Mental Health and Dementia - Article Example

Case study on Dementia Patient Student’s Name Course name Instructor’s name Institution Date Mental health and mental illness The World Health Organization defines health as the state of complete physical, mental and social well-being of a person and not simply the absence of a disease or infirmity in a person’s body. Thus health is viewed as the ability of a person’s body to function properly without experiencing any form of physical, mental or social disorders. Moreover when evaluating the term health, it is important for one to understand it from a broader perspective other than illness or diseases. Health is related to the wellness of a person both socially, physically, mentally and emotionally. For this reason the health of a person is measured through the overall wellbeing nature of their body to function appropriately while illness is measured by a specific diagnosis depending on how a person’s body is functioning. Mental health is therefore characterized by the state of a person’s emotional, psychological and social well being. Mental health thus has a direct impact on the behaviors of a person. For instance it affects how an individual relates with others, responds to their environment, and how one thinks and feels. Mental health disorders will arise as a result of several factors depending on the age of a person or their immediate surroundings. A person will experience mental problems, due to biological issues like hormonal changes, past life encounters that have led to trauma or family background of mental health disorders (Link et al, 1989). The Department of health in London, states that mental health will become a health complication once a person identified with the signs and symptoms experience recurrent forms of stress that interfere with the person’s ability to function appropriately. Persistent mental health issues eventually results to a mental illness. Mental illness can therefore be defined as a medical condition that affects a person’s thinking capability. By interfering with an individual’s thoughts, mental illness, negatively impacts the ability of a person to associate with others and perform their daily activities. Mental illness disables a person from coping with daily demands of life. Some of the mental illnesses include; panic disorders, bipolar disorder, posttraumatic stress disorder, obsessive compulsive, depression, borderline personality disorder and schizophrenia (Mental Health Strategies, 1999). Mental illness can affect persons from any age bracket, religion, race or social status. Nonetheless it is a health disorder that can be treated; individuals with mental illness can recover from it by receiving appropriate treatment and services. Early signs of mental illness can be used by specialists to diagnose specific kind of disease a person is suffering from. Dementia Alzheimer Society (2008) describes dementia as a group of symptoms that are characterized by memory loss and lack of proper cognitive functioning. Therefore dementia is associated with a series of slow brain activities that eventually affect the normal daily life of a person. According to NHS, dementia has become a common health problem affecting over 800,000 people around the UK. Consequently people at the age of 65 and above are at a greater risk of developing dementia than their younger counterparts. According to Davis R. (1989), individuals suffering from dementia often become paranoid, experience frequent memory loss, their thinking capacity is slow and at times are unable to control their emotions. Additionally dementia patients will lose interest in social activities they once enjoyed, experience personality changes and also detest social settings. Dementia is known to affect the mental ability of a person thus a person may start suffering from hallucinations and fail to make sound decisions on their own. Diagnosis of Dementia Doctors and nurses have designed several ways to diagnose dementia. An early diagnosis of dementia helps the patient, their relatives and the doctors, this is because once dementia is identified at an early stage in a patient it allows immediate treatment of symptoms (Griffiths et al, 2008). However during the diagnosis of dementia, doctors are advised to avoid taking into account any treatable symptoms like vitamin B12 deficiency, depression or normal pressure hydrocephalus which depict similar signs. Thus during diagnosis, doctors begin with examining the patient’s medical history when they first started experiencing the symptoms. Consequently several tests are carried out which will include; neurological evaluations, cognitive and neuropsychological tests, brain scans, laboratory tests and psychiatric evaluations. Over the past few years dementia has become one of the main priorities for the NHS. The number of dementia patients has continued to grow with an estimated 900,000 people in England alone being diagnosed with dementia at NHS hospitals. Additionally, patients with dementia tend to spend more days in clinical wards as compared to those without dementia. Crisp (2011) affirms that those diagnosed with dementia will require a considerably amount of attention and resources from the care giver or specialist than similar patients without dementia. An estimated 25% of the patients in hospitals are suffering from dementia, since most of them have lost the capability to care for themselves. Alzheimer Society (2009) documented that dementia comes with hefty financial and human costs. For instance the NHS annually spends an estimated £250,000,000 for the treatment of dementia and its symptoms. However the amount is assumed to be even higher as dementia fails to be recognized as a secondary diagnosis once a patient visits the hospital. The human costs on the other hand are equally frustrating; as reports by the Alzheimer’s society reflect that at least a significant number of relative carers have experienced negative impacts resulting from the physical or mental health of the patient with dementia. This is