Dementia the word itself says the meaning what dementia is? The condition in which deterioration of mental capacity to memorize the things, in other hand it means loss of memory, loss of function of certain part of brain. Dementia is a progressive brain dysfunction, which results in restriction of daily activities and in most cases leads in the long term to the need for care (Trevor, 1999) .Caroline (2001) defines dementia as an umbrella term used to explain different disease and disorders that affect the brain. Wood (1999) explained dementia as a syndrome of acquired loss of cognitive function, behavioural changes and loss of social function. In addition, Adams and Thorpe,(2003)states that the person with Alzheimer disease often has a temporary or permanent increase in the level of both physical and psychological disability with residual complication of poor care, such as weight loss, malnutrition reduced hygine,mobility or skin problem. I can say those complication plays great role to reduce the quality of life of individual. There is loss of short-term memory, disorientation in time and space, loss of ability to carry out complex daily living skills such as dressing or making a cup of tea, speech problems and deterioration in personality. Dementia is really a tough condition which interferes individual daily activities. The National Service Framework for older people(DOH,2001) standard 7 highlight that older people and mental health problems should have access to integrated mental health services, effective diagnosis, treatment and support for themselves and their careers. Simon and serge to (2001) there are behavioural changes in dementia which lead a relative to seek help from health care service. People with dementia have several behavioural difficulties changes, which are agitation, aggressive, discomfort from constipation, incontinence, sleep disturbance, communication difficulties and sexual inheriting. As I can say dementia can make life very complicated and unusual.
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Dementia seems major problem in UK.It is the terrible stigma of the individual who is sufferer. According to department of health UK 750,000 people in the UK with dementia and numbers are expected to double in the next thirty years which will be big problem in future (www.dh.gov.uk 5 March at 3 pm). This is becoming very big issues in the country. if we go through statics’ of dementia most of elderly peoples are suffering from this condition over age of 65.To maintain dignity of the elderly and demented people government has planned and budget for those who is suffering. Government is spending lots of money and has committed to ensuring there is greater focus on accelerating the pace of improvement in dementia care (www.dh.gov.uk 5 March at3:15 pm) through local delivery of quality outcomes and local accountability for achieving them. There are numbers of care homes for elderly among them many homes are dementia nursing homes. These are expensive and social care service has to pay money for them, increasing numbers of dementia obsiovsuly affect the system and economy status of the country because instead of using money in productive work, business and construction government is paying for dementia which is directly influences the country. Dementia takes the person out of work and it often takes family member out of work because they must care for the person (Bryden Christine).
According to research it says the global cost of caring 35.6 million people worldwide with dementia is$604 billion, it is fast becoming one world’s biggest health challenges (www.healthmad.com /condition and disease 7th march 2011)
HEALTH, WELL-BEING AND QUALITY OF LIFE
It is very complicated and hard to define health; there are hundreds of views from different author and different organizations. As we know all of us accept the definition of world health organization, health is a complete ,physical, mental and social well-being and not merely the absence of disease and infirmity which means health is in relationship with different factors like individual,physical,social,physicological,emotional,environmental and cultural it means health is not only absence of disease. Person may become ill with his/her mental and social status and his surroundings. (According to WHO)
Health is very important factor in human life as we know the saying health is wealth. Same like health well-being is also the important factor of healthy and wealthy life. Actually well-being is being healthy, happiness, free from stress, mentally, physically, socially and emotionally.
Health and well-being are the most important components of healthy life. These are the component which determines the quality of life. Along with health and well-being quality of life is very important which play big role in life of indivudal.Quality of life denotes how the individual is? His daily life activities, his or her well-being.
This is the term which determines living condition,facilities,possibilities,security,satisfaction,income,employment,food,education,quality healthservices,hygine,welfare and support. It is different from everyone. The main thing determine quality of life is our ability to enjoy all that life has to offer for instances, the ability to walk, talk and feel all contributes to our all quality of life.(B.christine supported this paragraph)
Health ,well-being and quality of life is combination of good quality of life but dementia is the condition which badly destroyed the good component of life, it is the heartbreaking condition and take out real quality of life of the person(B. Christine ;Dancing with dementia). People suffering from this disease they lost their dignity, their choices, their preferences and their exact experiences of life. This condition is the combination of much worse condition. There are no actual findings and diagnosis in blood test and no any abnormalities in cerebrospinal fluid. This is the structural changes, shrinkage and damage of brain cells which lead the functional changes and affect the functioning of brain, having dementia is destructive of psychological, emotional feelings, physical ability and social intimacy of individual(B.Christine;Dancing with dementia).As I can say dementia can make make life really hard and it can influences the health very badly.
