What Do We Understand about Dementia - Research Paper Example

What Do We Understand about Dementia? BY YOU YOUR SCHOOL INFO HERE HERE What Do We Understand about Dementia Research project rationale Dementia is a kind of brain disease which brings on permanent inability to think clearly and rationalise logically. The relentlessness of this disease in its progression is acute in that dementia impacts the victim’s ability to function properly in daily lifestyle. In most cases of dementia, affected human processes include memory capability, the ability to solve problems, language and attention (Brooker and Lillyman 2013). Dementia usually leads to death as a result of recurring damage caused to the brain, making the production of knowledge regarding this disease essential to reduce its pervasiveness for the elderly in today’s society in an effort to better combat this potentially life-threatening condition. Gaining an understanding of dementia is of significant benefit to the elderly population in order to improve treatment options and overall enhance quality of life for victims of the disease. Such knowledge is also beneficial for general society, as it is estimated that in the United Kingdom alone, there are currently 800,000 individuals suffering from dementia (Boseley 2012). It is estimated that the cost of providing medical care to those with dementia in the NHS is £23 billion annually (Boseley 2012). It is further estimated that dementia impacts the lives of 670,000 friends and family members of dementia victims who must provide care for this debilitating disease (Boseley 2012). Hence, if advances in research for care giving and treatment can be improved as a result of new fundamental knowledge of dementia, it could reduce the negative psychological, sociological and financial burdens of providing care for those struggling with dementia symptoms. This proposed research study therefore can provide valuable knowledge about the disease which, if applied by medical practitioners and general caregivers, could lessen the yoke on the elderly population forced to struggle with dementia, whilst potentially allowing government to allocate funding resources to other social programs that have benefit to all members of society rather than a marginal elderly population. 2. Literature review The common symptoms of dementia are well understood by the medical community (Taler and Phillips 2008; Shub and Kunik 2009; James 2011). However, the supplementary psychological consequences of battling dementia have been given much less research emphasis, of which knowledge of these outcomes could potentially dramatically improve the quality of lifestyle for those with dementia. It is estimated that 20 percent of individuals with dementia suffer from anxiety symptoms (Calleo and Stanley 2008). Several other researchers have estimated that anxiety as an outcome of battling dementia could impact up to 71 percent of sufferers (Ballard, Neill, O’Brien, McKeith, Ince and Perry 2000). It is recognised that the high volume of victims suffering from anxiety as a result of this disease leads to significant reduction of quality of life (Hoe, Hancock, Livingston and Orrell 2006). Anxiety symptoms are inclusive of fear, worry, restlessness and recurring fatigue, and some sufferers with anxiety experience agony as a result of coming to grips with inevitable death and attempting to fight against chance (Cooper 2003). Why is understanding anxiety as a consequence of dementia important? For those suffering from dementia, cognitive abilities are substantially reduced, especially in advanced stages of the disease. However, the most common form of treatment for those with anxiety is cognitive behavioural therapy, known to be effective in curbing anxiety disorders (Cuijpers, Sijbrandij, Koole, Huibers, Berking and Andersson 2014). For individuals with dementia, many dimensions of proper cognitive functioning are depleted, making them ill-equipped to think rationally and discern abstract concepts. Hence, the traditional method of treating anxiety disorders, cognitive behavioural therapy, would theoretically not be an effective treatment option for those experiencing symptoms of dread, worry, and other debilitating psychological problems as an outcome of dealing with dementia. To treat these symptoms, victims of the disease might have to rely on medical treatments such as phenelzine or pregabalin as a result of the ineffectiveness of more traditional psychotherapy methods. However, the problem with medicinal treatment for anxiety symptoms in the elderly population is that those with dementia may not fully understanding dosing instructions or remember that they even need to take the pills (Passer et al. 2009). Hence, without having an understanding of the legitimate underlying catalysts for anxiety disorders stemming from dementia, coming up with an appropriate treatment methodology might be unattainable. Furthermore, empirical literature has identified that many dementia victims suffer from substantial depression as a result of the complications and struggles with this disease. It is estimated that between 68 and 75 percent of all dementia victims meet the classification for major depressive disorders (Ferretti et al. 2001). People with major depressive disorders maintain symptoms that are inclusive of continuing low mood, self-hatred, feelings of substantial hopelessness, and perceptions of worthlessness. In some more severe cases, depression can even be accompanied by psychotic symptoms ranging from hallucinations and deluded thinking. Some with major depressive disorders also sustain anhedonia, which is the loss of pleasure in engaging in activities that were, prior to the disease, considered valuable and enjoyable (i.e. sex or recreation). Knowledge about the potential presence of anhedonia is important in better improving the lifestyles of those suffering with dementia as it has been shown that exercise is effective in slowing the progression of the disease (Adlard et al. 2005). This is theoretically why having new knowledge of dementia is important for improving the condition of the victim. Understanding that dementia maintains a higher volume of challenges other than cognitive disruption might better improve treatment methodologies, especially when there is such a high prevalence of individuals