Enhancing Dementia Practice - Essay Example

Enhancing Dementia Practice Total Number of Words: 2,528 Aims/Purpose: To identify and discuss the dementia strategies in Northern Ireland including its relevance to early diagnosis, support for carers, lifestyle and other cultural factors that underpin each of the identified strategies Research Method: When it comes to improving the quality care given to people with dementia, the strategies of Northern Ireland, as identified in this essay, were all taken from the online publication of its regional strategies. Basically, the regional strategy in North Ireland was published back in 2011. Research Findings: Few of the most important strategies in Northern Ireland include: educating people about the possible signs and symptoms of dementia, creating a friendly community for people with dementia, creating public awareness about the importance of early diagnosis, integrating a wide-range of services that will support the specific needs of people with dementia, and extending necessary trainings and support of carers of people with dementia. Conclusion: To be an effective Home Care Manager, it is necessary to incorporate all of the regional strategies of Northern Ireland into my own profession. 1. Introduction Dementia is often characterised by having memory impairment and increased risk of having aphasia – language deficit, agnosia – perceptual disorder, and apraxia – motor functioning disorder (Mendez and Cummings, 2003, p. 6). Aside from having progressive memory loss, people with dementia can be very much disoriented (Gilmour and Brannelly, 2010). Likewise, there are cases wherein people with dementia experience cognitive deficit when it comes to comprehension and reasoning (Gilmour and Brannelly, 2010). Among the common types of dementia include Alzheimer’s disease (62%) followed by vascular dementia (17%), mixed dementia (10%), lewy-body dementia (4%), fronto-temporal dementia (2%), Parkinson’s dementia (2%), and others (3%) (Alzheimers Society, 2015a). As of 2015, roughly 20,966 people in Northern Ireland were diagnosed with dementia (Alzheimers Society, 2015a). By 2051, the number of people with dementia in Northern Ireland is expected to increase between 60,000 (Department of Health, Social Services and Public Safety, 2011) to 61,000 (DSDC, 2015). (See Figure I – Types of Dementia below) Figure I – Types of Dementia Almost half the number of people with dementia is receiving care and support in care homes (Department of Health, Social Services and Public Safety, 2011). To help improve the quality of health and social care services given to people with dementia, the Health Minister of Northern Ireland received a funding of £6 million from the state government last September 2014 (Northern Ireland Executive, 2014).Through state funding, it is possible to further improve the quality care given to people with dementia from early diagnosis up to the end-of-life stage. Intended audiences of this essay include the carers and family members of people with Dementia in Northern Ireland (NI). As such, this essay aims to identify and discuss the NI dementia strategies including its relevance to early diagnosis, support for carers, and lifestyle that underpin each of the identified strategies. Eventually, the usefulness and relevance of each of the identified NI dementia strategies will be compared and contrast to my own practice as a Home Care Manager. After identifying all possible NI dementia strategies in Northern Ireland, its associated challenges when it comes to putting the identified strategies into practice will be tackled in details (i.e. staff training, awareness of the strategy, etc.). Throughout the main discussion, some ethical considerations, values, and anti-discriminatory policies will be discussed in relation to my practice. 2. Dementia Strategies in Northern Ireland in Relation to Early Diagnosis, Support for Carers, Lifestyle and Other Related Cultural Factors In Northern Ireland, there are quite a lot of regional strategies used to improve the quality of care and service given to people with dementia. Mostly for prevention purposes and support, few of the most important strategies in Northern Ireland include: (1) educating people about the possible signs and symptoms of dementia; (2) creating a friendly community for people with dementia (Alzheimers Society, 2015b); (3) creating public awareness about the importance of early diagnosis; (4) integrating a wide-range of services that will support the specific needs of people with dementia; and (5) extending necessary trainings and support of carers of people with dementia (Department of Health, Social Services and Public Safety, 2011; Northern Ireland Executive, 2011). For instance, to delay the onset of dementia for another five (5) years, it is necessary to educate people about the probable signs and symptoms of dementia including ways on how to minimize the risk of developing dementia (Department of Health, Social Services and Public Safety, 2011). Specifically the use of pharmacological intervention or medication can help slow down the progress of cognitive decline (Standridge, 2004). Aside from giving them the opportunity to receive necessary healthcare, social or pharmacological intervention, early diagnosis of dementia can offer people with dementia the opportunity to reverse the main origin of memory loss (Bradford et al., 2009). Other benefits of early diagnosis include giving the person with dementia including their loved ones to have more time to seek for support groups as they prepare themselves mentally, psychologically, and financially for necessary future care or social service intervention (Bradford et al., 2009; Iliffe, Manthorpea and Eden, 2003). In fact, this particular pro-active approach to early diagnosis and healthcare intervention matters a lot in terms of improving the overall well-being