Living Well with Dementia: Case Study - Essay Example

Living Well with Dementia: Case Study Mental health is often mistaken as solely a mental disorder, but from a wider spectrum mental health can be defined as the level of well-being, which usually varies from a person to person defining his or her potential state. Individuals realize themselves that how can they cope up with their routine life stresses, how can they work efficiently, and up to what level they are able to make a contribution to their social lives. Also, mental health could be understood as an expression of emotions and also as experiencing successful adaptations to a variety of demands. In the past, mental illness was understood in terms of fear and mystery, but today professionals have gain tremendous understanding of mental illness and have discussed in thorough its different types and ways people with mental illness are receiving help (Busfield 2011). Researchers and health practitioners have explored that mental illness is a medical condition, which disrupts an individual’s feeling, mood, and capability of relating to others and daily functioning. There is a wide range of mental illnesses including disorders like depression, anxiety, autism spectrum, attention-deficit, bipolar, borderline personality disorder, dissociative disorders, substance abuse disorder, eating disorder, panic, post-traumatic stress, schizoaffective, schizophrenia, insomnia, Alzheimer, and dementia (Busfield 2011). These types of disorders have a negative influence on the sufferer's life, and it is noticeable that depression is a leading cause behind these types of disorders. This paper aims to discuss a case study of a patient, who has been suffering from dementia for the last ten years and is now at a serious stage of the mental illness. David Wright is a 65 year old fun-loving and creative visual artist, who began to have trouble in recognizing colors and identifying people, but he continued his work and kept on working for some of his old clients and friends, who used to admire his work a lot. He has been suffering stress for a long time due to his young son who suffered kidney problem for 15 years including five years of dialysis procedures after which he died almost ten years back. Death of his young and only son had given considerable shock and depression to Mr. Wright. Since, then he started experiencing state of depression and sadness all the time, and he behaved in a pessimistic way wanting to stop all his life activities. For one year after death of his son, he did not create any painting and started experiencing some domestic and economical issues (Bourgeois and Hickey 2009). Additionally, he started taking anti-depression pills. He decided to start his own bakery shop, but his wife Allen who helped him a lot in recovering from the grievance of his son's death encouraged him to continue with his artistic job of painting and sketching. Consequently, he quit the idea of starting bakery and went back to his painting and sketching job. In Mr. Wright’s case, it has been noticed that he stopped taking food properly and increased his alcohol dose after his son's death, although his wife convinced him a lot to quit drinking and start eating properly, but he did not listen to her about this and kept of loosing weight and stamina day by day (Bourgeois and Hickey 2009). Consequently, he started showing symptoms of medical disorders as his body was suffering from a chemical imbalance due to the increased amount of toxin (drug) and malnutrition. At that time, when he consulted doctor he was diagnosed with Wernickle-Korsakoff syndrome, which is caused by a deficiency of vitamin B1 as alcoholism depletes this vitamin. He went on treatment for Wernickle-Korsakoff syndrome, but he did not follow precautions and prescribed medications properly and at the same time he also increased his alcohol consumption, mainly because even after a year and two he could not recover grievance of son’s death (Bourgeois and Hickey 2009). Day by day he was getting weak, and his better half was also suffering badly due to his declining health condition. Unfortunately, after three years his wife Allen also passed away due to a heart attack leaving him with his only eldest daughter, who was practicing law outside London. Another great shock of being separated from his better half took his independence away that resulted in him needing help with some aspect of his on a day to day basis whilst living at his home. Loss of wife resulted in a series of strokes he suffered, as the first stroke of his life he got on returning from his wife’s funeral. The stroke and loss of wife at that crucial stage of life shattered him further, and his physical, as well as, cognitive well-being was negatively influenced and resulted in him needing assistances from her daughter, who decided to move to London due to her father’s critical health condition. However, over the year his daughter noticed that Mr. Wright is facing crucial difficulties in identifying objects and remembering recent events (Bourgeois and Hickey 2009). He started to spend more time alone in a room crying and talking to his wife’s picture. Her daughter was seriously worried about his father’s condition, but he seemed to be not much attached to his