dementia: The vulnerable adult and capacity

Question 1

define dementia

Answer 1

Syndrome due to disease of the brain usually of a chronic or progressive nature in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement.

Question 2

what are the main causes of dementia

Answer 2

Alizhmers, vascular dementia- similar symptoms e.g. micro infarcts.
frontotemporal dementia
Lewy body
Progressive supra-nuclear palsy
Huntington
Prion.

Question 3

what benefits does medical management of symptoms have

Answer 3

increases the patients independence

Question 4

what are common signs/symptoms of dementia

Answer 4

memory disorder
vascular risk factor
Agitation and agression
Wandering
Depression- treatable
Psychosis
Sleep disturbance
Incontinenece.
delirium

Question 5

Are patients with dementia classed as lacking capacity

Answer 5

depends- some are, and in these cases the doctor will make treatment decisions in the patients best interest.

Question 6

what support do patient require in community

Answer 6

depends on the extent of dementia but without these services more and more people stay in hospital.

Question 7

what are the signs of dementia in stage 1

Answer 7

memory, personality and visual spatial awareness.

Question 8

what are the signs of dementia stage 2.

Answer 8

aphasia, apraxia, confusion, agitation, insomnia

Question 9

what are the signs of dementia stage 3

Answer 9

resistiveness, incontinence, eating difficulties, motor impairments.

Question 10

what are the signs of dementia stage 4

Answer 10

bedfast, mute, dysphagia, intercurrent infections

Question 11

CMHTs (community mental health teams) are used in dementia as a alternative to what

Answer 11

Intermediate care services (mental health and physical)
Alternatives to admission
Social care interventions
n-patient services- Medical/Psychiatric

Question 12

How are CMHTs (community mental health teams) good in terms of the patient

Answer 12

provide them with independence

Question 13

define advance planning

Answer 13

patient’s wishes are taken into account, of the future where they may lack the capacity to make a decision.

Question 14

what discrimination do dementia patients face

Answer 14

Stigma associated with dementia.
Age discrimination
Fear of diagnosis
Misunderstanding- natural part or ageing.
Avoid people with it
Poor quality care and failure to provide services.

Question 15

which act is key in the royal college of psychiatry

Answer 15

Mental capacity act

Question 16

what are the main challenges for dementia services.

Answer 16

Need for sustained training at all levels
Paternalism and risk averse practice vs autonomy
More open involvement and communication with families
Explanation that legally it is appropriate to take certain risks
An effective advocacy service for people with dementia
More frequent and accurate assessment of capacity
Robust best interests procedures
The increased use of trial home discharges.

Question 17

why is the mental capacity act key in dementia

Answer 17

most patients often lack mental capacity but this is not assessed by staff and therefore the patient management if often inadequate