Chcage 005 - Provide support to people living with dementia Task 1 PDF

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John Christopher Jison

Fernando Lopez

CHCAGE005 - Provide support to people living with dementia 1. The following questions relate to dementia and the different manifestations of dementia. Answer the following; (Medium) a. Describe what the term dementia means. Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. b. Name three (3) common indicators and symptoms of dementia memory problems, particularly remembering recent events. increasing confusion. reduced concentration. personality or behaviour changes. apathy and withdrawal or depression. loss of ability to do everyday tasks. c. List a potential impact on the family with a person with dementia. The effect on your entire family can be devastating when a family member is diagnosed with Alzheimer's disease or other dementia. A variety of emotions may be triggered by the diagnosis, including anger , anxiety, frustration and sorrow. There are also several options to be taken about medication, care, living conditions, finances, and care at the end of life. Family disputes are normal as a result. 2. Fill in the following table with a description of each type of dementia. (Medium) Type of Dementia a) Alzheimer’s disease b) Vascular

Description The brain is affected by Alzheimer's disease, which results in diminished memory, thought and behaviour. Rising age is the greatest risk factor for Alzheimer's disease, with three in ten persons aged 85 developing dementia. Vascular dementia is the broad term for dementia associated with problems of circulation of blood to the brain.

dementia or multi-infarct dementia c) Lewy bodies

d) Excessive alcohol intake or Korsakoff Syndrome

Lewy body disease is caused by brain nerve cell degeneration and death. The name comes from the presence of irregular spherical structures which grow within nerve cells , called Lewy bodies. They are known to lead to the death of brain cells. As the name suggests, alcohol-induced dementia is a type of dementia related to chronic alcohol intake. Memory, learning and other executive processes are impaired by this. Different causes of alcohol-induced brain damage that may be related to alcohol-related dementia are Korsakoff syndrome and WernickeKorsakoff syndrome.

e) Frontotemporal lobar degeneration

The term assigned to dementia as it is due to irreversible damage to the brain's frontal and/or temporal lobes is Frontotemporal Dementia (FTD). Mood, social behaviour, concentration, decision, preparation and self-control include the right and left frontal lobes at the front of the brain. Harm can contribute to diminished intellectual skills and attitude, emotion and behaviour changes.

(FLTD) including Pick’s disease f) Huntington’s disease g) Parkinson’s disease

h) Younger onset dementia

This is a neurological disease induced by a genetic mutation passed on by members of the family. Although your loved one may have the Huntington's disease gene at birth, the signs typically do not begin to occur until they are between 30 and 50 years of age. Many of the same signs found in other cases of dementia are seen with individuals with Huntington's. People with Parkinson's disease of the nervous system dysfunction have this kind of dementia between 50 % to 80% of the time. On average, about 10 years after a person first gets Parkinson's, the signs of dementia develop. It's a very similar form to DLB. They share the same symptoms, and there are signs of Lewy bodies in their brains for persons with these diseases. In a person who is under the age of 65, younger onset dementia is described as any type of dementia diagnosed. In individuals as young as 30, the disease can occur. That would most often be Alzheimer's disease, with the next most prevalent forms seen in younger individuals being vascular dementia and frontotemporal dementia.

3. Access the Dementia Australia website and review the current research. Answer the following questions; (Short) a. Identify the financial impact dementia has on the Australian economy in 2018 and projected the impact until 2025? Australia's number of individuals with dementia has grown to more than 413,106, with an expected loss to the government this year alone of more than $14 billion. Dementia Australia's 2016-2056 Economic Cost of Dementia in Australia research showed that if little is done to minimise the prevalence of dementia, the cost would plummet to more than $18 billion by 2025, and more than double to $36 billion in today's dollars in less than 40 years. By 2056, the number of people with dementia is predicted to hit over 1.1 million persons. Nationally, the study showed that this year alone, there are expected to be 244 new cases of dementia per day, which will rise to more than 650 persons every day by 2056. The study also found, however, that only a decrease of five percent in the number of people with dementia over the age of 65 could result in savings of $5.7 billion from 2016-25, and a whopping $120.4 billion by 2056. Reference: https://www.dementia.org.au/dementia-news/issue-07/economic-cost-of-

