Dementia: the Impairment of Ones Intellectual Capacities - Essay Example

Introduction Dementia is a debilitating condition which causes the impairment of one’s intellectual capacities. It may also cause memory loss, mental activity, destabilize visual spatial skills, and may cause extreme cognitive deficiencies. When it causes such cognitive deficiencies, they are usually persistent and irreversible, a factor that differentiates dementia from other conditions. According to the available classification and description of dementia, three categories of symptoms exist. As highlighted above, loss in mental activity and cognitive efficiency is a leading symptom of dementia. The second category comprises of evident challenges in the performance of personal activities that define an individual’s life. The third category is an evident mood change or alterations in one’s personality a factor that adversely affects interpersonal functioning. Many cases of dementia have been described as irreversible hence, patients suffering from dementia need proper management of the condition. One of the leading causes of dementia is the debilitating effect of the Alzheimer disease which triggers the deterioration of different body systems. Other causes of dementia include Down’s syndrome, vascular dementia and Lewy body diseases. The chances of developing dementia are remarkably higher in old age although aging is not a contributor to its development. Research has revealed that people of over 65 years are more vulnerable to developing dementia. This paper will discuss certain critical aspects of dementia training for carer and family. Range and Complexities of Current Service Provisions The current service provision to patients suffering from dementia depends on the stage of the condition. Dementia progresses in three stages with the initial stage being characterized by anxiety, confusion, agitation and stress. The middle stage of dementia has features such as increased distress, aggressiveness, frustration, and forgetfulness. The final stage denotes the completely debilitated state which is defined by memory loss in continence, uncontrolled weight loss, cognitive in deficiency, and finally the loss of speech. There is evidence that, the prevalence of dementia has sold in the recent years, but there is a lack of evidence of adequate intervention strategies. The health care system and the social service unit have failed to give dementia the expected priority. There are an estimated 560,000 people likely to develop dementia in the United Kingdom. Research reveals that the numbers of people developing dementia are likely to increase in the future. There is a projected 30% increase in the next 15 years. Currently, there are existing service providers who target to offer assistance and the pertinent support to patients suffering from dementia. Some people receive care and support within the home and this group accounts for a third of dementia patients. Two thirds of dementia patients are currently receiving care in community facilities. There are also day centres which offer support on a daily basis and are accessible to 1.7% of people with dementia. Dementia patients whose condition have progressed, usually require domiciliary care and about 3.9% of dementia patient in the United Kingdom are receiving this care. In the final stages of the condition, patients may need access to residential/nursing home care and about 200,000 people are already living in such homes. These statistics reveal the current service provision within the United Kingdom toward the dementia patients. The cost of care provision is one of the existing complexities surrounding the dementia issue in the United Kingdom. A total of 14.3 billion pounds account for the national economic burden brought about by dementia. The National Health Service (NHS) spends 3.3 billion pounds on providing care to patients of the debilitating condition. Established nursing homes that provide services to dementia patients spend an approximated 5.76 billion pounds. 1.73 billion pounds of the amount spend by the nursing homes is from self-funds. There is also an estimated informal cost of 5.2 billion pounds, which accounts for unpaid carers. An additional complexity in the provision of care to patients with dementia is the fact that care givers lack sufficient knowledge and the adequate skills to provide the level of care required by the patients. Dementia robs individuals of their independence, a factor that compels them to rely on others for support. Many of the carers providing support to the dementia patients have not undergone the relevant carer’s assessment. This limits their competence in care provision. Therefore, there are limited specialists who ensure that dementia patients receive proper monitoring and management. In the case of domiciliary care, local governments have introduced stringent eligibility criteria and only those with severe cases are allowed to have access to this form of care. This leaves a remarkable number of people requiring care, but not accessing it. Although there are existing care homes established by voluntary organizations, the private sector, or the local authorities, only a few of them exhibit the presence of registered specialists who can handle dementia. This means that, there is an existing under-diagnosis in those homes. Analysis and Reflection on the Current Commissioning Structures at Local and National Level England has established both national and local level intervention strategies in a bid to address the increasing prevalence of dementia. At the national level, England has established the national dementia strategy for England. This strategy targets to transform the kind of services provided to patients with dementia as well as the level of training accorded to the care givers. This transformation is set for achievement in five years. The strategy started with the identification of existing challenges to service provision and seeks to operate on a national level. The strategy does not define in specific terms the role of local authorities and service providers, but seeks to provide effective guidelines on how local service providers can determine the appropriate priorities according to a community’s needs. The national dementia strategy was established after the realization that the government spends too much money in the intervention of dementia, but most of the fans were directed to patients who had reached the final stage. Moreover, there were issues concerning the consistency and the cost effectiveness of services delivered at a local level. This is the reason why the national strategy sought to exhibit a new commitment which aimed at identifying dementia as an issue requiring priority in the health and the social care sector. The drafting of the strategy was started in 2008 and published in 2009. The new strategy exhibits a new structure of service provision which conforms to the views of the Alzheimer’s Society and other related organizations. The main objective of the new strategy is to empower both the carers and the patients with dementia. In the formulation of the strategy, 17 different objectives were identified that touch on different areas that need improvement. Prior to the development of this strategy, the government exhibited efforts towards care provision, but it appears that the level of care was inadequate and did not address the needs of the patients. At the local level, communities have set up homes where they offer care to dementia patients. Their action and response promotes the objectives defined in the national