The Difficult Ones: Caring for Patients with Dementia - Essay Example

? Health and Aging number: AP/ADMS 3740L- Health and Ageing 24th July, The Difficult Ones: Caring for Patients with Dementia Introduction David & James (1999) define dementia as the loss of an individual’s ability to take care of him or herself, a condition that is associated with problems in recognizing familiar surroundings and people. The problems associated with dementia condition among the elderly vary from emotional eruptions, memory loss, communication problems to wandering. Many care givers and families find it difficult to care for patients with dementia because of the problems associated with the condition. Nonetheless, these people need support and care. Therefore, families and caregivers will have to assume the responsibility of caring for patients with dementia. With the increasing number of the aging in our population, learning to provide the best possible care for dementia patients is essential. This paper will emphatically address the difficulties facing patients with dementia and its significance, the challenges that many families and care givers encounters in caring for patients with dementia and how these challenges could be minimized. Moreover, it will include a written proposal addressing these perspectives using healthy people 2020 objectives. Of importance to this paper are the course concepts; caregivers and families, quality of life, and coordinate care. Also, my insights and personal reflection from researching of literature reviews will not be omitted. Significant of dementia Ten years ago, an estimated seven million seniors required long-term care for sundry medical conditions (Quinn, Johnson, Andress, and McGinnis, 2003). Among them, it is estimated ten to fifteen percent of people over age sixty-five suffer from some level of dementia, with six percent being severely affected (Bar-Haim Eres & Katz, 2003). Currently, there are over two and a half million moderately and severely demented patients requiring extensive daily care (Tatano Beck, 1996). Tatano Beck (1996) further notes that this number is expected to nearly triple in the coming decades. Statistics are increasing exponentially in today’s rapidly aging populations around the world (Samuellsson et al., 2001). Patients with dementia need personal and professional assistance on various levels. In order for these patients to stay at home, family members take care for them, which results in a heavy emotional burden that benefits from outside assistance (Samuellsson, et al., 2001). Dementia is not a normal part of the aging process for most people; it is an organic declining of brain functionality (Che, Yeh, & Wu, 2006). With that decline comes the loss of ability to care for oneself. Those who suffer from memory loss and impaired capacity to care for themselves and communicate with others often get frustrated, angry, and occasionally even violent. Those who care for them also get frustrated, discouraged, and feel out of control of the situation (Che, Yeh, & Wu, 2006). The significance of dementia among the elderly population relates to the society, and thus cannot be overlooked. Elderly with dementia are experiencing stigmatization by their community which invariably prevents them and their care givers from speaking out on time (Richard, 2012). The society and the government still requires playing an immense role in helping the elderly find the appropriate care needed on time. Resources needed by unpaid care givers Unpaid care givers are mostly the back bone of community care, giving dementia patients the required support which leads to a successful community care (Aldred and Gott as cited in Jarvis, 2010). However, unpaid care givers do not only render their services in the community nursing but their provision of care cuts across all spheres of nursing profession. Caregivers get overwhelmed. Providing care for a demented patient in a healthy manner is a meaningful, positive, empowering contribution they can make. According to Jarvis (2010), carers’ health is basically the community health. Therefore, providing care givers with necessary resources needed for them to be able to give quality care required by the elderly is very important. The needs of patients suffering from dementia are demanding. Therefore their care givers should be provided with a healthy working environment. Providing these people with a good working environment helps them in providing the best assistance to the needy people. Healthy environment is not only advantageous to the wellbeing of the affected people, it contribute to the wellbeing of the patient and the care giver as well. Additionally, providing care givers with support groups who provide them with mental and emotional support could be very useful in relieving stress on the care givers. This will provide a forum for care givers to express and share their difficulties and challenges with people who have the same experience (Kelly, 2010). Hearing and sharing from other peoples challenges can motivate care givers; provide them the energy to continue providing quality care. Another essential resource for unpaid care givers is providing them with psychological assistance. The contribution of psychologists and counselors in relieving these people of stress as well as providing them with opportunities to share their difficulties and experiences cannot be underestimated. However, it is not possible to implement these services anywhere. Their implementation is only possible in hospitals, homes, community, and long term care homes. Government should also chip in to offer these people with the assistance where required in providing funds, and training health workers appropriately. Moreover, caregivers can share their experiences and healthy recipes with other caregivers, offering each other mutual support. Learning