Qualifi Level 3 Diploma in Health and Social Care – HSC307: Understanding Dementia Care Assignment Brief

 Table of Contents

Introduction. 3

Task 1: Understand the causes and effects of dementia. 3

AC 1.1: Discuss the reasons for increase in dementia in the population. 3

AC 1.2: Explain the signs and symptoms of dementia. 3

AC 1.3 Discuss the effects of a dementia on individuals. 3

Task 2: Examine the investigations associated with diagnosis dementia. 4

AC 2.1 Compare and contrast the available investigations associated with diagnosis of dementia. 4

AC 2.2 Assess the strengths and weakness of these investigations. 4

Task 3: Examine the treatment and support available for service users with dementia and their families. 5

AC 3.1 Explain the treatment and support available for service users when initially diagnosed with dementia. 5

AC 3.2 Discuss the long-term complications associated with dementia. 5

AC 3.3 Explain the treatment and support available for service users at the end stages of dementia. 5

AC 3.4 Explain the support available for families with relatives with end stage dementia. 5

Conclusions. 6

Bibliography. 7

Introduction

The focus of this assignment is on the various aspects of dementia care, encompassing causes, effects, diagnosis, treatment, and support systems for both individuals with dementia and their families. Dementia, a chronic and progressive condition, significantly impacts cognitive, emotional, and physical functioning. This paper aims to discuss the factors contributing to the increase in dementia cases, the signs and symptoms, and the diagnostic methods. Furthermore, it delves into the treatment options and the necessary support structures for individuals at different stages of dementia, especially during the end-of-life phase. Families play a vital role in dementia care, and the assignment also explores the emotional and practical support available to them.

Task 1: Understand the causes and effects of dementia.

AC 1.1: Discuss the reasons for increase in dementia in the populati78375080″>on.

Dementia being a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life has been in large increase in the population. Alzheimer’s is the most common cause of dementia. Dementia has become a major health problem because of the worldwide increase in elderly populations, especially those 80 years of age or older. (Skoog, I., et al., 1993) Factors or reasons causing the increase in dementia in populations are as follows:

Aging Population: Due to increase in life expectancy because of advancement in healthcare enabling people to attain older ages, and a lot of people entering their older years this has caused a great increase in dementia in the population. Studies have shown that Alzheimer and vascular dementia subtypes, the prevalence rates did not differ between men and women but increased with age. (Prencipe, M., et al.,1996)

Lifestyle and Environmental Factors: Unhealthy diets leading to cognitive decline, physical inactivity which poses a risk of chronic diseases, social isolation contributing to faster cognitive decline and sleep disorders od disturbances can interfere with the brain’s ability to clear amyloid proteins, which are implicated in Alzheimer’s disease. playing leisure activities including sports (without trauma), higher educational attainment and higher adherence to Mediterranean DASH-Intervention for Neurodegenerative Delay (MIND) diet appeared to reduce the chances of having dementia. (Bosi, M., et al., 2022)

Chronic Health Conditions: Hypertension reducing blood flow to the brain increases the risk of vascular dementia, type 2 diabetes have also been connected to cognitive decline and dementia. Chronic inflammation in the body due to infections also increases the risk of developing dementia. (Villemagne VL, et al., 2013)

Increased Awareness and Improved Diagnosis: As technology in diagnosing diseases continues to improve, it has increased the earlier detection of dementia leading to a greater number of diagnosed cases. Moreso, as the awareness is growing, individuals are seeking medical evaluations of memory loss and cognitive issues.

Genetic and Biological Factors: Genetic factors like APOE ε4 gene can also be a contributing factor that increases the risk of Alzheimer’s disease. As people grow old, their brains shrink in certain regions, neuron loss associated with Alzheimer’s disease. (Loy, C.T., et al., 2014)

Socioeconomic Factors: Lower levels of education have been found to be connected to with an increased risk of dementia. Healthcare being inaccessible leading to chronic diseases which are not managed effectively have been found to also contribute to increasing dementia in the population. Studies have shown that Alzheimer and vascular dementia subtypes were higher in subjects with a low level of education. (Prencipe, M., et al.,1996)

AC 1.2: Explain the signs and symptoms of dementia.

Dementia has different cognitive, behavioural and physical signs and symptoms that gets worse over the time. Alzheimer’s disease typically manifests itself as two syndromes that are frequently intertwined, one cognitive, the other behavioural. The behavioural syndrome is a combination of psychosis, aggression, depression, anxiety, agitation and other common but less well-defined symptoms. (E. Mintzer, J., et al., 2000). The signs and symptoms are explained as follows:

Memory Loss: This is one of the most noticeable sigs of dementia. This happens with people forgetting information and being unable to remember where they kept things. This memory loss may degenerate into long-term memory issues which involves people being unable to remember their history or past events and recognizing family members.

Difficulty with Communication: This happens when people have difficulty in finding the right word to use in communication, repeating questions or stories, and inability to understand complex languages.

Disorientation and Confusion: People with this disease may lose track of time, get lost and have trouble finding their way even in familiar environments.

