CHCAGE005 Progressive Neurological Condition Assignment Sample

• Subject Code : CHCAGE005
• University : Victoria University My Assignment Services is not sponsored or endorsed by this college or university.
• Subject Name : Nursing

Provide Support to People Living with Dementia - Part A

Provide Support to People Living with Dementia - Answer 1

 Dementia is not a disease but a syndrome of progressive neurological condition which the onset is slow but progressively and gradually gets worse with time including various symptoms of cognitive decline in adequate functioning, such as loss of memory, thinking ability, and behavioural changes. It is a symptom of several underlying brain disorders and diseases. 

Indicators and symptoms:

• Loss of memory: Patient starts facing problem in recalling things, phone numbers, places and time, and keeps repeating the questions multiple times.
• Behavioural changes: Stress, anxiety, aggressive behaviour, depression and disinhibition.
• Problem in communication: Finding difficulty in communicating and often misinterpreting conversations along with difficulty in understanding words and phrases.
• Sight and visual problem

Provide Support to People Living with Dementia - Answer 2

1. Amyloid plaques: Amyloid plaques are insoluble and hard agglomeration of beta amyloid proteins that forms cluster together between neurons in the brains of patients suffering from dementia.
2. Neurofibrillary tangles: These are insoluble twisted fibers present inside the cells of brain. These tangles contain tau protein, however, the tau proteins that are present inside the brain are abnormal and the structures of microtublule collapse in case of persons suffering with dementia.

Plaques presence around a neuron causes them to die, possibly by triggering an immune response in the immediate area. Tangles form inside of neurons and interfere with the cellular machinery used to create and recycle proteins, which ultimately kills the cell (BrightFocus foundation, 2015 ).

Provide Support to People Living with Dementia - Answer 3

Alzheimer’s disease: It is a progressive neurological disorder which results in the degeneration of brain cells. It is the most common cause of dementia which results in cognitive decline in functioning.

The key symptom of Alzheimer’s disease is memory loss (Mayoclinic, 2018).

1. Vascular dementia: Infarct means stroke, multi-infarct dementia or vascular dementia is the series small strokes i.e. blockage of blood supply over a small period of time (Medline plus, 2020).
2. Lewy bodies : Lewy body are made of abnormal deposits of alpha-synuclein in brain that causes Lewy body dementia (National institute of aging, 2020)
3. Korsakov Syndrome: It is a chronic memory disorder which is caused by severe deficiency of vitamin B-1, It is most commonly caused by excessive alcohol consumption (Alzheimer’s association, 2020).
4. Pick’s disease: It is a type of dementia that affects the parts of the brainwhich control behavior, emotions, personality, and language of a person. It is also known as frontotemporal dementia (WebMD, 2018).
5. Huntington’s disease: It is a progressive neurodegenerative disorder which shows gradual development of involuntary muscle movements which tends to affect hands, face and feet and shows progressive deterioration of memory.
6. Parkinson’s disease: It is a neurodegenerative disorder which is characterized by rigidity, slow movement, and tremor. Patient with Parkinson’s disease includes loss of nerve cells and aggregation of the alpha synuclein proteins in the form of Lewy bodies (Dakin, 2019).
7. Younger onset dementia: Younger onset of dementia is a term used when dementia develops in people who are under the age of 65 years.

Provide Support to People Living with Dementia - Answer 4

a. The five sign of the abuse in the older individual can be

• Agitation
• Isolation
• Unexplained bruises or scars
• Loss of weight for no reason (National Institute on Aging, 2016)

b) The first reporting after identification of the elderly abuse should be done to the National Centre on Elder Abuse. The organization aim to reduce the rate of the mistreatment occurring with the older individual to improve the mental and physical wellbeing. The organization increase awareness reading the elder abuse in professional and public that helps to reduce the rate of the elder abuse. The organization provide accurate training to the individuals that can be utilized to assist the individual in need (National Centre on Elder Abuse, 2020)

Provide Support to People Living with Dementia - Answer 5

The psychosocial intervention is one of the methods that can be utilized for the image enhancement that helps to improve the quality of life of the patient. The psychosocial intervention aims to improve the complication associated with symptoms and helps to reduce the agitation or wandering in the patient. The intervention is also considered to have a positive effect on the cognitive function of the individual that directly improve the quality of life of the patient. The person-centred approach will be utilized by the psychosocial intervention that aims to assist the patient according to individual need and preference (Johnston & Narayanasamy, 2016)

Provide Support to People Living with Dementia - Answer 6

• Depression: One of the most common symptoms that are associated with dementia is depression and it is associated with low mood, irritable, angry or anxious. The depression also disturbs the biological clock of the patient that includes loos of appetite, decreased energy and reduced sleep. The depression directly affects the patient family as they will get stressed due to deteriorated health of the patient. The depression directly leads to a decrease in social presence and reduced friend circle (Kitching, 2015).
• Grief and loss: Individual suffering from dementia faces loss and grief that directly lead to irritable mood and depression. The grief and loss directly increase feeling to die and increased negative thought. The grief and loss faced by the patient directly increase stresses of the family member as they try to improve the patient health. This behaviour decreases the social circle of the individual as no one wants to interact with dementia patient (Blandin & Pepin, 2017).
• Anger and despair: the increase complication of dementia leads to anger and agitation in the dementia patient that lead to over-stimulation of the expression. The loneliness can also trigger the agitation and anger in the patient. Anger and despair directly increase the reluctant of the family member with the patient due to irrelevant behaviour. The surrounding individual as stay from the patient due to the anger of the patient (Gale et al., 2018).

