Alzheimer's disease- an abnormal protein surrounds brain cells and another protein damages their central structure. In time brain cells gets lost and starts to die. Vascular dementia- is when nerve cells in brain doesn’t receive enough oxygen from blood the nerve cells dies. Mixed dementia- is when Alzheimer's disease and vascular dementia is together. Lewy bodies- is when a little clump of protein develops inside the brain cells, and it damages the way cells works and communicates with each other and starts to die. Causes of frontotemporal dementia- usually it is diagnosed for a younger people. When the clumps of protein damages nerve cells in the frontal and temporal lobes, makes brain cells to die. Sometimes it could be genetic trough families as well.
People with dementia can have a short-term or a long-term memory loss. Short-term is when they forget something that’s happened just recently or even straight away. Long-term is when they forget something that’s happened long time ago. Sometimes it can include communication as well. There are some examples of what my clients meets every day: forgetting day-to-day events, day, month or time of year, forgets time of day, sometimes they forgets if they were eating or drinking, forgets how to do a personal care and why they need it, might repeat the same question or quotes over and over again, sometimes they can struggle to remember their family members, their names, where they keep things, which room is which and etc. With memory impairments an individual's behaviour can change as well, their mood might swing, as sometimes they can’t recognise people, they might get scared. But there are people, who can remember what happened long time ago, and repeat the words and situations from that day.
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Always make sure that speaking clearly and slowly, that there is no distractions, such as: tv or radio on. As sometimes for an individual that has a dementia is harder to concentrate, always make an eye contact, give them longer time to respond. Sometimes you need to use body language or even a physical contact when you need to show something and explain. For example, if person is hungry and wants to eat the breakfast, but recently forgot how to hold a spoon, you need to gently put the spoon into their hand, you need to show and explain how to hold it.
There is many other factors that can cause changes in an individual’s condition, that may not be attributable to dementia, such as: Urine or chest infection, Depression, side effects from medication, brain injury, stroke, lack of sleep.
All people has better and worse days, it is the same with people who has dementia. They go up and down. For example, they can go down, if they feel lonely and left alone, if medication has been changed- or it has side effects, if they experience and abuse, if has chest or urine infection, or any other illnesses, also if always has different people visiting them. But sometimes they can have better days, for example: if they feel safe, receives the right treatment, if they see their loved ones regular, if they see the same carers, or if they do activities that they enjoy.
It is very important that dementia is diagnosed as early as possible, as an individual and its family can get prepared for it, receive all information, plan their treatment, their care, receive the right medication. While an individual is able to make decisions by itself, can explain their wishes, help to prepare a correct care plan, and explain likes and dislikes. Can make its own financial decisions. As early it diagnosed, better it is, as people can find the ways to live with it easier, and longer as independently as they can, in their own homes.
It is very important to record possible signs or symptoms of dementia in an individual in line with agreed ways of working, as if an individual has no diagnosed dementia it can be beginning of signs and person must see a doctor before it got worse- and to receive the right treatment. Also it can have more other illnesses, such as chest or urine infection, depression, illnesses that need to be dealt with. If person already has dementia, it all needs to be recorded, as an individual might require extra support, or even has more illnesses that needs to be checked. When recording must be written, signed, dated and timed. If symptoms are seen, and left without sorting by a support worker, it can even lead to prison.
If there is any signs or symptoms of dementia we must report it to the manager, to organisations that deals with it with all records of changes, pass the information to GP, so they can do the memory test and physical examination, also they could do a blood test incase the symptoms are from something else.
Diagnosis of dementia can be very scary and upsetting for an individual, its family and friends. They all can go through five stages, such as: denial, anger, bargaining, depression and acceptance. The stages might not go in a row and might miss some of stages. Person with diagnosed dementia might think what would be done to avoid this or even feel guilty. Family might feel exactly the same, they might feel guilty, that they haven't noticed it before, they might feel low and sad, as they don’t know how to help and handle this situation. They might be scared as sometimes people with dementia they forget their family members. Family needs to to give and prepare all supports for they loved one. But however, with time going people go through acceptance, and they can get all information and other help for support.
Person centred approach to dementia care, is when client is treated with respect and dignity, when an individual is placed at the centre of everything and is involved in their care planning. When the care is provided the way an individual wants, with no pressure a client feels happier and safer. But non-person-centred approaches- Is when care provided, the way that someone else thinks it is good for a patient, without listening to their wishes and needs. Basically, is more about how easier to provide a care and complete daily tasks, not involving a client. But more usually it can lead to neglect.
For example: A carer has a bed visit at 7pm, and assists person into the bed, but client gets unhappy and upset, as she didn’t leave the tv on, as she hasn't checked a notes and person is not able to tell by himself. And after few more days patient started to be aggressive and refused to go to bed, as couldn’t explain what's wrong. If person would be in centre of everything, they wouldn’t have this situation.
A client doesn’t like a fish and everyone is buying and heating up the meals of fish as they don’t ask, and the client don’t eat it, carers started to think that person has eating problems, but if that would be a person centred approach, an individual would eat more, as could say what he likes to eat, when choice is given. If person couldn’t speak there would be some notes in the care plan.
There is many different teqniques that can be used to meet the fluctuating abilities and needs of the individual with dementia, for example if person forgets to complete a personal care but is able to do it by itself a carer can remind it to them and assist without doing it for them. Or id person forgets what is planned for a day, always can use a calendar with small notes, for example: doctor appointments, family visits, activities. Also, if person forgets which room is which or where things are always can stick notes with titles. Most important is always to keep care plan up to date and follow it.
Lots of people thinks if person has dementia, they will lose their mind, ability to communicate, that they will forget everything, but sometimes an individual is exactly the same thinking as everyone else, but might have a little mood swings, or forgets some of the things and etc. Myths and stereotypes may affect an individual by making their life harder. For example: if family, friends or carers will think that an individual don’t understand, or will forget they might treat an individual with neglect. For carers people might say how you can deal with people that has dementia, they are aggressive, they mood is changing all the time and its very unsafe. But most of the people with dementia they are nice and friendly, and it doesn’t mean that if you have dementia you are aggressive. People with dementia is the same people that we all are. So, it can affect everyone, an individual, carers, families. if there wouldn’t be so many myths and stereotypes, maybe we would have more carers helping people.
There is many ways that individuals, families and carers can be supported to overcome their fears, such as: books, leaflets, internet websites, but it must be up to date. Also, families and individuals can get a support from GP, medical centres. If an individual is not able to complete daily tasks, can get a full support from domiciliary care companies. Carers can get support from manager, or by completing trainings up to date.
Causes of frontotemporal dementia- usually it is diagnosed for a younger people. When the clumps of protein damages nerve cells in the frontal and temporal lobes, makes brain cells to die. Sometimes it could be genetic trough families as well.
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