because the medical condition that a patient was admitted for was absolutely unrelated to the diagnosis of dementia. Moreover 77% of the family care givers registered a high level of dissatisfaction of the quality of care offered in clinics and hospitals. The provision of proper medical care and assistance for patients with dementia presents a considerable challenge to hospitals. It is important to recognize the delicate nature of the care delivered to dementia patients by nurses. This is because with an equipped nursing body, the patient’s recovery chances are high. Majority of the nurses allocated to care for patients with dementia, lack the proper skills and training to do so. This makes it difficult and more complex for these nurses to care for dementia patients. Thus it is vital for nurses to undergo proper training and acquire enough knowledge in the field (Mabel et al., 2012) A Case study of a patient with dementia symptoms (Beryl's Case). The following is a case study of a female patient, Beryl, who is showing symptoms of dementia. Beryl is a 79 year old widowed woman with two adult children living far away from her, with the abrupt death of her husband two years ago Beryl has been forced to live alone. According to a national report by the Alzheimer Disease International 2012, dementia is a common disease for people at her age and older. Beryl is exhibiting signs and symptoms of dementia which if not treated early may eventually develop to Alzheimer. Beryl has exhibited a number of symptoms that include; memory loss, hallucinations, emotional instability, paranoia and insecurity. One of the main outcomes of dementia is a person’s failure to account for their actions. Many patients suffering from dementia lose the ability of their brains to function properly resulting to mental instability. The psychological reactions to dementia are normally very severe depending on the type of dementia one is suffering from. Once a person comes to term with their loss of abilities due to dementia, the person may be compelled to experience emotional trauma. Corrigan (2004) explains that the emotional trauma experienced by dementia patients results to; anger, frustration, anxiety or depression. In the case of Beryl, her personality has changed as she tends to be suspicious of her surroundings and get upset more often. These symptoms have made her feel vulnerable since she misunderstands things around her. Although Beryl may be experiencing some form of anxiety resulting from the emotional trauma experienced, she is still actively involved with her behaviors before the symptoms. For instance Beryl still takes her walks down the street despite the fact that she has depicted signs of memory loss which may lead her to get lost. Another scenario is whereby Beryl wakes up at odd hours to mow the lawn. These two instances show that the patient is still in contact with her previous role thus if she was deprived from partaking in these activities, Beryl’s condition may get worse. Consequently this may also give rise to depression, since she may feel like she is losing control of her daily life. Depression in patients with dementia, may give rise to changes in mood, agitation, delusion and anxiety. Beryl expresses mood swings and agitation when Florence stops her from mowing the lawn and tries to calm her down and get her back to sleep (MetLife Foundation, 2011). Although Beryl’s mental health is at stake, her symptoms can be diagnosed and early treatment offered. Dementia may be a temporal mental illness developing for Beryl due to her age but with proper care Beryl may be up and about once again. However if Beryl fails to receive appropriate medication and care from specialists, her condition may get worse which will eventually lead to negative physical, social and mental health. The mental illness, dementia, affects Beryl’s social wellbeing as she tends to be paranoid, experience instances whereby she hallucinates and gets confused by her environment (Makadam & Sampson, 2011). Consequently Beryl is experiencing cognitive changes whereby she is unable to remember where she kept things and states false claims. Her inability to recall her own actions tends her to believe that they have been stolen; for instance she complained to her friend Florence that someone had broken into her home and stole money which was not the truth. On the other hand we are informed that Beryl cannot remember the names of her grand children. With such recurrent memory loss, Beryl is likely to encounter difficulties in daily routine activities such as taking care of her garden, going shopping, driving or even worse fail to feed and dress herself (WHO, 2012). Beryl is exhibiting poor health and with that her daughter’s need to call her GP for consultations and appropriate diagnosis. Early diagnosis will be able to establish whether Beryl is indeed suffering from dementia and if so what type of dementia it is. The diagnosis process is highly dependent on the clinical skills and abilities of the doctor as opposed to technology. A report by the Scottish Government that was done in 2012, asserts that dementia calls for the proper understanding of the disease by the doctors and nurses and specialists cannot rely of technology for the diagnosis of a patient. In Beryl’s case it is evident that her old age is a major contributing factor to the symptoms. Therefore a brief explanation on the history of the symptoms will be the beginning of the diagnosis process. Identifying for how long Beryl has been experiencing the mental disorders, will be a determining factor on which stage her health is at. This history examination can be followed by a physical examination test, a memory cognition test and a number of standard laboratory tests. Dementia patients are different and each one of them needs to be treated according to their needs as others may also suffer from physical illnesses. Thus to care for a dementia patient it is important that a good relational care skills is exhibited by the care giver or specialist (Skills for Health et al., 