DEMENTIA, IMPACT ON HEALTH
People having dementia start to forget their daily activities and their personal hygiene and face a daily struggle to cope. Their mind often gets blank when trying to recall which become more and more difficult as time goes by. Life becomes fragment and enormous pile of difficult task (B. Christine; Dancing with Dementia). Person cannot able to control themselves and we can see the changes in behaviour, speech and memory.Anxiety,stress and depression are main causes and rising level of anxiety is losing way and good track of the individual which is prominent in dementia even impaired in communication, speaking reading, writing all seems like it is scrambled.(B.Christine ;Dancing with dementia) What I have noticed while working in dementia unit with dementia people’s used to screaming,shouting,crying,worried about money, worried about their children, their job,husband,wife and home seems like they are missing their brain somewhere since so longer. The brain damage will affect differently according to the site of damage and nature of dead of cells and lobe of brain as well as environment and life history of the individual. Lord(2001) states that person with dementia have thinking processes that are already slowed, a treatment approach called orientation was developed to encourage interaction between staff and the person with dementia throughout the day, there is potential for this to encourage the development of a close relationship which staff come to know more about the unique person. In order for reality orientation to be effective, reorientation techniques have to be applied by all the carers who come in contact with the person. Sometimes it’s very hard for staff to become close and encourage person with dementia because of their aggression and agitation. According to Ballardetal,(2001) agitation is a state of extreme restlessness or irritability often characterized by pacing,hitting,yelling,or receptivness.This state can be produced by medications, physical discomfort,anxiety,fatigue,sleep loss,insecurity,sensory overload, sensory deprivation, or sensory distortion such as that produced by cataracts or titanus. Agitation also may result from impatience or irritability on the caregiver. These entire physical, emotional and psychological imbalances with old age and disability to do the daily activities and personal hygiene cause the poor leaving status and poor health.
TYPES AND CAUSES OF DEMENTIA:
According to Alzheimer`s society there are many different types of dementia although some more far common than others. They are often named according to the condition that has caused the dementia (www.alzherimers.org.uk,28th march 2011).
Alzheimer`s disease.(55 percent)
Vascular dementia.(20 percent)
Dementia with Lewy bodies.(20 percent)
Creutzfeldt jakob disease
HIV related cognitive impairment. ( 10 percent)
Mild cognitive impairment.
Rarer cause of dementia.
Alzheimer`s disease is the most common cause of dementia, affecting around the 465,000 people in the UK.The term `Dementia` is used to describe the symptoms that occur when the brain is affected by specific disease and conditions(www.Alzheimers.org.uk 28 march 2011,10:45 pm).In this condition, the chemistry and structure of the brain changes, leading to the death of brain cells(www.Alzheimers.org.uk 28 march 2011 11;00 pm).Alzheimer`s disease attacks the hippocampus and then brings about a gradual shrinkage of the brain,fronto-temporal dementia targets the frontal lobes. This means that the area of our brain that deals with mood and behaviour begins to suffer from a loss of cells (S.david; Introducing Dementia, The essential facts and issues of care).symptoms are such that they are unlikely to be recognized illness to start with. Anger and aggression are often the hallmarks of the illness. They may see just as unreasonable behaviour and trigger off a crisis such as marriage breakdown, leaving the person which is really heartbreaking it will influences the life of that person mean negative impact on his/her life. Like Alzheimer` disease and fronto-temporal dementia there are more causes and the condition for dementia (B.jane; caring for some with dementia). A number of rare conditions can cause dementia. Pick`s disease particularly affects the front of the person`s brain, leading to loss of judgment and inhibitions.Lewy body dementia is an illness which is related to Parkinson`s disease and which can fallow a different course from Alzheimer’s disease, with many spells of confusion, hallucinations and rapid decline to death (S.David; Introducing Dementia).According to the survey people over the age of 70 are at greater risk and one in five people over of age 80 suffer from the dementia. In the UK there are 17,000 younger people with dementia.(that is, under the age of 65) (S.David;Introducing dementia)
PREVALENCE (all ages)
Calculation of the numbers of people with dementia is based on the prevalence rates as fallows;
40-65 1 in 1,000
65-70 1 in 50
70-80 1in 20
80+ 1 in 5 (gray and fenner 1993)
The pattern after age of 90 is unclear. An extrapolation of the prevalence table would indicate that by the age of 100 everybody would suffer from dementia. We know, however, that this is not the case, as there are many people over 100 with no sign of dementia (S.david; Introducing dementia).