to cook nutritious meals can be accomplished by caregivers at virtually any intellectual level. Keeping the curriculum succinct and easy is important to retention and forming new, healthier habits. Becoming involved in the cooking process, if feasible, is a sound, stimulating physical and intellectual pursuit for the dementia patient, particularly if it is an activity she used to enjoy. Measures of quality of life The view of quality of life in dementia patient has been theorized based on impairment (Chiu et al., 2010). Therefore, the quality of life in dementia patient is disrupted. Nonetheless, if certain measures were put in place, they could help in structuring a healthy and fulfilling life. Pulsford (1997) stresses the importance of appropriate activities for the demented patient to help reduce behavioral problems and improve quality of life. Among these, he includes cooking and gardening activities. A small, manageable organic garden may be possible at either the patient’s home, in a community garden, or even in pots on the porch. It also gives the caregiver an opportunity to positively interact with the family and friends, helping them reduce stress and agitation. At the same time, it increases their morale, bringing more fresh food to the table (Pulsford, 1997). Research has revealed that self-esteem neither increases nor decreases during the course of a person’s life (Orth, Trzesniewski & Robins, 2009). However, patients with dementia might experience a low self-esteem because of the difficulties associated with dementia. To establish a quality measure in addressing this concern, elderly people with dementia needs encouragement and motivation about their care. Family and caregivers will have to ascertain how they provide care for this population. Of the challenges the elderly are likely to encounter is the need for assistance in carrying out their activities in their daily living (ADLs). To some, this service influences their integrity. To cope with this challenge, patients with dementia should be shown respect. Informing them of care before taking further step would help boost their morale and give them a sense of fulfilled and peaceful living. Eating live, organic, healthy foods has numerous positive effects on both the patient and the caregiver. It results in higher energy, an improved attitude, and a healthier approach to weight control. It creates opportunities to interact positively with one another and for social and other activities. It reduces the likelihood of other negative health issues arising and can reduce or even eliminate the need for certain medications. It improves quality of life. It can be accomplished without very much time or financial investment, does not require much training, and can, in fact, save money, as fresh foods do not require prepackaging or factory preparation. When locally sourced from organic farmers, cooperative ventures can be created. Everyone wins when patients and caregivers eat healthy meals, seek community activities around healthy food, and make sound nutrition a part of daily life. Help required by the older adult to manage their care The progressions of dementia in older adult affect almost all level of care, it could be very challenging for the elderly to participate in their own care and function independently. One of the goals of healthy people 2020 was to improve the function of the older adult (2010). Community involvement can create an opportunity for the elderly to empower themselves. They can participate in different activities that will improve their dependency to channel the management of their care. Elders can be empowered through education to broaden their mind on how to carry out their daily activities, what and how to eat to stay active and healthy, and how to be independent with help. Course concept Healthy Eating/Food Preparation Since in the current world there is no possibility of eradicating dementia, to reduce the prevalence among elderly requires a concrete preventive solution. Dementia patients are at a high nutritional risk (Quinn, et al, 2003). However, providing them with semblance of normalcy is very important. This offers them with an opportunity to have a healthy, tasty meal three times a day, offering them with an opportunity of comfort and continuity, as well as supporting their health. It also gives caregivers a feeling of self-empowerment to know they are doing the right thing even if the patient cannot express himself to agree (Che, Yeh, & Wu, 2006). Watson and Deary (1997) discuss the rather obvious direct correlation between feeding difficulties and a decline in nutrition. They point to the imperative importance of the patient and caregiver assessment and alleviation of eating difficulties for the well being of the patient (Watson & Deary, 1997). In the progressive stages of dementia, the patient loses the ability to care for herself, including healthy feeding and ability to feed her. Bar-Haim Erez and Katz also support full assessment of dementia patients to discern their level of self-care, cognitive abilities, and other levels of functioning (2003). They recommend specific test models to validate levels of deterioration, which can again correlate to their level of nutrition. Caution must be accorded to patients, especially in their eating habits. Proper eating can alter negative moods, increase energy and resistance to disease, exercise cognitive skills, and provide opportunities for socializing with others. Alspach (2004) conducted long-term studies on the impact of obesity, high cholesterol, and hypertension on the dramatic increasing incidences of dementia in women. Few men survived into their 80s to be included in the testing (Alspach, 2004). In the study, Alspach realized that those who chose to eat leafy and cruciferous greens at least eight or more times in a week in middle age