dementia b. What percentage of residents in aged care (elderly) have a form of dementia for 2018? People with dementia account for 52% of all residents in residential aged care facilities in Australia in 2018. c. What are the estimated figures for people with younger onset dementia in 2018? In 2019, an estimated 27,247 individuals with younger-onset dementia are predicted to grow to 29,353 individuals by 2028 and 41,249 individuals by 2058. d. What is the most common form of dementia and what percentage of those with dementia are affected with Alzheimer’s? Dementia is the umbrella term for a variety of psychiatric disorders, with a global deterioration in brain activity as a primary symptom. About 100 disorders that can cause dementia are present. Alzheimer's disease, vascular dementia, and Lewybodies dementia are the most common forms of dementia. The most common and well known is Alzheimer's disease. e. There are a number of different types of Vascular dementia. What are the two (2) most common types? There are a number of different types of Vascular dementia. Two of the most common are Multi-infarct dementia and Binswanger's disease. f. What are the three (3) cardinal symptoms of Lewy body disease? Three cardinal signs are present, two of which must be present to allow the diagnosis: Hallucinations of visuals. Parkinsonism (tremors and rigidity close to those found of Parkinson's disease) Fluctuation in the mental state such that at one point the person may be lucid and coherent and at other times confused, disoriented and confused. This fluctuation usually happens over a span of hours or even minutes and is not due to any immediate physical disease underlying it. 4. Access the Dementia Australia website and review the current research. Answer the following questions; (Medium) a. How much alcohol per day does a male and female need to consume to be at risk of alcohol related dementia? b. List three (3) symptoms of Frontotemporal dementia. c. Some types of dementia can be directly caused by an inherited gene mutation. What gene can cause Huntington’s disease? Huntington's disease causes mutations in the HTT gene. Guidelines for producing a protein called huntingtin are given by the HTT gene. A DNA fragment known as a CAG trinucleotide repeat is the HTT mutation that causes Huntington 's disease. This section consists of a series of three building blocks of DNA that occur several times in a row (cytosine, adenine , and guanine).

d. List at least four (4) main symptoms of Parkinson’s disease? What are the estimated numbers of people in Australia with Parkinson’s disease as of the current year? 5. Fill in the following table. Approximate prevalence of moderate to severe dementia in the Australian Population as of the current year: almost one in 10 people over 65 have dementia

Age

65 – 79 years 80 – 84 years 85 years plus

Three in 10 people over the age of 85 have dementia

6. With Alzheimer’s disease being the most common form of dementia, fill in the following table describing the areas of difficulty of a person with Alzheimer’s disease. Area Cognition

Behavioural personality

Included in the area Thinking Reasoning Judgement Remembering (memory) and Someone with frontal lobe deficits may act rudely or insensitively.

Day to day functioning

Dementia also alters how a person responds to their environment. A person with Alzheimer’s disease may be forgetful and have trouble following conversations. They may become angry and frustrated because they cannot follow what is going on. Wandering ang getting lost Repeating questions Normal daily task (showering, toileting, grooming, eating, cooking)

7. With Alzheimer’s disease being the most common form of dementia, fill in the blanks in the following table, outlining the three (3) stages of Alzheimer’s disease. Area of difficulty Memory

Mild

Moderate

trouble Forgetfulness of events remembering names or about one's own when introduced to personal history new people - Forgetting material that one has just read - Losing or

Severe Severe memory loss; only fragments of memory retained

Orientation

Problem Solving

Community

Home and hobbies

Personal care

misplacing a valuable object Maybe disoriented - Confusion about where Lose awareness of recent they are or what day it is experiences as well as of to time and date - An increased risk of their surroundings wandering and becoming lost - Increasing trouble Impaired social Have increasing difficulty with planning or judgement, severe communicating difficulty with handling organizing problems - Difficulty learning new ideas, and a lack of willingness to try new things Challenges Social Isolation Becoming isolated from performing tasks in Less engaged from the community social or work friends and family settings. Personality and Experience changes in Activities mildly behavioral changes, physical abilities, impaired including suspiciousness including the ability to and delusions or walk, sit and, eventually, compulsive, repetitive swallow behavior like handwringing or tissue shredding Forget about The need for help Requires assistance in all personal care tasks by choosing proper clothing areas bathing less orfor the season or the wearing the same occasion clothes repeatedly - Lose interest in bathing

8. Provide a description of the following verbal and non-verbal communication strategies commonly used when working with clients who have dementia and provide an example of when you could use these strategies during care support (Medium)

Strategies

Description

Reality orientation

Reminders of the day, People suffering from memory loss "thrive to the time, relationships, familiarity," the relieving essence of daily

Situations for use This type of therapy is use for clients with early signs of dementia – re orienting them to reality; providing factual information such as the date and time, location and events.

occasions

Reassuring words, phrases, physical reassurance, body language and validation

activity can be much more potent for people suffering from dementia. People with dementia have more trouble learning to do new activities, but a predictable schedule will keep a person with dementia from being overwhelmed and forgetting what they were doing. Reassuring sentences, phrases, tactile reassurance, body language is a psychological coping tool that we can use to lessen the anxiety, frustration of the dementia client and also to create trust and cooperation. Validation therapy operates by acknowledging the values , principles and realities that people with dementia believe in. Rather than argue with them, the caregiver agrees with what they say and redirects them to something else.

Empathy

Being able to know how to empathise with the customer, as a caregiver, you can understand their condition if they feel stressed, irritated and powerless. This way, it would be better for the caregiver to know how to recognise the truth of the moment, positive or bad, and to know how to cope with the situation. Acceptance of the A communication strategy to encourage If the client is restless and people with dementia by accepting their irritated (e.g. they say person’s reality reality. Rather than disagree with them, the someone's making sounds care agrees with what they suggest and beneath their bed); redirects them to something else consider what they're asking you, though, direct them to various items or events that they can do to distract their focus. There are several explanations why habits are If the client communicates Allowing expressions evolving. Often actions may be due to their frustration, it is of distress changes in the brain, a job may be too helpful for the caregiver to difficult for them, or a person may not feel be sensitive and watchful. well or suffer from an emotional problem As a source of anxiety, it ( e.g. depression) can be a symptom of It is important to try to explain why a person something that has to be with dementia is acting in a certain manner, treated and needs urgent so that it can be easier to find solutions to care. avoid the recurrence of actions or have some required help.