The total numbers in the UK are estimated at between 450,000 and 500,000 with a possible rise to over 650,000 in the first quarter of the 21st century (Bosanquet et al 1998).Even higher figures were quoted by the Alzheimer`s society in its evidence to the Royal Commission on long-term care in 1998, namely 720,491 now and 894,000 by the year 2021(S.David; Introducing dementia).As I can say after studied of dementia and its causes the major risks factor which can lead to dementia is old age, with the prevalence rate doubling every five years after the age of 65. http://www.medicine.ox.ac.uk/bandolier/booth/Risk/dementia1.jpg(www.google.co.uk/image 30 April at 11 pm)
According to the research and studied researcher find out the possible causes of dementia,
Dementia is linked to old age
The family link
According to the research people over age of 80 suffer from dementia which is the prove of old age, it is become more common because people are living longer.(S.david;introducing dementia).The risk to some people is a genetic one. People with Down`s syndrome are very likely to develop Alzheimer`s disease. In Down`s syndrome there is an extra copy of chromosome 21, which also carries one of the genes which, if faulty, leads to Alzheimer`s disease in small number of families. (S.david; introducing dementia).American research in 1989 suggested that 6 percent of people with Down`s syndrome in their 30s have Alzheimer`s disease, with the figure rising to 75 percent for those over the age of 55(Holland 1993).Previous head injury may increase the risk of developing dementia (B.jane; caring for someone with dementia).There are many factors which can cause dementia but scientist have thought that one of the environmental factor aluminium can be important cause of dementia, and there was a rapid clear-out of aluminium pans in some households. Although there is evidence of aluminium deposits in the brains of people who have died of Alzheimer`s disease (S.david; Introducing dementia).Likewise scientists have thought that mercury is another chemical which has been targeted, especially in connection with amalgam filling dentistry. Other chemical may poison both brain and body (S.davis; introducing dementia). According to the research and survey shows elderly peoples are prone to dementia Beta amyloid is gradually deposited in the brain as people get older. So its presence does not by itself indicate that a person will develop dementia (S.david: introducing dementia). Old age and low immune system, older persons are secondary to intrinsic problems such as orthostatic hypotension, arrhythmias, Parkinson`s disease, neuropathies, epilepsy, and medication the patient may taking, which can cause risk of fall. Falls commonly occur in older person but patient with dementia are even at greater risks (NICE 2004). Problems associated with falling include loss of mobility, psychological difficulties, hypothermia, pressure related injury, soft tissue damage. According to Chemnitz (1991) since patients with dementia can take medication antipsychotic, antidepressants, sedative/hypnotics, vasodilators, and diuretics are particularly associated with increased risk of falls, they should be used in the smallest doses that will achieve the desired effects. There should be proper training regarding medication review, modification and withdrawal for the nurses. As I can say dementia is common in elderly which can causes many complication in their life with great impact on their health.
The main conclusion of this assignment is that evidence that elderly people over age of 85 has more chances of dementia and has direct effect on health of the person. About 50% of cases of dementia have concurrent physical health problems. The burden of care produced by a physically sick patient is greater than that of fit one. Statistical analyses of the relation between old age and dementia is very close because the major risks factor which can lead dementia is old age, with the prevalence rate doubling every five years after the age of 65.Dementia and old age and its influences on health has greater link. Person may not be diagnosed they are suffering from dementia and that could be early stage, if they are living on their own. Especially they are at risks of having inadequate diet. It can cause malnutrition and reduced appetite of the individual.AS person grow older they may face significant life changes that can put individual at risks of depression, illness and disability, low immune system, weakness of bone and muscle, pain and loneliness. Depression is main factor which can lead dementia in elderly. There appears to be enough evidence, from different studies and research growing age, depression and dementia share many similar symptoms including memory problems, sluggish speech and movement and low motivation. As we know older person has more risks of dementia, dementia linked with physical discomfort, pain, anxiety, loss of mobility stiffness and poor balance which prone to falls. Most studies have proved that person with dementia or elderly person who are unable to leave their bed may develop pressure sores as I can say this is the prove of poor health. As growing age weakness of muscle as I have mention before, if the person with dementia does become incontinent it will be the worse and it really harm the dignity of the individual. There are strong association between old age, dementia and the poor health condition of the person. Older person can’t look after themselves properly because of physical disability; Poor health and improper hygiene cause the infections like chest infection, skin infections and localized infection.Physical, phsycological, emotional imbalance lead greater difference in life of individual. Likewise poor diet and depression improper housing can cause poor quality of life and can badly affect the health of individual. Throw rugs are dangerous to elderly people, especially dementia patient. Loose rugs are hazardous because the patient may catch his foot underneath the edge, trip and fall, possibly suffering a broken hip.
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