Problems with Planning and Organizing: Decision making abilities begin to reduce with people having dementia, doing everyday activities also becomes difficult.

Personality and Behavioural Changes: People with dementia experience rapid mood changes, a loss of interest in social activities, restlessness and aggressive behaviour, repeating the same actions (such as folding papers, pacing or collecting objects).

Changes in Coordination and Motor Function: being unsteady leading to frequent falls, and movement symptoms such as stiffness, tremors or a shuffling gait which occurs in people having Parkinson’s disease dementia and Lewy body dementia are also sigs of dementia.

Hallucinations and Delusions: People with Lewy body dementia may experience hallucinations (seeing and hearing things that are not there), some others may hold false belief (like thinking their carer is stealing from them).

Emotional Instability: in the early stages of dementia many people with dementia experience feeling of sadness, hopelessness, or anxiety which arises from confusion and disorientation.

AC 1.3 Discuss the effects of a dementia on individuals.

Dementia is a progressive neurological condition that affects individuals across multiple areas of their life. It leads to cognitive decline, including memory loss, impaired judgement, disorientation, and language difficulties. Emotionally, individuals may experience personality changes, mood swings, depression, and anxiety. Physically, dementia impacts motor skills, coordination, and mobility, often resulting in increased dependency on caregivers for daily activities.

Socially, individuals with dementia may withdraw from social interactions, leading to isolation and strained relationships. The loss of independence and identity can be deeply distressing, as individuals increasingly rely on caregivers for personal care. As the disease progresses, it raises challenges to dignity, increases health risks, and often necessitates palliative care in the later stages.

Overall, dementia significantly affects the individual’s cognitive, emotional, physical, and social well-being, requiring ongoing support and care from caregivers and healthcare providers.

Task 2: Examine the investigations associated with diagnosis dementia.

AC 2.1 Compare and contrast the available investigations associated with diagnosis of dementia

Clinical and Cognitive Assessment: This involves doing a clinical history by evaluating their memory, behaviour, functional abilities, and checking underlying conditions like depression. Another form of investigation under this is the cognitive screening tests which has to do with a quick assessment to evaluate their memory, attention and language. The advantage of this investigations is that it is simple, quick, widely available and they provide a holistic understanding of the patients cognitive, functional and behavioural status. It has its limitations in that it relies on the patients’ caregivers accounts, and it is not very sensitive in early dementia or in individual with higher education.

Laboratory Investigations: Blood tests for thyroid function, vitamin B12, folate levels and liver and kidney function tests are carried out in this investigation. Cerebrospinal Fluid (CSF) for amyloid-beta, tau and protein used in supporting the diagnosis of Alzheimer’s diseases are also carried out in the laboratory. Advantage of laboratory investigations is that it helps identify reversible causes of dementia-like symptoms and its high sensitivity and specificity for Alzheimer’s disease. It is useful for in differentiating between types of dementia. It has its limitation in that it cannot diagnose dementia but helps rules out other conditions that mimic cognitive impairment, and it is also invasive and uncomfortable for patients.

Neuroimaging: This uses a CT scan which is a non-invasive imaging technique used to detect structural changes such as brain atrophy, strokes or tumours. MRI tests which provides more detailed images of  brain structure, showing more atrophy patterns specific to certain types of dementia, such as Alzheimer’s or vascular dementia. The CT scan is quick and relatively inexpensive while the MRI test is more superior. The CT scan is limited in its lower resolution compared to the MRI test and its inability to differentiate between different types of dementia. MRI tests are very expensive.

AC 2.2 Assess the strengths and weakness of these investigations

Task 3: Examine the treatment and support available for service users with dementia and their families.

AC 3.1 Explain the treatment and support available for service users when initially diagnosed with dementia.

There is various support available to service users who are diagnosed with dementia, ranging from combinations of treatment and support to help manage conditions and maintain the quality of life of those service users. Some of these treatment and support include medical treatment which involves offering cholinesterase inhibitors (e.g., Donepezil, Rivastigmine) to boost their levels of acetylcholine, a chemical that helps with memory and judgment and memantine to regulate glutamate activity to help with cognition, they may also be offered counselling to help them with the diagnosis and provide a platform to share experience and receive encouragement from others in similar situations. Other Supports and treatment include educating the service users and their caregivers about dementia, its progression and ways to manage daily challenges. Service users can also be encouraged to have balanced diet, exercise daily, adjusting their home to improve safety and support independence, such as using visual cues, labelling and simplifying the living space. Carers can also be offered training on how to manage the symptoms of dementia, offered temporary relief, allowing them to rest and recharge while ensuring the person with dementia is still being cared for, creating avenue for like local and online support groups for carers to share their experiences. Service users should have regular monitoring by healthcare professionals to help track the progression of dementia and adjust treatment as needed.

AC 3.2 Discuss the long-term complications associated with dementia.