Frequent reminiscence to connect with person 9. The following questions relate to the progression of dementia and potential impacts on the person with dementia, their family or significant others. List a minimum of two (2) factors (for each question a-e) why the person with dementia, their family or significant others could experience the following emotions: (Medium) a. Depression: Depression is very common among people with dementia. People in long-term residential care appear to be particularly at risk of depression. Other factors that may be contributing to a person’s depression may be: Reaction to diagnosis and perceived impact on lifestyle Social isolation Stress and Fatigue Disturbed biological rhythms in sleep Ideas of worthlessness b. Loss and grieving: Dementia is progressive and that means that over time, the person with dementia will experience changes in how they communicate, remember, think and manage day-to-day tasks. Some of the changes caused by dementia involve loss of independence for the person with dementia. Family members may have to take on new tasks such as paying bills, legal paperwork etc. This may feel overwhelming If someone close develops dementia, we are faced with the loss of the person we used to know and the loss of a relationship. The family member might experience grief when the person is physically present but psychologically or emotionally absent. For example, when the person with dementia is physically alive but no longer able to participate in conversations like they used to or have the same role in the family they had before their diagnosis. c. Anger: Feeling of anger and frustrations are natural – factors may cause this feeling are a family member having to be a carer; angry with others who do not seem to be helping out; angry at the person with dementia for their difficult behaviours and angry at support services. Loss of independence; not being able to do things they usually do or asking help from someone else to complete the task for them. d. Despair: Despair is an experience we have when we cease being active in the face of insurmountable difficulty, ie lose hope. Person with dementia often and their caregivers are basically left on their own, sent home with the parting words “there is nothing that can be done,” 'There's no cure' from health professionals. Not being able to understand why of all people they had the condition and fear of not knowing what will happen in the future when the illness progresses. e. Social embarrassment a family member might feel: Dementia has a profound impact, not only on the life of the person with dementia, but on the lives of those around them: spouses, partners, families, and friends. Social impacts may include a reduction in work hours or loss of employment

Loss of relationships, time with friends and families and social activities, or the need to relocate or change living arrangements in order to provide care. f. What communication strategies can be used to address these emotions when identified in people with dementia? Use nonverbal cues. For example, maintain eye contact and smile. This helps put the person at ease and will facilitate understanding. And when dementia is very advanced, nonverbal communication may be the only option available. Active Listening. If you don’t understand something they are telling you, politely let them know. Speak clearly and naturally in a warm and calm voice. Refrain from ‘babytalk’ or any other kind of condescension. Talk about one thing at a time. Someone with dementia may not be able to engage in the mental juggling involved in maintaining a conversation with multiple threads. Have patience. Give them extra time to process what you say. If you ask a question, give a moment to respond. Don’t let frustration get the better of you. 10. Provide a short response on how dementia contributes to the following; (short) a. Isolation] Dementia-affected people and family members are at increased risk of being socially excluded. A individual with dementia's ability to talk will get weaker and conversations that once appeared to come too naturally can be harder for them, and can be difficult not just for the person with dementia, but for those around them. One in 10 persons would stop spending time with a person with dementia, and a diagnosis would humiliate almost half. b. Financial burden on the family The cost of caring for those with dementia covers the time given to offer support, as well as any expenses involved with treatment, such as transport for visits and reimbursement for services. Such expenses include lack of earnings, failure to continue working or early retirement of both the caregiver and the person suffering from dementia – these causes can have a direct effect on the financial status of the family. c. Social devaluation Social devaluation is a systemic assumption that a group or individual has a lower social worth than others. Individuals with Dementia lose some of their skills, miss things, or even even the people around them. Eventually, as soon as the disease advances, they will have difficulty completing their everyday activities, such as feeding themselves, toileting, showering, shaving. Both these changes make some of the people around them nervous. 11. Briefly explain how you can use competency and image enhancement as a means of addressing devaluation? (Short) In coping with devaluation-some depend on image, others on competence. Image techniques aim to increase the odds of other people reacting favourably to people with disabilities (demence). Competence programmes seek to develop the capabilities of people with disabilities so that they can be shown to be successful at some tasks and thereby be able to play a responsible and constructive role in society. 12. Provide a minimum of two (2) examples of competency and image enhancement you

could implement with a person with dementia. (Short) As a caregiver, we will support clients and those around them with some wellness education. We will provide them with information about (dementia) that can help them understand it and how to cope with it without prejudice. In addition, we should enable them to develop / join programmes that will enhance their talents and abilities, thereby allowing them to assume a responsible and constructive role in society. 13. How do you apply a ‘person-centred approach’ in all interactions (for example: conversations, assisting with personal care, engaging with family members), with a client with Dementia? (Short) People-centered treatment is not just about giving people everything they want o...