carers
What is ageism attitude and language?
ugly and useless an elder vs the elderly the grey hordes plague of wrinklies silent epidemic of dementia
What is the gray panthers?
The Gray Panthers are a series of multi-generational local advocacy networks in the United States which confront ageism and many other social justice issues. The organization was formed by Maggie Kuhn in response to her forced retirement from the Presbyterian Church at the age of 65 in 1970.
What are we most worried about in late life? (all)
40%= cancer
29%= dimentia
heart disease= 10%
stroke=7%
What is dementia?
Not a disease in its own right. It is a deterioration in intellectual functioning and social behaviour.
5 main features of dimentia
- syndrome due to disease of the brain
- chronic or progressive in nature
3.disturbance of multiple higher cortical functions
e.g
decline in memory, thinking, learning capacity, judgement
- consciousness is not clouded
- accompanied by deterioration in emotional control, social behaviour or motivation
What are different types of dementia syndromes
Alzheimer’s disease 62% Vascular dementia 17% Mixed dementia (AD & VaD) 10% Dementia with Lewy bodies 4% Fronto-temporal dementia 2% Parkinson’s dementia 2% Other dementias 3%
what are the 3 bounds of dementia severity?
mild
moderate
severe
why do we categorise?
they require different types of support
what is mild dementia
cognitive decline limits functional activities but independent living is possible
what is moderate dementia
seriously inhibited functional activity. Familiar material retained but independent living not possible
what is severe dementia
complete inability to retain new info. Assistance required for all daily living activities. Very limited communication
how many currently have dementia
850,000 in uk
how many have dementia under 65? (early onset)
40,000
why do more women have dementia?
They live longer
how many are women ?
2/3 with dementia are women
What does having a learning disability do to our risk?
Increases risk of dementia
What is Kitwood’s model of dementia?
Dementia=NI+H+B+P+SP
NI - neurological impairment H - health & physical fitness B - biography, life history P - personality SP - social psychology
What were previous views on dementia?
Disease
Ct scans
Us and them
living death
what are current views on dementia?
Disability Care plans 'all of us' living well communication
What are the signs of dementia?
often subtle onset
only recognised after diagnosis
symptom under-reporting, don’t attend GP surgeries, lack of self-awareness
gradual loss of self or ‘personhood’
What is Kitwood’s definition of personhood?
A standing or status that is bestowed upon one human being, by others, in the context of relationship and social being. It implies recognition, respect and trust.
9 common signs and symptoms of dementia?
- Struggling to remember recent events but easily recalling past events
- Hard to follow conversations or Tv programmes
- Forgetting names of friends and everyday objects
- Repeating yourself + losing thread of what you are saying
- Problems with thinking and reasoning
- Feeling anxious, depressed, angry about forgetfulness
- Comments on forgetfulness
- Confused in a familiar environment
- Decline in ability to talk, read or write
What are the 5 main aspects of well pathway for dementia?
- preventing well
- diagnosing well
- supporting well
- living well
- dying well
What are the pharmacological treatments?
- acetylcholinesterase inhibitors
2. NMDA receptor antagonist (glutamate)
What are acetylcholinesterase inhibitors?
donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl)
may temporarily improve memory
mild to moderate Alzheimer’s disease
what are NMDA receptor antagonist (glutamate)?
memantine (Ebixa)
moderately severe to severe Alzheimer’s disease
What effects do antipsychotics have for dementia patients?
side effects: greater in older people - increased stroke risk, increased cardiovascular risk, Parkinsonian side effects, falls, additional deaths
class effects, not limited to one particular drug
not licensed for the treatment of agitation (except risperidone)
20-30% of people in nursing homes with dementia are on an antipsychotic
How much does dementia cost a year?
26.3 billion pounds
What is the breakdown of cost?
Unpaid care= 11.6 billion
health care=4.3 billion
state social care= 4.5 billion
individual social care= 5.8 billion
other costs= 0.1 billion
Where does UK stand in the state/family obligation to care responsibility balance?
no legal responsibility and no statutory obligation beyond the NHS (in the middle)
how many in the UK with dementia live at home?
64%
what are the positive aspects of care-giving?
- reciprocity and mutual affection
e. g returning partners past care - companionship
- job satisfaction
- sense of duty
e. g in sickness and in health
What is the new culture of dementia care?
Social model of disability- impairment
What does Social model of disability- impairment entail?
Person-centred care such as:
1.individualised plans
- perspective of the person with dementia
- dementia friendly communities
