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Dementia in the Ageing Population Assessment Answer


Assessment details: 

Word Limit1000 words (+/-10%)
Course Learning OjectivesCLO 1. Implement the principles of infection control, holistic nursing assessment, and nursing care to support activities of daily living.
CLO 3. Understand the basic principles of human development across the life span and adapt basic care, communication, and assessment techniques accordingly.
CLO 6. Apply the principles of a person-centred approach when practicing basic nursing skills.
Longer lives are a positive outcome of advances in improved nutrition, healthcare and medications. Increasing longevity, however, can have significant implications for the health care needs of the older person, as ageing can cause a decline in health and functioning, with many health conditions, and associated impairments. 

A diversity of clinical placements provide care to our ageing population, including aged and residential care (with both high and low care in these settings), dementia care, rehabilitation and/or placement within a hospital or multipurpose health service. This semester you will be attending clinical placement and for many of you this may be your first experience into aged care. 

This assignment requires you to write an essay discussing the implications for nursing care for a patient with one of the degenerative conditions associated with ageing listed below. 

  • Parkinson’s disease
  • Dementia (including Alzheimer’s disease)
  • Osteoarthritis 
  • Chronic cardiac failure 
  • Chronic respiratory failure 
In your assignment, consider the following:

  1. Discuss the issues associated with this degenerative condition, (for example, confusion, deteriorating mobility etc.)
  2. Explain how the condition affects the older persons’ ability to perform their activities of daily living
  3. Consider the implications for patient safety that should be considered in the development of nursing care plans for patients suffering from this condition (consider basic, patient centred nursing care and communication requirements)


Dementia in the ageing population

Ageing is associated with progressive degeneration of tissues that has a harmful impact on the structural and functional ability of the vital organs. It has been observed that loss of physical integrity during ageing can cause a decline of homeostasis and alter the responsibility towards the environmental stimuli and increase the risk of diseases and death. The number of ageing population in the world is increasing rapidly which creating challenges over the healthcare facilities to reduce their mortality and morbidity rate. The medical advancement is offering better care and facilities to the elder population and they can achieve good health and services despite their difficulties and overcome their complications. 

In this assignment, we will discuss the dementia which is common degenerative conditions in ageing and identify the correct care plan to support the care users.  

Dementia is a syndrome in which deterioration of memory, ability, and behavior occur. It is common in elder people and considered a common phenomenon in ageing. In the world, 50 million people having dementia and approximately 10 million people develop the syndrome every year. It has observed that in 60-70% of cases, patients with dementia having Alzheimer which is another form of dementia. It can cause multiple disabilities and dependency in elder people. Furthermore, it has a strong negative impact on careers, families, and societies (WHO, 2019).         Dementia is progressive in nature and in which deterioration in cognitive function results. It can affect the memory and thinking patterns of the individual along with the orientation, comprehension, and learning capacity of the affected individuals. The deterioration of cognitive function is responsible for an emotional outburst, and poor social behavior of the individual. Dementia can develop due to a variety of diseases and injuries of the brain. It has recognised that lack of awareness and knowledge about dementia cause social stigmatization and create barriers in diagnosis and care. Dementia can have specific effects on an individual depending on their nature and personality before the illness. The early stage of dementia can be overlooked by the individuals as the onset is gradual and have symptoms like forgetfulness, becoming lost in gathering, and unaware of the time. In the middle stage, the symptoms of dementia are more clear and specific. The individual often forgets about the recent events or name of their relatives, lost at their home, facing difficulties during communication, require helps in personal care, repetitive in nature, and expressing strange behaviour(WHO, 2019). In advanced stage or last stage of dementia, the individual is becoming completely inactive, and dependent on carers. The sufferers can face the loss of memory; unaware about time and place, unable to recognise the relatives, requires support in their activities of daily living, and expressing aggressive behaviour along with mood swing.  

Dementia often creates difficulties in performing ADLs. ADLs are evaluated to assess the cognitive function capacity of the individuals. As dementia is a progressive syndrome, the ability of the individual to perform the ADLs declines gradually. In Alzheimer’s disease (which is a common cause of dementia in ageing people) the neuro degeneration causes gradual progression of behavioural and function impairment in affected individuals (Marshall et al., 2012). It recognised that Alzheimer’s disease dementia is responsible for impairment of ADLs in moderate to severe stage. The individual faces difficulties in grooming, toileting, dressing, eating, and bathing. Additionally, instrumental ADL is signifying specific activities like cooking, shopping, household works, and driving. The instrumental ADL start declines at the mild cognitive impairment stage (Suzuki et al., 2019). It is considered as an initial stage of Alzheimer’s disease dementia in individuals.            

In dementia, it is essential to assess the ADL for identifying the client’s needs and financial and physical cost of the care. For this purpose, Brathel Index (BI), Functional Independence Measure (FIM), and Katz Index are used for the assessment of ADL. Furthermore, three specific scales are used to assess the basic ADL in dementia are Blessed ADL, Functional Activities Questionnaire, and Bristol scale.     In general, several brain functions required for performing the ADLs. In dementia, the functional capacity of the brain is affected as a result of the difficulty in ADLs occur. Dementia can affect the executive functioning of the brain. The individual faces difficulties in following the multiple steps for washing hair or dressing. In some cases, dementia patients forget about their assign tasks or how to perform the task due to memory loss. Dementia is responsible for poor decision-making skills in affected individuals. In addition, the sufferer countenances problems in concentrating and completing the specific activities. Dementia cause behavioural and psychological changes that require assistance (Luttenberger et al., 2012). Visual spatial changes in dementia patients are responsible for uncertainty about the situation and incidents among them.          

Dementia care plan is based on person-centered care which offers guidance, support based on care and services, value the choices, dignity and purposeful living of the individual.  As per the opinion of Brooker (2004), the person-centered care must have four components like valuing and respecting the patients, understanding the patient’s unique needs, perspectives of the individuals, and creating a positive social environment that promotes positive relationship and wellbeing(Fazio et al., 2018).  

  • Dementia care plan demands to know the person living with dementia. The understanding of the client’s values, beliefs, likes, dislikes, and abilities helps the caregivers to provide better support in the future. It can be utilised in every interaction and experience with clients. 
  • Additionally, it is essential to accept the person and their reality. Caregivers should understand the world from their client’s perspectives. It helps in developing a therapeutic and empathetic relationship with the clients. 
  • The caregivers should recognise the meaning engagement of their clients and support them. The engagement should be meaningful and purposeful for the individual living with dementia. The overall process should respect the interest and preference of the individuals and allow them to choose the appropriate alternative. It would offer comfort and meaningful life to the sufferers(Marchant, 2015)
  • The caregivers should always respect the individuality of the clients and treat them with dignity. It helps in creating of supportive and sympathetic relationship between the caregivers and users. 
  • The supportive environment offers comfort and opportunities to the clients. Therefore, it can develop a community that respect the values, individuality, and celebrates the occasions, offer the opportunities for autonomy, experiences and engagement (Fazio et al., 2018).    
  • It is essential to evaluate the care practice and make appropriate changes for better results. At present multiple tools are available to access the person-centered care for dementia patients. Therefore, regular practice of model and share the findings can help in bring positive changes in care plan of dementia patients (Fazio et al., 2018).    

At last it can be concluded that the individual living with dementia can live their life joyfully if proper care and services are available for them. In addition, the caregivers should also be capable of handling the patients with dignity and respect. It would motivate the positive communication and interaction between the caregivers and users. The emotional and physical support of the caregivers can eliminate the hurdles of dementia and the patients can live their life comfortably and contentedly.  

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