After the diagnosis of the patient with dementia immediately education should be provided to the family to understand how to help the patient and different method that can be used to assist the patient during any issue. The patient can be provided with caregivers as they can help the patient accurately due to their increase understanding regarding different complication associated with patient health (Supporting families to care for people with dementia, 2017). 

Provide Support to People Living with Dementia - Answer 7

The surrounding environment for the dementia patient should be built in such a way that helps to provide a safe and friendly environment. The good structure with a familiar space can help the patient to feel comfortable and it also helps to improve the mental wellbeing of the patient. The surrounding space should also help the patient to improve the deal with different things that can include outdoor space with accessibility toward the public space. The use of everyday technology should also be included that help the dementia patient to understand and utilize them for daily routine (Førsund et al., 2018).

Provide Support to People Living with Dementia - Answer 8

It is a method that can be utilized to decrease the confusion in the patient encountered with dementia by utilizing different aspect. The aspects that are used include people, place and time that help to increase the dementia patient understanding different aspect. The reality orientation can be one of the good supports for the dementia patient as it helps to reduce the confusion and improve the cognitive functioning of the individual (Camargo et al., 2015)

Provide Support to People Living with Dementia - Answer 9

Stability and familiarity help the dementia patient to reduce the adverse behavioural complication faced by the dementia patient. The supportive environment assists the patient during care and helps to improve the behaviour of the patient. Individual choice should be preferred during framing the surrounding environment so that it can increase the comfort and experience of the patient (Poulos et al., 2017).

Provide Support to People Living with Dementia - Answer 10

The care giver can get the information about the client by observing the pattern of symptoms shown by him and his activities by communicating with his family members.

Provide Support to People Living with Dementia - Answer 11

If a person is suffering from dementia, there must be something to enhance his cognitive ability so, form this we can identify the need of the patient.

Provide Support to People Living with Dementia - Answer 12

Behaviours of concern are behaviours of such frequency, intensity or duration in which the physical safety of a people are considered as a serious matter of concern to increase the quality of life (Betterhealth, 2020)

Provide Support to People Living with Dementia - Answer 13

Common behaviour of concerns are depression, aggression, and verbal outbursts. This can be triggered by medical, psychological, and environmental aspects such as medication side effects, unfamiliar caregivers, sensory overload etc

Provide Support to People Living with Dementia - Answer 14

Aggression can be de-escalated by respecting personal space, not being provocative, establishing verbal contact, being a good listener, and debriefing the patient (Richmond, n.d. )

Provide Support to People Living with Dementia - Answer 15

Behaviours of concern are considered to be the different type of behaviour of the individual and they are considered to be the challenging behaviour. Sometimes behavioural of concern can he negative for the individual that includes hurting themselves. Need driven behaviour include the different compromised behaviour individual encounter to attain or express.

Provide Support to People Living with Dementia - Answer 16

Evidence-based method is considered to be one of the techniques that can be utilized to plan the strategy for the dementia patient. The evidence-based practise help to provide the understanding of reading different technique that can be utilized to help the patient to reduce the behavioural issue. The evidence-based method provides the health care provider with the latest technology that can include in the plan to improve the care (Clemson, Laver & Jeon, 2018). 

Provide Support to People Living with Dementia - Answer 17

The evaluation of the impact of the different intervention strategies over dementia can be understood by analysing the patient condition. The physical examination can be performed to evaluate the cognitive functioning state of the individual that can help to understand the effect over the mental wellbeing of the individual. Evaluating the neuropsychiatric symptoms that can help to understand the actual state of the patient (Giguere et al., 2018).

Provide Support to People Living with Dementia - Answer 18

The verbal communication technique that can be utilized with dementia patient include

• Empathy
• Focus on the topic
• Value different cultural aspect of the individual

The nonverbal communication technique that can be used to deal with the dementia patient include

• Active listening
• Voice modulation
• Appropriate facial expression (Vogel et al., 2018).

Provide Support to People Living with Dementia - Answer 19

• Mindful training is one of the methods that can help the dementia patient to reduce stress and agitation. Acceptance and commitment therapy is utilized to decrease the stress of the patient and improve the mental wellbeing of the individual (Berk et al., 2018).
• Meditation therapy is also one of the methods that increase energises our brain and increase the positivity that can be utilized to reduce the stress and agitation in the patient. Meditation therapy helps to decrease the disturbance in the thought process and slow down the thinking process that helps to rescue stress. It also has a positive influence on the physical wellbeing of the individual and helps to improve patient recovery (Russell-Williams et al., 2018).
• Cognitive behavioural therapy is also one of the methods that can be utilized to reduce stress and agitation in the dementia patient. The therapy includes a different aspect that can be utilized to reduce the stress in the patient that include emotional-orienting training, behavioural training and stimulation-oriented treatments (Carrion et al., 2018).