daughter as he was with his wife and son, so rarely listened and obeyed what her daughter told him for his own benefit. However, the most common symptoms of dementia he was showing included loss of memory specifically short term memory; for example, he started forgetting what happened earlier in the day or few hours, he was unable to recall conversation, and was being repetitive at times (Ballard 2001). Forgetting way back to home from shops is another common sign of a weak memory, about which her daughter was well-aware and so, she never permitted him go out alone after the stroke, but one day he secretly went out from the backyard door and reached the shop that he usually used to go for shopping. As he was also in the aging process, his eye sights were getting weak, and didn’t notice something on the ground which he hit while walking on the street and fainted. When he woke up, he was lying on his bed and did not remember anything, but he got a minor injury on the back side of his head (Ballard 2001). This injury further instigated his memory loss and cognitive imbalance syndrome, and on doctor’s prescription he started anti-psychotic medications, but no considerable improvement was observed in his health condition. Moreover, with the passage of time and treatment, he kept on showing different moods and interests. Surprisingly, one day he was caught stealing spade from his neighbor’s garden for which he presented no reason, again after three days he stole the spade and started digging ground in his backyard (Bourgeois and Hickey 2009). His daughter was surprised to observe such weird behavior from his side, but on asking Mr. Wright presented no proper reason behind such an act. Later, it was observed that he started showing change in interest and moods frequently. Likewise, it has noticed that he started reacting in an extremist manner towards whatever event takes place around him (Bourgeois and Hickey 2009). For instance, professionals have discussed that mood change is one of the most prominent symptoms of dementia, and usually people suffering from dementia react angrily, sadly or in extremely frightened way if somebody shouts at them or someone else around or if they watch an emotional movie, they start reacting in a way that if something is happening in real (Bourgeois and Hickey 2009). Same happened with Mr. Wright, and he mostly got angry with his assistant, who assisted him in taking a bath and using washroom. Moreover, he was also facing communication difficulties as he could not find right words for objects. Medically this problem is termed as aphasia in which dementia patients lose their power of expression, and they cannot understand behavior gestures of other people like a smile or anger. Mr. Wright started identifying objects with their functions like her daughter and assistant noted that he used to call TV as program and computer as game (Krishnamoorthy, Prince and Cummings 2010). Also, it was noticed that he started playing games on computer specifically solitaire, and whenever he lost a game he became extremely angry and even sometimes he used to hit his fist on the wall or sometimes throw objects like a ash tray on the floor. It is now ten years since his son passed away and he showed both minor and major symptoms of dementia due to severe depression and shock (Krishnamoorthy, Prince and Cummings 2010). It is noteworthy that according to NICE guideline dementia patients show a variety of symptoms depending upon the location and number of damaged brain cells, but in some cases patients show all possible symbols, like in case of Mr. Wright. Initially, it was noticed that as Mr. Wright took significant negative influence of his son and wife’ death so, he talked to their pictures to express love and emotions, but later this condition turned into hallucination. This cognitive imbalance situation occurs among 25 percent patients of dementia and mostly such hallucinations are auditory or visual. Mr. Wright has been observed with visual hallucinations as his daughter and assistant both have seen him talking to his son and wife while lying on the bed or standing in front of the window as if his wife or son is physically present and talking to him (Compton and Kotwicki 2007). Dementia can be upsetting with the patient and other family members who started getting afraid of such behavior of patients and in cases of Mr. Wright hallucination increased because he has a poor eye-sight and hearing problem due to aging. Currently, he is experiencing all possible problems associated with dementia including apraxia (Compton and Kotwicki 2007). This mental illness refers to the inability of the person to perform pre-programmed motor tasks and perform daily life activities, like brushing teeth and dressing. The way his condition and symptoms are getting worse with time it is predicted that soon he will forget instinctive functions like, chewing, swallowing, and walking as it happens with most patients in the last stages of the disease (Ballard 2001). It should be noted here that such mental illnesses have become common in present societies and health professionals have made remarkable progress in exploring and practicing therapeutic approaches targeting cognitive illnesses like dementia among people. According to