sustaining depressive symptoms. Being able to understand the catalysts for what reduces quality of life for victims of dementia, such as sustaining a major depressive disorder, could improve caregiver strategies for improving the health condition (both mental and physical) of dementia patients. For those with major depressive disorders, psychotherapy is the most viable and effective treatment option. However, as with anxiety treatment strategies, it would require the proper cognitive functioning of the patient to have any positive impact. Furthermore, antidepressants are often utilised as a treatment strategy for major depressive disorders, however as with anxiety treatment, cognitive impairment could complicate proper administration and compliance of these pharmaceuticals to effectively assist dementia victims with depressive symptoms. Victims of dementia also maintain the challenges related to social stigmas that complicate the quality of life, which is a stereotype related to mental illnesses and the elderly. People with mental illnesses often respond to these social prejudices through shame, attempting to keep their condition secret from others (Byrne 2000). Such stigmas resulting in shame can reduce self-esteem and even impair self-efficacy. Hence, it should be quite valuable to understand what types of stigmas exist in the social condition that could, theoretically, impact proper functioning of the dementia victims and negatively alter their psychological conditions. This might provide more effective caregiver strategies for assisting dementia sufferers or improve their mood which might, theoretically, improve their ability to cope and their condition to improve. 3. Focus and research questions With the vast gap in knowledge that exists related to supplementary challenges and concerns of dementia, this proposed study maintains three distinct objectives: 1. Examine the potential symptoms of anxiety that pervades proper adjustment for dementia victims with emphasis on potential effective treatments and caregiver strategies to reduce anxiety. 2. Uncover the prevalence of depression that might accompany dementia and potential strategies to reduce the persistent low mood for sufferers. 3. Determine what types of social stigmas exist for elderly victims of dementia, their impact on lifestyle adjustment and mood, and potential strategies for changing the social condition to be more tolerant and empathetic toward dementia sufferers. The focus of the study is to examine ancillary burdens, both psychological and sociological, that might accompany dementia. Because traditional treatment methods, such as psychotherapy and cognitive behavioural therapy, might not be effective for those with substantially impaired cognitive functioning, it might be valuable for the medical community and caregiver populations (both private and public) to understand why anxiety, depression and stigmas have impact on quality of life and successful coping or adjustment when facing dementia. By studying these three specific, recognised consequences of dementia, it can provide new understandings about how to approach providing effective and productive assistance to those suffering with this degenerative disease. There is very little existing literature describing effective treatment methodologies for dementia-related depression and anxiety (as well as coping with social stigmas and their prevalence for the elderly victim). Therefore, the focus is to gain new perspectives on the disease and caregiver strategies that have been shown effective or otherwise ineffective in helping an individual cope at the psycho-social level. By limiting the scope of the study to depression, anxiety and social stigmas, it should provide the study with opportunities to focus in depth on these particular challenges and determine a new best practice ideology for assisting victims of dementia or the caregivers that are burdened by these challenges. 4. Methodology This study will approach examination of the consequences of dementia using content analysis. This is a common method utilised in social sciences to understand the significance of human communications through the examination of various written texts, inclusive of multimedia sources or written texts. According to Henerson, Morris and Fitz-Gibbons (1987), attitudes and beliefs cannot be measured directly since they are always evolving and maintain many multi-faceted manifestations, and evaluation of these must be inferred. Hence, quantitative approaches (such as surveys) could not effectively address the breadth and complexity of attitudes and values that would dominate how a dementia sufferer assesses their condition and environment. As it pertains to social stigmas and the underpinning catalysts of what might drive depression and anxiety, investigation will be reliant on a qualitative approach which infers from various data sources related to this phenomenon. For instance, there are many books available that were constructed by those with direct experience working with dementia patients, providing familial care to dementia sufferers, and with direct clinical experience (case studies) of different dementia sufferers. Content analysis of these texts could provide valuable correlations in experience and evaluate potential levels of empathetic reasoning that dictated the construction of new and innovative care giving strategies not necessarily connected with traditional treatment methodologies. For instance, one particular doctor, Richard Taylor (2011), put together the Voices of Dementia journal, which documents opinions and understandings of various individuals sustaining familiarity with dementia or who have suffered with the disease. Exploration of such journals, utilising content analysis approach, could identify the subjective sentiment and attitudes of caregivers, medical practitioners and victims dealing with dementia symptoms and challenges. In the first volume of Voices of Dementia, one caregiver wrote: My idea is to arrange for youth groups to visit people in the later stages of dementia...to overcome any negative thoughts the teens might have in association with dementia as a result of the stigma attached to the disease (Taylor, 2011, p.10). This individual with direct experience provides a potential solution for reducing social stigmas which could have long-term positive consequences in society on those who struggle with the social prejudices of dementia. This should provide a unique perspective on dementia, caregiver strategies and potential stigma-reducing opportunities to better improve the quality of lifestyle of dementia victims. The only limitation to the study is that the researcher will not be able to recruit human participants with experience in dementia care and those who have struggled with the disease. Researcher limitations and timeframe available for completing an in-depth qualitative study will prevent gaining real-world sentiment from samples with direct experience and knowledge which might contribute more quantifiable opinion and sentiment to enhance study results. 