maintained their cognitive abilities (Alspach, 2004). It is thus conceivable that those inflicted with dementia have a better chance of improving their health while reducing their cognitive and physical losses if they eat live, fresh foods. Recommendation to policy makers, institution, and health care provider Cost Implication Decreasing morbidity (death) and costs of care while increasing quality of life for dementia patients are imperative (HealthyPeople.gov, 2013). Dementia patients are at higher risk for falling, injury, and general disability (HealthyPeople.gov, 2013). Eating healthy means cutting down on other concomitant health issues and thereby, expenses. Creating avenues for low-cost foods available to seniors is another way of decreasing costs. It is not only the duty of the caregivers and family members to participate in the care of dementia patients, government involvement will be paramount. Government should support local and private institutions, long term care homes, retirement homes, and home care by releasing funds to provide quality care and nutritional meals that support the prevention of dementia. Free health services for seniors with dementia, fostering the idea of providing meals on the wheels at a cheaper rate that the seniors can afford. Physical Activity and fall prevention Dementia is mostly the cause for lack of activities among elderly and why they require health services (Australian Government Department of Health and Ageing as cited by Ttrynor, Inoue & Crookes, 2011). According to healthy people 2020, falls are the prevailing cause of death among the older population and it mostly resulted in disability if they survive the injury. Therefore, it is important to provide activities appropriate to level of function for dementia patients. This includes creating opportunities for socialization, movement, and intellectual stimulation. Wall and Duffy (2009) reviewed several studies on the positive effects of music therapy on dementia patients. Offering music during activities like yoga or playing of games is an appealing option. Local musicians from schools and the community could come and play during these periods. When seasonally appropriate, outdoor programs, activities and concerts in the park could offer additional opportunities for exercising well and socializing. Or simply effective utilization of a stereo and music the dementia patient enjoys would have a positive impact and afterward to encourage movement. Making this program healthy and, if possible, getting the patient involved in the process with supervision can fulfill some of their needs. Healthy exercise can also incorporate comfortable socializing with family members, caregivers, and others. Recommendations Physicians Marwijk and Spiegel (2009) expressed concern about the overuse of antipsychotic medications in dementia patients to control such dementia symptoms as “agitation, aggression, wandering, shouting, repeated questioning, sleep disturbance, depression, and psychosis” (191). Designed for those suffering from schizophrenia or bipolar disorders, antipsychotics can cause substantial harm to fragile older patients (Marwijk & Spiegel, 2009). Several of these symptoms can be better controlled through proper and different activities performance and a more collaborative approach among caregivers and health care providers. Since 1921, links between aluminum and Alzheimer’s has been controversial but verified (Kawahara & Kato-Negishi, 2011). Aluminum is known to cause neurotoxicity and accumulate in the brain, “causing cognitive deficiency and dementia” and negatively impacting several disease states, including Alzheimer’s (Kawahara & Kato-Negishi, 2011, 15). A key issue, therefore, is removal of all aluminum from the environment, including containers and cooking utensils. This can be accomplished through the education process or by an on-site visit not everyone realizes that favorite cooking pan is made of dangerous aluminum. Sensitivity panel should be conducted to determine what the patient can use in terms of utensils and cooking materials. Whenever possible, prepackaged, canned, and frozen foods should be avoided (and tossed out) and replaced with fresh, live, organic foods. Many seniors can be sensitive to many of the utensils and other additives. Part of helping older patients care for themselves and for family members is to educate them on what type of activities they can do. Living healthy is good for everyone. It is very important for government to offer free and low-cost activities program centers like yoga classes, thai chi programs and education in a fun atmosphere or in the patient’s home. Both personal caregivers and those who operate live-in residential care facilities can be involved. For the convenience of caregivers, a one-day class may be offered, or one-day, on-site training is a viable option. If at all feasible, they should be offered to the patient and care providers at no cost to them as part of their normal healthcare. In addition to a simple curriculum, other community activities can be incorporated. For example, it is important to involve locally sourced programs in community centers where elderly can go to participate in different activities and as well socialize with other seniors within the community. Doctors and other healthcare providers could be contacted and made aware of the services available. Weekly outings can be offered for seniors and caregivers for socialization and promotion of healthy living.Trips away from home are stimulating for the dementia patient and the caregiver (Pulsford, 1997). Such a social setting could also promote families getting together with their elders, as well as offering opportunities to meet with other seniors and caregivers in a safe atmosphere. This can be accomplished through local charitable and community outreach organizations, even