Dementia and its effects on patients, family and carers Flashcards
What are the 4 main types of dementia ?
- Alzheimer’s disease (Most common, quite slow)
- Vascular dementia (2nd most common, happens a little quicker, usually after event like mini stroke or something decreasing function)
- Fronto-temporal dementia (Different type of memory loss, get behavioural changes or actions such as a person engaging in swearing a lot more than did before)
- Dementia with Lewy bodies (Tiny bits of protein that appears in nerve cells in brain)
What are some facts about dementia in the UK?
- 850,000 people are estimated to be living with dementia in the UK
- 52% of the UK public - 34.5 million people know someone who has been diagnosed with a form of dementia
- 1 in 3 people born in the UK this year will develop dementia within their lifetime
- 1 in 14 people over 65 have dementia in the UK and 1 in 79 of the whole population
- Biggest risk factor for dementia is increasing age
- Doesn’t just affect people over 65, currently 42,000 people under 65 who have it in UK
- More common in women due to higher life expectancy.
What are some facts around the cost of dementia in the UK?
The majority of dementia costs per year are due to;
- informal care at £11.6 billion (44.2%) - (most expensive)
- social care costing £10.3 billion (39%)
- healthcare costs £4.3 billion (16.4%) - (least expensive)
- The total cost of dementia is large and rising over £26 billion in the UK
For people in community setting the average annual cost per person is;
- £26k for mild dementia
- £43k for moderate dementia
- £55k for severe dementia
For people living in residential care setting the average annual cost per person is;
- £31k for mild dementia
- £38k for moderate dementia
- £37k for severe dementia
How does dementia affect the person ?
- Day to day memory
- Mood (Frustrated, irritable, anxious, unusually sad)
- Language/communication problems (Difficult to follow along and remember words for things)
- Visuospatial skills (Stairs, seeing objects in 3D)
- Orientation (Date or where are - often only happens with new learning, e.g on holiday not in usual habitat)
- Concentrating, planning, organising (e.g making tea, has to get steps back in order)
What are the different symptom stages of Dementia ?
Symptom Stages of Dementia;
- Early stage
- Middle stage
- Late stage
Used to be mild, moderate and severe (nothing mild about dementia)
What are the features of the Early stage of Dementia ?
Small changes;
- Forgetful
- Mislaying items
- Getting lost
- Judging distance / seeing objects in 3D
- Struggle to find words
- Poor judgement, hard to make plans / decision
- Change in mood
- Difficulty thinking something complex through
Can be put down to ageing or stress or bereavement
We don’t often see this until its progressed later then look back on
E.g if forgetting whose turn it is to pay for dinner
Usually family who will report it (more likely to be ageing if self report)
What are the features of the Middle stage of Dementia ?
More moderate changes;
- More forgetful
- Behaviour changes
- Fail to recognise people
- Communication challenges
- Time / place / events / getting lost
- Safety
Diagnosis can be helpful to understand why person is changing
Help with personal care activities and don’t understand why this is happening and someone is coming in to your room to help you take your clothes off to get you washed and thinks is being attacked
Mid stage more stressful than others as patient is more mobile but still needing constant help and feedback
Too scared to go around on their own (in case forget)
Difficult as feel although you are losing someone or relationship is changing
Emotional someone forgetting you
How should you handle a dementia patient with false information, i.e to go to mums for dinner when mum died 50 years ago?
Instead of lying to person and going along with what they are saying or invalidating their feelings you want a middle ground and ask them so why might you need to get home to get dinner from your mum (instead of don’t be silly your mum is dead or yeah go for it)
What are the features of the Late stage of Dementia ?
Late stage;
- Unaware of time / place
- Communication challenges (Repertoire of words and understanding is limited)
- Not recognises familiar faces
- Need assistance in eating
- Incontinence
- Mobility problems
- Behavioural changes
Usually in a care home at this stage
Person is reliant for washing, eating, etc
Upsetting - like a loss of a person although they are here and you can physically see and touch them
May not recognise themselves
How does Dementia affect not only the patient ?
Ripple / bullseye effect
Most people live at home
Feeling of obligation to give care
What are the reasons that someone may care-give to Dementia patients
Reasons for caregiving;
- Emotional bond with person with dementia
- Sense of duty / obligation
- No alternative
What are the positives of caring for someone with dementia ?
Positives of caring for someone with dementia;
- Satisfaction in the role
- Strengthening of family relationships
- Increased sense of self worth
- Challenge
- Rewarding (including companionship)
What are the negatives of caring for someone with dementia ?
Psychological impact (common in family member):
- Strain
- Burden
- Burnout
- Depression and anxiety
Shifting roles - Adult children becoming parents, life partners taking on parental role
Role conflict - Sometimes partner or spouse needs to give up job giving financial difficulties
Social isolation for carer - 36% of carers spend more than 100 hours a week caring for someone with dementia
Family conflict - 63.5% of carers say they have had no or not enough support ( Conflict - If sense caring responsibilities aren’t being shared equally)
Physical impact;
- Physiological effect of chronic stress
- Immunosuppressant
- Physical impacts (e.g neck problems being made worse lifting patient etc)
What are some statistics of role conflict in family members having to look after dementia patient?
20% of female carers have gone from full-time to part-time employment as a result of their caring responsibilities and 17% felt penalised at work
63% of carers for people with dementia are retired while 18% are in paid work. 15% of dementia carers say they are not in work because of their caring responsibilities
Financial strain on carers
What are the factors that usually requires a patient to go into a care home?
Tends to be a combination of physical and psychological difficulties on the carer that causes these people to have to go into a care home