2010). Dementia patients require a lot of attention and reassurance. Therefore as a dementia care giver, family members and specialists need to have a powerful observational skill and be emotionally involved with the dementia patient. These skills allows one have a better understanding of what the patient is going through and respond to their emotional and physical needs (Thompson & Heath, 2011). New environments may agitate the person resulting to emotional instability thus causing them to be anxious all the time. It is therefore important that a dementia patient receives professional care in their own homes as this will facilitate better care. Notably, familiar environments makes the patient to feel comfortable and in charge of themselves and their surroundings. This is because the patient feels like that they are in a better place to make their own decisions independently. Moreover an environment that allows a patient to feel comfortable enables them to keep up with their daily routines which contribute to a quick recovery and positive outcomes. In fact according to Thompson (2011), if the relatives of a patient are not in a position to provide home care for the patient, it is important that they are able to find a facility equipped with professional care workers. In addition to these the family members should visit the patient frequently and with the adequate support of a specialist the patient will register a quick recovery. Therefore Beryl’s daughters should take all this aspects into consideration as they seek proper medical care for their mother. Discussion According to the World Alzheimer Report (2012), stigma continues to be setback in the fight against dementia. Regardless of the research efforts put in place for early diagnosis, treatments, care and support offered to patients, society is yet to come to terms with the disease dementia. Stigma acts as a roadblock and hinders people from acknowledging the signs and symptoms which will assist them in accessing the help they need to lead a healthy life. Stigma of dementia is becoming even worse since the disease is associated with old age. Old age on the other hand faces discrimination since people tend to view it as a stage in which a person becomes vulnerable and over dependence. The old have continued to face a considerable amount of discrimination in the world. This is because stigma has a direct impact on older people in terms of driving, securing employment and the ability to make independent decisions. An older person is considered to function less as compared to others as people tend to assume that a person suffers cognitive decline with age. Hence old age is subjected to discrimination on the biased assumption of the expected link between age and deformation. Thus if an old person performs exceptionally well for their age people take it as a surprise and will not seek medical advice or evaluation if this old person registers a decline in their performance. Such assumptions by younger people de-motivates the older generation making them feel unwanted (World psychiatric Association, 2002). With such an apparent form of stigma, majority of the older people with dementia will avoid discussing their symptoms with their GP until it is too late. Consequently doctors and nurses fear to discuss cognitive symptoms with their patients since the discrimination associated with dementia demoralizes a person. The stigma associated with dementia tends to make older people seem like they are suffering from a mental illness and there is nothing that can be done about it. Such views are shared by society who makes it difficult for physicians to diagnose their patients since they do not want to give them a stigmatizing label. It is these kinds of thoughts and ideas that make it difficult for individual to seek proper diagnostic examinations until it is too late and the symptoms cannot be brushed off (Rusch et al, 2005). In addition to this, stigma associated with old age and dementia as a disease for the old people, many carry with them the ideology that older people are incapable of making sound decisions. Thornicroft (2006) affirms that this type of assumption results to an unfortunate loss of autonomy, dignity, and contributes to poor self esteem that is linked to stigma and dementia. It is believed that the association between ageism and dementia creates a barrier for patients to obtain carers’ community services and seeking help from friends and family. Moreover, majority of these patients view the act of accessing help as being vulnerable and clinging which to them is highly stigmatizing. Kneale (2012) describes social exclusion with age comes when an older individual feels inadequate to participate in society in the most basic ways. Thus social isolation can be defined as the act of feeling inferior to partake in social activities due a number of complex problems that makes one inferior. According to a research conducted by the International Longevity Centre-United Kingdom, there are several people aged 50 years and above who are socially discriminated from accessing decent homes, local amenities and public transportation. This research indicated that social exclusion among the aged people is a normal occurrence. For example in 2012, 13% of every 6 people in their fifties faced social discrimination. On the other hand 38% of those aged 85 years and above faced additional types of social seclusion. This research was able to show that there are higher chances for people to face social exclusion as they age. Further the report highlighted that an aged person’s demographic, economic status and health status are likely associated with whether or not this person is socially excluded (Kneale, 2012). The stigma associated with dementia has contributed to a patient being treated differently by both family and friends. Some patients will receive positive treatment while others will receive negative once depending on the attitude of their carer towards the disease. For instance some patients reported that their friends had broken off any ties with them since they could no longer be in a position to join them in leisure activities they did together. In other circumstances patients have been shipped off to healthcare facilities and left there without any family member or friend visiting (Thornicroft, 2006). World Alzheimer report (2012), indicates that 28% (487) of the patients with dementia interviewed affirmed that they had been treated differently since the diagnosis while 50% (826) declined in England. 