churches. REFLECTION This lesson has had a positive impact on my own experience. Discoveries made through research on this problem prove that professional care givers to demented patients need a better understanding of the disease condition. Having the essential knowledge and understanding required to take care of a demented patient helps them render quality care to them. Through various literature reviews and broad research done to complete this paper, my understanding of dementia has significantly broadened. Offering care to a demented patient is possible, while advising care givers on the methods of reducing stress in their work is possible. However, knowledge is not only useful to the patients only (Alspach, 2004). At an individual level, it has significantly changed by eating habits. More fresh and live greens are part of my daily meal. Fruits, and fish, classified as white meat are increasingly becoming my favorite foods. There are a number of advantages associated with healthy eating habits. In addition to its ability to improve the living standards of an individual, enlarging people’s lives, healthy eating provides more energy to the people. Interestingly, a person who feeds on a heavy and healthy breakfast is more active the whole day. This is not theoretical to me as an individual, as through the past tests and practices have proven the literature true. Healthy eating is also economical. Times are getting harder, and everybody jumps at any available opportunity that could help them save a few coins. Having a god breakfast in the morning reduces the urge to have a coffee during the day, while a snack may also be withdrawn from the budget. While at times in some instances people forego lunch to avoid constraining their budgets and take sugary foods to relieve the craving for food, healthy breakfasts help in reducing this significantly. Moreover, healthy eating habits increases concentration levels of people. In a full stomach, a person’s brain is active longer hours. Moreover, a person does not look forward to the lunch time or tea time break to grab a snack. Studies have associated healthy people with high productive levels both at work and in schools. Healthy feeding is not only essential in improving a person’s productive levels, it also helps in improving the sleeping hours which improves a person’s ability to freshen up (Richard, 2012). Personally healthy feeding has helped me save money, improve my health and even boost my grades performance. With old age, people become weak. When they are affected with dementia, their conditions become weaker, and this requires more care from the care givers. The care givers require more knowledge on how to take care of the patients. If the care givers eat healthy, they can support these people especially because they get stronger. Individually, the patients can also maintain strength and avoids frequent falling through healthy eating. Care givers require more knowledge on how to effectively take care of the patients in various situations. Especially when they fall or wander, care givers need to know how to handle such situations whenever they arise. In the course of their work, care givers go through high stress levels. They require both psychological and emotional support from other people in the society. While the services of a counselor or a social worker are essential, the care givers can also be provided with emotional support from the family, friends and relatives of the patient. Quality of care is an important element for people affected with dementia. Quality of care is determined by the ability of a care giver to provide services to the patients either in homes cares, their homes or government hospitals. The best way in which a care giver could offer quality care to the patient is by ensuring that the patient is always within reach. Providing them with the best type of food that is healthy and easy for digestion is yet another way of providing quality care to the patients. While disseminating their services, the care givers need to know the various first aid methods to offer to these patients in case they fall. Taking care of dementia patients is not an easy task. It requires a lot of dedication from the care givers, while the patients themselves require a lot of financial support. Some care givers work voluntarily while others are on pay. All these require compensation in one way or another, since they require money for their personal lives. In the process of taking care of the dementia patients, the care givers experience a lot of emotional torture, and stress. These require services of a counselor or psychiatrist. These are not possible without government’s support. Therefore, it is recommended that the government invests more in this problem by either providing cheap counselors to the care givers or providing more institutions for dementia patients. Learning about the differences between eating healthy and eating foods laced with chemicals, commonly referred to as junk, has opened dialogues with others. This is beneficial especially with the parents of autistic children whose controlled diet has made a world of difference in her behavior and teach (Quinn et al., 2003). The woman is given the opportunity to halt meds and provide the child with normal life after she makes a discovery of severe sensitivity to chemicals in processed and non-organic foods. Knowledge is essential in changing people’s lives and perceptions about life. Personally, it has improved my way of thinking, especially in planning for old age. Nobody wants to die young. However, research indicates that our eating habits influence the number of years that we live. Poor feeders are believed to be live shorter lives when compared to healthy feeders. Poor eating among the people leads to low levels of disease resistance while at the same time it