of people with dementia and their loved ones (Moise, Schwarzinger and Um, 2004). This explains why people in Northern Ireland have considered the need to create public awareness about the importance of early diagnosis as one of its most important strategies in terms of improving the quality life of people with dementia (Department of Health, Social Services and Public Safety, 2011; Northern Ireland Executive, 2011). The problem with delayed or missed diagnosis of dementia includes the fact that people with dementia do not have the opportunity to have immediate care and treatment (Bradford et al., 2009). In relation to early diagnosis, the basic principles and values that underpins the need to inform people with dementia and their loved ones is to ensure that people with dementia should be able to live their lives without shame but “with dignity” (Department of Health, Social Services and Public Safety, 2011, p. 5) and respect (Northern Ireland Executive, 2011). As such, early diagnosis and caring for people with dementia should consider adopting the “rights-based approach” (Kelly and Innes, 2013, p. 61). It means that at all times, healthcare professionals and informal carers should be trained on how to acknowledge and avoid violating the human rights of people with dementia. Another strategy in Northern Ireland is to create a friendly community programme for people with dementia (Alzheimers Society, 2015b). In relation to socialisation purposes, the process of establishing a more friendly community for people with dementia aims to improve not only the concept of inclusion for people with dementia but also their overall quality of life (Alzheimers Society, 2015c). Another NI strategy is to integrate a wide-range of services that will support the specific needs of people with dementia. In the process of integrating a wide-range of health and social services, people with dementia can easily access therapies, treatments, social activities, or social support services they need to continuously improve their way of living (Department of Health, Social Services and Public Safety, 2011). Extending necessary trainings and support of carers of people with dementia is another important strategy in Northern Ireland (Department of Health, Social Services and Public Safety, 2011). Basically, the provision of training programs can help both healthcare professionals and informal carers to learn more about the proper management of dementia. As such, trainings provided to both healthcare professionals and informal carers should be based on the “best practice” (i.e. signs and symptoms of dementia, how to diganose dementia, their roles as a formal or informal carer, the use of effective communication strategies, the need to treat people with dementia with respect and dignity, strategic ways on how to delay the progress of dementia, etc.) (Department of Health, Social Services and Public Safety, 2011, p. 32). For example, given the fact that the nature of dementia is very complex, Chesney, Alvarado and Garcia (2011) strongly suggest that training programs on dementia should not only be “performance-oriented” but also “clinic-based”, “specialist-supported”, and “flexible” to the specific needs of each person with dementia. As such, Chesney, Alvarado and Garcia (2011) explained that the audiences of the training program should be active in terms of participating in the assessment/diagnosis, detection, and planning for care for people with dementia. Only then, the training programs can be effective in terms of increasing the knowledge and skills of professional healthcare staff and informal carers. Likewise, training programs on caring for people with dementia should also inform the target audiences about the need to respect their privacy and confidentiality regardless of whether or not the person with dementia is suffering from severe memory loss (Kelly and Innes, 2013). 3. Usefulness and Relevance of Each Identified NI Dementia Strategies to My Own Practice Considering the constantly increasing number of people with dementia, the strategies in Northern Ireland was designed to ensure that people with dementia can live comfortably within their own homes rather than being admitted to either care homes or hospitals (Northern Ireland Executive, 2011). For ___ years, I work in a community as a support provider to people with dementia and their carer(s). As a Home Care Manager, I strongly agree that people with dementia including their carers should be well-informed about the importance of early diagnosis including their right to receive proper medical, healthcare, and/or social service intervention. Basically, carers should be constantly reminded about the proper way of caring for people with dementia. Even if a person with dementia has already suffered from irreversible memory loss, these people should be treated with dignity. As such, decisions made on behalf of people with severe memory loss should be made out of good judgment and based on the principles of justice and benevolence. In the study of healthcare ethics, the term “benevolence” means that formal and informal carers should at all times consider the overall welfare of the person with dementia more than their own self-interests whereas the term “justice” means that formal and informal carers should at all times fairly treat and care for people with dementia (Cassidy and Blessing, 2008, p. 45). Unfortunately, in my profession as Home Care Manager, I have witnessed some incidence wherein people with dementia were not properly treated with dignity and respect. For this reason, I strongly feel that the process of educating people through proper training is important in terms of improving the quality of life of people with dementia. Likewise, training programs can also be used to create more public awareness about the importance of early diagnosis. In real life practice, the family