Choosing the Best Road in the Face of Dementia - Essay Example

 It is no simple matter to take care of an individual who is suffering from dementia. The two main alternatives are family-based care in the victim’s or a relative’s home or care in a long term facility, such as “assisted living” homes or nursing homes. There are two important aspects when it comes to deciding among these alternatives. The first is the financial cost and the second is the emotional costs for those involved. Depending upon the situation, these are hard choices. Nursing home care is often less costly than providing proper care in the home. The emotional costs are high in either case, though they are different, so it must be decided on an individual bases and periodically reviewed after the decision is made. Dementia is a collective term used to refer to a range of diseases that involve the deterioration of cognitive function over time. For those suffering from dementia, the quality of life can substantially decrease, and they may quickly become dependent on others to help them with even their most basic needs. The symptoms of dementia increase dramatically with age and cognitive functioning can degrade very rapidly(American Psychiatric Association ). The prevalence of dementia in our population also increases with age(Bornstein, M. H. & Lamb, M. E. ). Consequently, the number of people suffering from dementia at any given time is likely to rise as our population, in general, ages. Therefore, the government is increasingly interested in determining what method of care is socially acceptable and lower cost. Check with your local government to see what they have decided so far. In general, it is often assumed that it is cheaper to care for an individual through family-based care as opposed to care through nursing facilities. However, this does not take into account costs that are incurred by family members in terms of finances or time. This is an important factor, as dementia patients frequently require full time care. Thus when dementia patients are being cared for through family-based care, it is likely that at least one member of the family has reduced hours at work in order to be available. When labor and out-of-pocket costs are taken into account, studies have shown that for patients with severe levels of dependence, it was more economically viable for them to be cared for through nursing home care than through family-based care (Chiu et al. 1999). Therefore, despite the high fees of nursing home care, it is still usually equal in cost, or cheaper than family-based care. Financial cost is not the only consideration, and certainly not the primary focus when deciding the best type of care for those we love who are suffering from dementia. Dementia is progressive, and it destroys mental function. When it is a family member or loved one undergoing these changes, the process can be very painful to watch. This can cause feelings of helplessness and mental trauma, and even irrational guilt. There are many reports of caregivers for dementia patients suffering from severe depression as a consequence of watching the progression of the disease (Eisdorfer et al. 2003). Caring for an individual with dementia exerts significant mental and emotional pressure on those responsible for them. The role reversal is often of particular difficulty(Boss 445-450). Possibly the worst of these problems is that dementia patients often begin to behave quite childishly as the disease progresses, being not just ungrateful, but often positively hateful. Knowing that they do not mean it, and are not responsible for this hurtful behavior does not really prevent the pain it causes. Sometimes an angry reaction in return will even promote horrible guilt feelings in the caregiver. Over the long term, the patient may lose the ability do even the simple hygiene tasks of bathing and brushing and may need help with toileting. When the patient no longer even recognizes their loved ones and behaves in ways dangerous to themselves and others (Nigg et al. 473-482), it is time to reassess the viability of home care. How does one determine what to choose when taking care of a family member with dementia? First, get a competent professional to assess cognitive functioning of your loved one. Using tests for functionality, (Mack and Patterson ; Mattis, Jurica and Leitten ) (Polanski and Hinkle 357), this same professional can advise you objectively, based upon the patient’s need and history. Placing a mother, a father, or any relative in a nursing home in the care of strangers incites feelings of injustice and abandonment. Even placement in the relatively more comfortable environment of assisted living homes seems like not taking enough care of loved ones. Yet, the costs of taking care of a dementia patient at home are considerable, especially as the disease progresses. Not only are the financial costs considerable, but the emotional toll can be severe. There can be real damage to a family from long term difficulties of in home care for a victim of dementia(Wilcoxon 495). Those “strangers’ ready to help your loved one are specially trained and they are not there 24/7. Taking care of an individual with dementia is a serious commitment of family resources and this could go on for years. Those who face the decision with family members or relatives need to take all the aspects into consideration to ensure they make a fully informed decision. Before making the final decision, the possible long term facilities should be inspected. If you are welcomed with no notice and allowed to freely look around, then it is probable that you will find there is superior care in that facility. Check with local regulatory agencies to see what, if any, complaints have been filed. Check out activities and the caregiver to patient ratio. Sample the food and talk to any residents who seem lucid and interested in talking. See how easy it is for a nurse, who works an eight hour shift and goes home, to laugh and joke when a senior is berating or behaving badly. In addition, the best way to frame the decision is to honestly assess what you would want if you were making such a decision for yourself to go into care. Works Cited  American Psychiatric Association. DSM-IV-TR. Arlington, VA:, 2000. Print. Bornstein, M. H. & Lamb, M. E., ed. Developmental Psychology : An Advanced Textbook. . Hillsdale, NJ: Lawrence Erlbaum Associates., 1984. Print. Boss, P. G. "Normative Family Stress: Family Boundary Changes Across the Life-Span." Family Relations 29.4 (1980): 445-50. Print. Chiu, L., Tang, K.Y., Liu, Y.H., Shyu, W.C., and Chang, T.P. "Cost comparisons between family based care and nursing home care for dementia", Journal of Advanced Nursing 29.4, (1999) pp. 1005-12. Eisdorfer, C., Czaja, S.J., Loewenstein, D.A., Rubert, M.P., Argüelles, S., Mitrani, V.B., and Szapocznik, J. "The effect of a family therapy and technology-based intervention on caregiver depression", The Gerontologist 43.4, (2003) 521. Mack, James L., and Marion Patterson. "CERAD Behavior Rating Scale for Dementia, Second Edition." (2001)Print. Mattis, Steven, Paul J. Jurica, and Christopher L. Leitten. "Dementia Rating Scale-2." (2001)Print. Nigg, C. R., et al. "Stages of Change Across Ten Health Risk Behaviors for Older Adults." The Gerontologist 39.4 (1999): 473-82. Print. Polanski, P., and J. Hinkle. "The Mental Status Examination: Its use by Professional Counsleors." Journal of Counseling & Development 78 (Summer 2000): 357. Print. Wilcoxon, S. "Healthy Family Functioning: The Other Side of Family Pathology." Journal of Counseling & Development 63.8 (1985): 495. Print. Read More