reduces the chances of the body’s ability to stage defense against serious diseases. To ensure that people remain strong in their aged periods begins with healthy feeding habits at a tender age (Chiu et al. 2010). In preparation for my old age, I have adopted proper eating habits that will help me grow as a strong and healthy person. I eat more foods that have the capability of improving my immune system, so that I can fight more diseases. Incorporating this knowledge in patients suffering from dementia improves their recovering process. Conclusion Dementia as a problem affecting the old people is serious and cuts across the society. Although different people are affected by the disease in various levels, it rapid increase among the aged people has necessitated stringent measures to curb this problem. There are difficulties associated with this health problem. Part of these problems affects the people who had poor eating habits in their child hood. Most of the health related problems can be solved by maintaining proper health standards. The only way people can maintain healthy lives is through healthy eating and practices. Many studies have been conducted on the effects of tai chi and regular training methods in improving the lives of the people. Results are impressive, as people’s health has improved significantly. However, the biggest factor contributing to good health is healthy eating, as this paper establishes. As people eat healthy, they improve their concentration levels as well as their lives. This reduces the problems that come along with dementia. Care givers of patients suffering from dementia are affected by a number of reasons. These largely depend on the level of the disease of the patient being handled. To encourage them to be more productive in handling these patients, they need support in form of counseling services, emotional support and motivation from various groups such as the patient’s parents and family, friends and the government. Health care centers and hospitals as well as home cares also play a big role in motivating these people. References Alspach, G. (October, 2004). Improving the odds for avoiding dementia in advanced age. Critical Care Nurse, 24(5): 8-11. Bar-Haim Erez, A. and Katz, N. (2003). Cognitive profiles of individuals with Dementia and Healthy Elderly: The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA-G). Physical & Occupational Therapy in Geriatrics, 22(2): 29-42. Che, H.-L., Yeh, M.-L., and Wu, S.-M. (2006). The Self-empowerment process of primary caregivers: A Study of caring for elderly with dementia. Journal of Nursing Research, 14(3): 209-218. Chiu, Y., Chiu, Y., Hsu, W., Lee, S., Chen, S., & Kao, H. (2010). Developing a Chinese quality of life in dementia instrument for patients with early-to-moderate dementia: an exploratory test of validity. Journal Of Clinical Nursing, 19(15-16), 2174-2184. doi:10.1111/j.1365-2702.2010.03254. David, K.E, James, R.C, (1999). Dementia in the elderly; An overview.; ProQuest Nursing & Allied Health Source, 23(3): 1-9. HealthyPeople.gov. (April 10, 2013) Dementias, including Alzheimer’s Disease. U.S. Department of Health and Human Services. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=7 Jarvis, A. (2010). Working with carers in the next decade: the challenges. British Journal Of Community Nursing, 15(3), 125-128. Kawahara, M. and Kato-Negishi, M. (January 5, 2011). Link between aluminum and the pathogenesis of Alzheimer's Disease: The Integration of the aluminum and amyloid cascade hypotheses. International Journal of Alzheimer’s Disease, 2011, 17 pages. Retrieved from http://www.hindawi.com/journals/ijad/2011/276393/ Kelly, M. (2010). Who cares............for the carers?. Journal Of Renal Care, 36(1), 16-20. doi:10.1111/j.1755-6686.2010.00139.x Orth, U, Trzesiewsk, K.H, Robins, R.W, (2009). Self esteem development from young adulthood to old age. A cohort sequential longitudinal study. Personality process and individual. Retrieved from http://www.owlnet.rice.edu/~antonvillado/courses/10a_psyc102001/Orth,%20Trzeniewski,%20&%20Robins%20(2010)%20PPID.pdf Pulsford, D. (1997). Therapeutic activities for people with dementia – what, why . . . and why not? Journal of Advanced Nursing, 26: 704-709. Quinn, M. E., Andress, E. L., and McGinnis, P. (August, 2003). Health characteristics of elderly residents in personal care homes: Dementia, possible early dementia, and no dementia. Journal of Gerontological Nursing: 16-23. Richard, M. (2012). Care Home Idol. World alzhiemer’s report highlight importance of dementia awareness campaign. Retrieved from http://www.carehome.co.uk/news/article.cfm/id/1557972/world-alzheimers-report-highlights-importance-of-dementia-awareness-campaign Samuelsson, A. M., Annerstedt, L., Emstahl, S., Samuelsson, S.-M., and Grafstrom, M. (2001). Burden of responsibility experienced by family caregivers of elderly dementia sufferers. Scandinavian Journal of Caring Sciences, 15: 25-33. Tatano Beck, C. (1996). Nursing students’ experiences caring for cognitively impaired elderly people. Journal of Advanced Nursing, 23: 992-998. Traynor, V., Inoue, K., & Crookes, P. (2011). Literature review: understanding nursing competence in dementia care. Journal Of Clinical Nursing, 20(13/14), 1948-1960. doi:10.1111/j.1365-2702.2010.03511.x Van Marwijk, H. and Spiegel, W. (2009). Overuse of antipsychotic medication in elderly people with dementia? A view from general practice. Mental Health in Family Medicine, 6: 191-193. Wall, M. and Duffy, A. (December, 2009). The effects of music therapy for older people with dementia. British Journal of Nursing, 19(2): 108-113. Watson, R. and Deary, I. J. (1997). A longitudinal study of feeding difficulty and nursing intervention in elderly patients with dementia. Journal of Advanced Nursing, 26: 25-32. 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