5. Ethical issues Because the study does not recruit human participants, but instead relies on textual content analysis as the method of investigation, there are no significant ethical issues associated with this study that should be considered. The only potential ethical concern is the method of presentation of findings that should be empathetic toward the condition and ensuring an unbiased and neutral analysis of data by the researcher, removing any preconceptions and prejudices that might exist regarding dementia and its social ramifications. 6. Data collection and data analysis Content analysis, in exploration of such testimonials as in the Voices of Dementia journal, online recorded testimonials from dementia sufferers and caregivers, and other multi-media sources should identify sociological correlations, psychological similarities or disparities, or potential justifiable solutions in aiding dementia sufferers in appropriate qualitative fashion. Additional consultation with various sociological, psychological and gerontology texts will provide analysis capability for the researcher and enhance knowledge of anxiety and depression symptoms and catalysts (in a case study fashion) that might contribute to providing more contemporary knowledge of the disease and its complications. Any notable and recognised correlations related to depression, anxiety and social stigmas will be documented using a field note journal and presented in table format when presenting findings from the study. 7. Outcome and timescale It is the aim of the study to uncover the underpinning attributes and challenges of anxiety, depression and social stigmas that might exist, which complicate effective dementia adjustment by victims. By gaining personal insights from those with direct experience, finding potential solutions that have worked empirically or subjectively for individual case studies, this project can provide a new foundational knowledge for better assisting dementia sufferers in today’s society. It should also provide valuable knowledge of what treatments related to depression, anxiety and social stigma reduction (or victim coping strategies) have been successful and which might be deemed ineffective for those suffering with this disease. The study will aid in gaining new ground in comprehending the struggles of dementia and what might be the catalysts for what drives the onset of anhedonia, depression and anxiety other than those already documented in previous research studies that are rather homogeneous rather than potentially innovative for the modern dementia sufferer. Timescale of Study Consult with secondary literature in sociology, medical practice and psychology related to gerontology, dementia, social stigmas and case studies. 1 July – 25 July Begin correlation from field notes constructed and supplementary texts in various domains of knowledge (sociology, psychology, gerontology). 26 July – 2 August Begin construction of draft dissertation 3 August – 18 August Proofreading, editing and insertions 19 August – 25 August Submission of final project 26 August References Adlard, P.A., Perreau, V.M., Pop, V. and Cotman, C.W. (2005). Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer’s Disease, Journal of Neuroscience, 25(17), pp.4217-4221. Ballard, C., Neill, D., O’Brien, J., Ince, P. and Perry, R. (2000). Anxiety, depression and psychosis in vascular dementia: prevalence and associations, Journal of Affective Disorders, 59(2), pp.97-106. Boseley, S. (2012). Dementia research funding to more than double to £66m by 2015, The Guardian. [online] Available at: http://www.theguardian.com/society/2012/mar/26/dementia-research-funding-to-double (accessed 10 June 2014). Brooker, D. and Lillyman, S. (2013). Dementia care: nursing and health survival guide. Abingdon: Routledge. Byrne, P. (2000). Stigma of mental illness and ways of diminishing it, Advances in Psychiatric Treatment, 6(1), pp.65-72. Calleo, J. and Stanley, M. (2008). Anxiety disorders in later life: differentiated diagnosis and treatment strategies, Psychiatric Times, 25(8). Cooper, M. (2003). Existential therapies. London: Sage. Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., and Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: a meta-analysis, Clinical Psychology Review,34 (2), pp. 130–140. Ferretti, L., McCurry, S., Logsdon, R., Gibbons, L. and Teri, L. (2001). Anxiety and Alzheimer’s Disease, Journal of Geriatric Psychiatry and Neurology, 14(1), pp.52-58. Henerson, M.E., Morris, L.L. and Fitz-Gibbon, C.T. (1987). How to measure attitudes. Newbury Park: Sage. Hoe, J. Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of life of people with dementia in residential care homes, British Journal of Psychiatry, 188, pp.460-464. James, I.A. (2011). Understanding behaviour in dementia that challenges: a guide to assessment and treatment. London: Jessica Kingsley Publishers. Passer, M., Smith, R., Holt, N., Bremner, A., Sutherland, E. and Vliek, M. (2009). Psychology. United Kingdom: McGrath Hill Education. Shub, D. and Kunik, M.E. (2009). Psychiatric comorbidity in persons with dementia: assessment and treatment strategies, Psychiatric Times, 26(4). Taler, V. and Phillips, N.A. (2008). Language performance in Alzheimer’s Disease and mild cognitive impairment: a comparative review, Journal of Clinical and Experimental Neuropsychology, 30(5), pp.501-556. Taylor, R. (2011). A journal of and by individuals living with the symptoms of dementia, The Voices of Dementia, 1(1), pp.1-17. [online] Available at: http://gpli.org/images/dementia_journal.pdf (accessed 13 June 2014). Read More