165 people from those who approved to being treated differentlyconfirmed that they had been subjected to social exclusion. This group of people affirmed that social exclusion was the most apparent form of stigmatization they and the people they cared for experienced since the diagnosis. Some of the claims included not being invited to social gatherings such as parties, weddings and family get together. Additionally, majority of their friends and some family members have stopped calling or visiting and have cut all forms of communication ties with them. Relative care givers on the other hand also face social exclusion. This is because most of these care givers have put all their time and efforts in taking care of the patient that they fail to have sufficient amount of time to go out and interact with friends. In other instances friends of care givers have given up on inviting them to social events since the carer is always busy with the dementia patient. Some carers did not want to go to social events since their patient will automatically be treated as a child which is frustrating for them (Thompson & Heath, 2011). The World Alzheimer Report (2012) also shows that there is a close relationship between stigmatization and social exclusion. This is because stigma accelerates social exclusion in society for patients with dementia thus making these patients unwilling to seek medical help. The kind of discrimination linked with dementia, has led to labeling of all patients suffering from dementia and categorizing them in one group. People need to be more knowledgeable and educated about the disease and that it is takes a different phase over time. Understanding the disease will reduce the form of discrimination and social exclusion experienced by many. Conclusion In order to overcome the challenges presented by dementia to carers, patients, the national health system and the government, it is important that there is public awareness about the disease. Educating people about the disease its symptoms and how to provide care services will contribute to an early diagnosis which allows one to receive treatment faster. An early diagnosis will enable most of the families of the patients to have a better understanding of their current situation and cope with it. This will in turn facilitate a positive attitude by these individuals (Prince et al, 2011). Nonetheless, an early diagnosis determines the number of years the patients and the their families is going to adapt to the new lifestyle, speak well, continue making decisions on their own and still become active members of society without facing social exclusion. People with dementia require physical and emotional care and support without any kind of discrimination. Dementia is a degenerative mental condition for the aged, thus younger people should not view the old as disoriented members of the society. On the other hand the government and ministry of health should allocate an adequate amount of money to facilitate for the treatment of dementia. References Alzheimer’s Disease International. 2012. National Alzheimer and Dementia Plans Planned Policies and Activities. Retrieved 17th December 2014 Alzheimer’s Society. 2008. Dementia: Out of the Shadows. London : Alzheimer’s Society. Retrieved 18th December 2014 . Alzheimers Society. 2009. Counting the cost: Caring for people with dementia on hospital wards. Corrigan, P. 2004. How stigma interferes with mental health care. American Psychologist, 59(7): 614-625. Crisp, H. 2011. Health Foundation Spotlight on Dementia Care. London: Health Foundation. Davis, R. 1989. My Journey into Alzheimers Disease. Wheaton, Illinois: Tyndale House Publishers. Griffiths, P., Jones, S., Maben, J. & Murrells, T. 2008. State of the Art Metrics for Nursing: A rapid appraisal. King's CollegeLondon: London. Kneale, D. 2012. Is Social Exclusion still Important for older people? International Longevity Centre-UK. Retrieved 18th December 2014 Link, B., Cullen, F., Struening, E., Shrout, P., & Dohrenwend, B. 1989. A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3): 400-423. Maben, J., Morrow, E., Ball, J., Robert, G. & Griffiths, P. 2012. High Quality Care Metrics for Nursing. , King’s College London: National Nursing Research Unit. MetLife Foundation. 2011. What America Thinks: MetLife Foundation Alzheimer’s Survey. Retrieved from18th December 2014 Mukadam, N., & Sampson, E. L. 2011. A systematic review of the prevalence, associations and outcomes of dementia in older general hospital inpatients. International Psychogeriatrics, 23(3): 344-355. Prince, M., Bryce, R. & Ferri, C. 2011.World Alzheimer Report. London : Alzheimer’s Disease International. Rüsch, N., Angermeyer, M. C., & Corrigan, P. W. 2005. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20(8): 529-539. Skills for Health, Department of Health & Skills for Care. 2010. National Dementia Strategy Project: scoping study report. England's Department of Health. The Scottish Government. 2010. Scotland’s National Dementia Strategy. Edinburgh. Thomson, R. & Heath, H. 2011. Dementia: Commitment to the care of people with dementia in hospital settings. London: Royal College of Nursing. Thornicroft, G. 2006. Shunned: Discrimination against People with Mental Illness. Oxford : Oxford University Press. World Health Organization (WHO). 2012. Dementia: a public health priority. Geneva : World Health Organization. World Psychiatric Association & World Health Organization. 2002. Reducing stigma and discrimination against older people with mental disorders. Geneva : World Health Organization. Read More