strategy. In the recent past, the Local Government and the Public Involvement in Health Bill has introduced a new forum whereby local authorities can form partnerships while identifying the needs of the local populations and conforming to objectives defines at the national level. Critical Appraisal of Areas where Services are needed but not being met Although there are existing service provision systems, there are gaps in the level of training, the number of carers available, and under diagnosis of dementia. As highlighted above, only about 25% specialists have passed the carers assessment attaining certification indicating their competence in service provision. Limited training to carers affects the quality of services delivered as well as the number of patients receiving the care. Without doubt, the ratio of trained carers does not match the increasing number of dementia patients. Although the national strategy was developed to address this issue, there is still an existing gap that needs to be filled in. Carers in hospitals, nursing homes, community facilities and homes need to receive adequate training so that they can deliver quality services to individuals with dementia. On the other hand, there is still limited access of services to many dementia patients. According to the statistics highlighted above, some patients exhibit severe symptoms but are not received in domiciliary care homes. This denies them the opportunity to receive quality health care and social support. Therefore, there is a salient need of introducing a nationwide campaign on the importance of training an increased number of carers and health specialists who can provide the require care to dementia patients. The increasing rates of under-diagnosis of dementia result because of the limited capacity of health and social care providers to identify dementia in its early stages. There is a salient need for proper diagnosis of dementia in the society so that measures can be taken to alleviate severe dementia cases. Lack of appropriate training and compensation to care-givers is an additional issue that needs to be resolved. This is the reason why many care givers provide services that do not meet the required standards for dementia patients. Therefore, training and compensation should serve to empower and motivate care givers towards the provision of better services. Examination of the Theories of Personnel Management and interprofesional Relationships and their Impacts on Health and Social Care Provision One of the theories used in personnel management is McGregor’s theory X and Y. McGregor developed two theories based on certain assumptions in each case. Theory X highlighted that workers exhibited a dislike for their work, were lazy, and relied on stringent instructions for them to perform. On the other hand, theory Y highlighted that people had the capacity to assume new responsibilities exhibits a high level of creativity and were willing to work as long as the employer ensured that a favourable working environment exists. Moreover, this theory also believes that workers derive a measure of satisfaction from the tasks they perform. Therefore, it emphasizes the fact that leaders should grant subordinates an opportunity to work freely with minimal supervision. In the case of dementia and health and social care provision, this theory is applicable. According to theory X, one would assume that health care providers to dementia patients did not like their responsibilities. Such a perspective would compel both the government and the private sector to supervise health and social care provision. Notably, theory Y is more appropriate in managing personnel dedicated to providing health and social care to dementia patients. This is because, if workers are provided with a favourable working environment, proper training, adequate compensation and motivation to their work, they can provide quality services to dementia patients. On the other hand, Maslow’s theory on the hierarchy of needs places emphasis on the satisfaction of needs of workers at different levels. The highest needs which, when satisfied can prompt a health care provider to deliver quality services is self-actualization. Self-actualized workers exhibit a high level of motivation towards work and are more likely to be creative. In its application of care provision to dementia patients, the theory highlights the salient needs for proper training, adequate compensation and empowerment of caregivers so that they can deliver quality services. On the other hand, inter-professional relationships in dementia care provisions are of critical importance. The cooperation of different professionals and specialists is one of the emphasized strategies in the integrated programs of health care provision. Professionals and care givers face the compulsion of developing functional working relationships to facilitate an interchange of ideas and skills. This will have benefits in health and social care provision. Appraisal and Evaluation of Service Provision using Relevant Tools Experts have defined five dimensions that can be used to assess the quality of services provided. One of these dimensions is effectiveness, which denotes how much the service delivered can produce positive outcomes to the individuals and the society. An additional dimension is efficiency, which seeks to determine whether the services delivered make good use of the available resources minimizing waste. Accessibility is the third dimension and denotes the ease with which patients can reach the facilities providing services. The fourth dimension is accountability, which seeks to determine whether delivery of services does not depend on race, ethnicity, social economic status or even gender, but a fair system of service delivery exists. The fifth dimension considers the safety of the services provided, ensuring that they do not cause any harm to the patients. Other aspects of assessing services delivered seek to identify whether the right priorities are followed. Moreover, other tools assess whether services are delivered in a way that meets the defined standards. Finally, assessment seeks to identify whether services provide to dementia patients can be improved in a bid to increase the patient satisfaction. All these assessment dimensions can be used to assess the quality of services provided to dementia patients. Conclusion As mentioned above, dementia can have highly debilitating effects on an individual making him or her dependent on others. This introduces a need for people with dementia to receive the relevant services that address their needs. In the United Kingdom, there is evidence of increasing preference of dementia. The increase has caused an evident financial burden and there are still needs requiring to be met in order to ensure that dementia patients do not suffer excessively. Bibliography Coon, D. W., Gallagher-Thompson, D., & Thompson, L.W 2003, Innovative interventions to reduce dementia caregiver distress: A clinical guide. New York, NY: Springer Pub. Co. Downs, M., & Bowers, B J 2008, Excellence in dementia care: Research into practice, Maidenhead: Open University Press. Huppert, F. A., Brayne, C., & OConnor, DW 2005, Dementia and normal aging, Cambridge: Cambridge University Press. Sartorius, N 2005, Families and mental disorders: From burden to empowerment, Chichester, West Sussex, Angleterre: Wiley. Weiner, M. F., Lipton, A. M., & American Psychiatric Publishing 2009, The American Psychiatric Publishing textbook of Alzheimer disease and other dementias, Washington, DC: American Psychiatric Pub. Read More