NICE reports there are approximately 750,000 people in the UK who are suffering from dementia and this number is expected to double in the next few decades. In this regard, NICE guidelines have shown that the National Dementia Strategy is published in February 2009, and it has set a clear vision about people with dementia. The strategic report named “Living well with dementia” highlights that dementia patients and their caretakers should be helped to ensure that patients live well with the illness and conditions, and in this case health care system should not be mattered and everyone should be given equal assistance (Behan and Britnell 2009). As in the case of patients who suffer from dementia it is impossible to separate care needs and health related issues, hence according to NICE key policy local health care departments should jointly plan and provide services to the local population. Additionally, NICE key policy underpins that specific guidance must be provided on key services like memory services for early intervention, dementia advisors, and community personal support. Also, funding will remain as an important part of national dementia strategy as in 2009 Department of Health announced £150 million funding over the next 5 years to support implementation of health and treatment programs (Behan and Britnell 2009). Along with the key evident policies, national health departments of the UK are progressively working to decrease the prevalence of dementia among people and to help those who are already affected by this mental illness (Dh.Gov.UK 2013). There are innumerable key principles that are be to integrated into all commissioning activities such as building up the quality and dignity into every service, people’s legal right are to be protected, and implementation of therapeutic approaches to maintain and enhance patients’ abilities. However, people with alcohol-related dementia like Mr. Wright form approximately 10 percent of total dementia population (Behan and Britnell 2009, Garbutt, Bodmer and Jathanna 2013). Services to cater health needs of alcohol related dementia are somewhere between standard dementia and alcohol services. It is because traditional services are unable to cater needs of acute alcohol drinkers, but as Mr. Wright had reduced consumption after his daughter arrival thus, improvements in his health condition are expected with the appropriate therapeutic methods and services (Garbutt, Bodmer and Jathanna 2013). To deal with the case of Mr. Wright, a number of approaches seem suitable as per health professionals’ recommendations. NICE guideline for dementia recommends that cognitive stimulation programs should be carried out and monitored by highly qualified and experienced professionals as these programs are highly effective for treatment of moderate dementia. Medications like donepezil, galantamine, and rivastigmine can be prescribed to manage symptoms of dementia particularly if the patient is having speaking difficulties because they have had a stroke or series of stroke (NICE 2006, WebMD 2013). This recommendation seems suitable for Mr. Wright as he is also suffering from communication difficulties. Additionally, as in case it has noticed that he has become malnourished due to improper diet, thus to avoid other health problems that can emerge due to deficiency of vitamin B12, he should take multi-vitamins capsules (NICE 2006). Moreover, it should be noted that as patients with such problems start showing symptoms before they are diagnosed with specific disease. Thus, it is highly important for friends and family members to provide such patients emotional support through counseling and patience. Family members and other people around a dementia patient are needed to make correct and practical decisions of adopting such approaches that could help them maintain their positive attitude towards the patient and help him or her to recover in minimum time possible. List of References Ballard, C., 2001. Dementia: Management of Behavioural and Psychological Symptoms. Oxford: Oxford University Press. Behan, D. & Britnell, M., 2009. Living well with dementia – the National Dementia Strategy Joint commissioning framework for dementia, London: COI for the Department of Health. Bourgeois, M. & Hickey, E., 2009. Dementia. New York: Taylor & Francis. Busfield, J., 2011. Mental Illness. Malden: Polity. Compton, M. & Kotwicki, R., 2007. Responding to Individuals With Mental Illnesses. Atlanta: Jones & Bartlett Learning. Dh.Gov.UK, 2013. Dementia. [Online] Available at: http://www.dh.gov.uk/health/category/policy-areas/social-care/dementia/ [Accessed 18 January 2013]. Garbutt, J., Bodmer, H. & Jathanna, S., 2013. Living well with Dementia:Transforming the quality and experience of dementia care for the people of Norfolk, London: NHS Norfolk . Krishnamoorthy, E., Prince, M. & Cummings, J., 2010. Dementia: A Global Approach. Cambridge: Cambridge University Press. NICE, 2006. NICE SCIE guideline to improve care of people with dementia. [Online] Available at: http://www.nice.org.uk/nicemedia/live/10998/30323/30323.pdf [Accessed 18 January 2013]. WebMD, 2013. Dementia - Treatment Overview. [Online] Available at: http://www.webmd.com/alzheimers/tc/dementia-treatment-overview [Accessed 18 January 2013]. Read More