Provide Support to People Living with Dementia - Answer 20

The caregivers during dealing with a dementia patient can increase the burden and stress that can directly hamper the care process of the individual.

• Sleeplessness
• Irritation
• Tiredness
• Anxiety
• Isolation
• Isolation (Penning & Wu, 2016).

Provide Support to People Living with Dementia - Answer 21

Yoga is one of the methods that can help to decrease the stress and improve the mental wellbeing of the individual. Yoga helps to improve the physical wellbeing and decrease the disturbance in the sleep pattern by improving the thinking pattern. Anxiety is one of the major that can increase the complication of the patient yoga helps to reduce the anxiety by improving the mental wellbeing (Cocchiara et al., 2018).

Provide Support to People Living with Dementia - Answer 22

Person-centred care is considered to be one of the best methods that can be utilized to reduce the recovery time of the patient. People with dementia face individual complication that directly increases the need for individualized care to provide accurate care. The person-centred approach help the care process to be tailor according to the individual current health status (Fazio et al., 2018).

Provide Support to People Living with Dementia - Answer 23

 Reporting requirements includes communication plan and analysis under which developing a plan is needed first which outlines the strategies for communicating and then analysis of the report (Better Evaluation, n.d.)

Provide Support to People Living with Dementia - Part B

a) Issues faced by Marcus: Marcus is suffering from dementia which leads to multiple issues faced by him such as loss of memory, anxiety, irritation and some odd behaviour such as eating with open mouth, feeling of embarrassment and detachment.

Issues faced by Marcus’s family: The family is stressed after knowing that Marcus is suffering from dementia. The family members has started feeling ashamed and embarrassed for the odd characteristics shown by him and sometimes get frustrated for his annoying behaviour of forgetting things and asking multiple times for a single thing.

b) Person suffering from dementia suffer with loss of memory, cognitive thinking, disorientation, they often lose the ability to speak or hold conversations, find difficulty in walking and swallowing, and find difficulty in recognizing people and places. A person suffering from dementia also faces emotional challenges such as aggression, paranoia, hallucination, suspicion, boredom and loneliness (Live better with, 2015).

Not only the patient but the family members and the caregivers also face issues such as it becomes overwhelming and overburden for them. It becomes physical, emotional and financial pressure for them which leads to immense stress for family members as well as caregivers (World Health Organization, 2020). According to Brooks (2015), Family members who provide care to the person suffering with dementia had negative impact on their health both physically and mentally. It leads to stress, depression, anxiety, and hypertension.

c) The patient suffering with dementia shows changes in their behaviour and personality and the family of the patient should be aware of this, below is the list of things a support worker can say in order to explain the changes in Marcus are due to having dementia: The support worker can compare the symptoms of dementia with the symptoms shown by the patient and make everything clear to the family members and let them know that forgetting things and places and the odd behaviours shown by Marcus is a matter of concern and are due to dementia. The family members may also become hopeless and feel the emotional stress but pointing the family members in right direction is the core duty of support worker. The support work should explain the diagnosis and the process of their medical and care management.

d) In development of a care plan for Marcus, family members can also provide some important information to the support service by letting them know about the things and the tasks which patient find difficult to do, how often the patient forgets things and places, changes shown in the behaviour of Marcus so, that it become easy for the support service to develop an appropriate care plan.

e)

i) It has been shown that patients who have more independence in performing task of day to day life such as bathing, dressing and toileting leads a better quality of life. To ensure this it is important to maintain their independence as long as possible. To maintain Marcus’ independence following interventions would help:

• Physiotherapy- A physiotherapist reduces the burden of care by offering individually tailored techniques and educating the caregivers about them and promotes the independence in patients with dementia.
• Encouragement for participating in daily activities.
• Focusing on patient’s ability
• Providing opportunities for social engagement
• Creating comfortable and safe environment to reflect the patients’ personality and preferences (Medcom, 2016).

ii) Person with dementia find difficult to communicate, their verbal skills decline and they often forget the meaning of words and phrases and tries to communicate by pointing at the objects a

communicate with him, it is necessary to call him by his name repeatedly throughout the conversation so that Marcus tends to refocus and feel involved. Maintaining eye contact and listening carefully while communicating are one of the most important factors as patient with dementia needs undivided attention, and speaking gently will be effective while communicating with him.

iii) Marcus is a dementia patient and is stressed most of the times, to provide him reassurance first, it is necessary to identify the cause of his stress at that moment, calming him, giving him personal comfort, shifting his focus to a different activity and giving him support, care, and medication will help him to calm down.

f) Activities such as recalling the old memories, fostering emotional connections, self encouragement, engaging him with different tasks of house, some exercise and meditation, taking Marcus on walks, and making him feel productive will help him to meet his individual needs.

Reference for Provide Support to People Living with Dementia

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