members and friends of people with dementia can act as an informal carer. To ensure that all informal carers of people with dementia are well-informed about the need to respect the autonomy and confidentiality of people with dementia, it makes a lot of sense for the Home Care Manager to extend necessary training and development program or action plan to each informal carers (Department of Health, Social Services and Public Safety, 2011). In my own profession as Home Care Manager, I do my own research study before I teach informal carers about the proper way of caring for people with dementia. As Home Care Manager, I find it useful to establish an open forum between me and my audiences during each training program. Using open forum as a strategy, I can easily discuss and brain-storm with a large group of informal carers about some of the best ways to improve the quality service given to people with dementia. By openly discussing this issue with some informal carers, both the Home Care Manager and informal carers can play a significant role in creating a more independent life to all people with dementia. For example, informal carers should be well informed that there are different stages in dementia and that necessary care and treatment should be in accordance to the specific needs of people with dementia. Aside from educating the informal carers on how they can play a significant role in creating public awareness about the signs and symptoms and onset of dementia, it is equally important to teach them that smoking and high blood pressure are some factors that can be easily modified to help reduce or delay the onset of dementia. In the process of teaching the family members and carers about the importance of early diagnosis and proper way of caring for people with dementia, people with dementia could somehow receive the best quality care to support their emotional, cognitive, psychological, and physical needs. To prevent the risks of encountering legal problems, other important issues that should be extended to all informal carers include all the existing legislations on mental health particularly among people with dementia who are not capable of making their own decisions. The regional strategy of Northern Ireland with regards to caring for people with dementia includes the need to create a friendly community for people with dementia (Alzheimers Society, 2015b) and integrate a wide-range of services that will support the specific needs of people with dementia (Department of Health, Social Services and Public Safety, 2011). However, even though these two (2) regional strategies are equally useful in terms of uplifting the quality of life of people with dementia, I have not tried to put these two (2) different strategies into my own practice as Home Care Manager. 4. Associated Challenges when it Comes to Putting the Identified Strategies into Practice Cultural differences such as the use of language and differences in cultural beliefs can be a can be a challenge when providing necessary trainings to informal carers. To avoid being disrespectful to my target audiences, I do my own research with regards to the cultural and ethnic background of each informal carer. Creating a friendly community for people with dementia can be useful in terms of providing support group for them and allowing them to live a normal life despite their current health condition. One of the challenges associated with creating a friendly community for people with dementia is the risks wherein some people within the community may not fully understand why people with dementia should be given extra care and attention. To solve this challenge, the Home Care Manager should use effective leadership and communication skills when creating public awareness on dementia. One of the challenges of integrating a wide-range of services that will support the specific needs of people with dementia is limitation in time. Given the limited number of working hours each day, the Home Care Manager should be able to carefully plan his/her own work schedule. 5. Conclusion As a Home Care Manager, I have been focused on training informal carers about the proper way of caring for people with dementia. However, I do not exert effort to create a friendly community for people with dementia nor integrate a wide-range of services that will support the specific needs of people with dementia. Therefore, to improve the quality of life of each people with dementia, I should try to incorporate these (2) regional strategies when managing people with dementia in Northern Ireland. References Alzheimers Society. (2015c). Dementia Friendly Communities. [Online] Available at: https://www.alzheimers.org.uk/site/scripts/documents.php?categoryID=200436 [Accessed 11 March 2015]. Alzheimers Society. (2015a). Demography. [Online] Available at: http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=412 [Accessed 11 March 2015]. Alzheimers Society. (2015b). Help us change dementia care in Northern Ireland. [Online] Available at: http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=843 [Accessed 11 March 2015]. Bradford, A., Kunik, M., Schulz, P., Williams, S. and Singh, H. (2009). Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors. Alzheimer Disease & Associated Disorders, 23(4), pp. 306-314. 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Northern Ireland Executive. (2011, November 8). Health Minister Edwin Poots today announced the publication of a regional strategy for improving dementia services in Northern IrelandDEMENTIA STRATEGY WILL IMPROVE SERVICES IN NORTHERN IRELAND - POOTS . [Online] Available at: http://www.northernireland.gov.uk/news-dhssps-081111-dementia-strategy-will [Accessed 11 March 2015]. Standridge, J. (2004). Pharmacotherapeutic approaches to the prevention of Alzheimers disease. American Journal of Geriatric Pharmacotherapy, 2(2), pp. 119-132. Read More