Dementia is a chronic and progressive condition that affects cognitive, emotional, and physical functioning over time. As the disease advances, individuals with dementia experience a range of long-term complications that significantly impact their quality of life and require continuous support. Some of these complications include memory deterioration which becomes more pronounced making it more difficult for individuals to recall events, making poor decisions and making individuals with dementia often struggle with speaking and understanding language, making communication more difficult. They may also experience behavioural changes like becoming aggressive, anxious, depressed agitated or having verbal outbursts, these behaviours can increase their risk of harm or injury. They may also have physical decline resulting to problems with balance, coordination and walking, and leading to difficulties in eating, loss of bladder and bowel control. Incontinence and poor hygiene can lead to recurrent UTIs, which can worsen cognitive symptoms. Individuals will require full-time care in the later stages of dementia due to their cognitive and physical impairments and posing physical and emotional exhaustion on caregivers. It also poses end of life complications like individuals requiring palliative care to manage pain and other symptoms and leading to many individuals dying from complications such as infections, malnutrition or the effects of physical decline.

AC 3.3 Explain the treatment and support available for service users at the end stages of dementia.

At the end stages of dementia, treatment and support are primarily focused on comfort, managing symptoms, and ensuring quality of life for the service user. Some of the treatment and support available in these last stages of dementia include palliative care which focuses on relieving symptoms such as pian or manage behavioural symptoms, at this stage care is also centred on comfort like repositioning to prevent bedsores, providing comfortable bedding ensuring they are not experiencing discomfort. They will also be supported with activities of daily living like feeding, personal care, mobility and repositioning to prevent malnutrition, maintain dignity and prevent infections and prevent pressure sores. They may experience fear, anxiety or agitation, hence would need constant reassuring, a calm environment and familiar objects to soothe their emotional distress and they would need to be communicated in ways that are meaningful for the individual such as through touch, facial expression, and non-verbal cues to understand the person’s needs. Those nearing end-of-life are usually supported with hospice care for their dignity and comfort during their final days of life. Support is also available for families by counselling them and providing emotional support to help them cope with the emotional toll, and respite for care givers, providing them with time to rest while their loved one continues to receive care. Spiritual supports are also provided for families who find comfort in spiritual practices. They are also supported with regular monitoring and to prevent infections like urinary tract infections (UTIs) and managing complications that comes with it

AC 3.4 Explain the support available for families with relatives with end stage dementia.

Several support systems are available to help them navigate these difficult times. Supports from counselling and therapy to bereavement services exist for families with relatives with end stage life dementia. Families’ can access professional counselling to help them manage grief and emotional turmoil. Organizations like Alzheimer’s Association also offers support groups where families can share experiences, receive advice. Caregivers are given short breaks from their responsibilities to attend to personal matters. Practical support and hospice and palliative care are also available for families with relatives with end stage dementia. Families also receive education on how to manage the symptoms, provide comfort and understanding what to expect during end-stage dementia

Conclusions

This assignment has explored the complexities of dementia care, emphasizing the need for a holistic and person-centred approach to support both individuals living with dementia and their families. It has addressed the importance of early diagnosis, effective treatment strategies, and the provision of continuous care, particularly as the disease progresses towards its later stages. The role of family support and the integration of healthcare professionals remain pivotal in managing the long-term complications associated with dementia. Ultimately, a compassionate and informed approach is essential to enhancing the quality of life for individuals with dementia and ensuring their dignity and comfort throughout their journey.

Bibliography

Provide list of references in Harvard Style.

Skoog, I., Nilsson, L., Palmertz, B., Andreasson, L.A. and Svanborg, A., 1993. A population-based study of dementia in 85-year-olds. New England Journal of Medicine, 328(3), pp.153-158.

Langa, K.M., 2018, June. Cognitive aging, dementia, and the future of an aging population. In Future directions for the demography of aging: Proceedings of a workshop (pp. 249-268). Washington, DC, USA: National Academies Press.

Villemagne VL, Burnham S, Bourgeat P, et al. Amyloid’s deposition, neurodegeneration, and cognitive decline in sporadic Alzheimer’s disease: a prospective cohort study. Lancet Neurol. 2013; 12(4): 357-367.

Prencipe, M., Casini, A.R., Ferretti, C., Lattanzio, M.T., Fiorelli, M. and Culasso, F., 1996. Prevalence of dementia in an elderly rural population: effects of age, sex, and education. Journal of Neurology, Neurosurgery & Psychiatry, 60(6), pp.628-633.

Bosi, M., Malavolti, M., Garuti, C., Tondelli, M., Marchesi, C., Vinceti, M. and Filippini, T., 2022. Environmental and lifestyle risk factors for early-onset dementia: a systematic review. Acta Bio Medica: Atenei Parmensis, 93(6).

Loy, C.T., Schofield, P.R., Turner, A.M. and Kwok, J.B., 2014. Genetics of dementia. The Lancet, 383(9919), pp.828-840.

Mintzer, J., F. Mirski, D. and S. Hoernig, K., 2000. Behavioral and psychological signs and symptoms of dementia: a practicing psychiatrist’s viewpoint. Dialogues in clinical neuroscience, 2(2), pp.139-1

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