1.1 Explain what is meant by the term ‘Dementia’
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The word dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problem solving or language. These changes are often small to start with but for someone with dementia they have become severe enough to effect daily life. A person with dementia may also experience changes in their mood or behaviour.
1.2 Describe the key functions of the brain that are affected by dementia. The key functions of the brain that are affected by dementia are
Temporal Lobe – Responsible for vision, memory, language, hearing, learning. Frontal Lobe – Responsible for decision making, Problem solving, controlling behaviour and emotions. Parietal Lobe – Responsible for sensory information from the body, also where letters are formed, putting things in order and spatial awareness. Occipital Lobe – Responsible for processing information related to vision. Cerebrum Lobe – This is the biggest part of the brain, Its role is memory, attention, thought and our consciousness, senses and movement. Hippocampus – Responsible for memory forming, organizing, storing and emotions.
1.3 Explain why Depression, Delirium and age related memory impairment may be mistaken for Dementia.
Delirium, Dementia and Depression are disorders that are often confused by care-givers as they are complex and patients can be afflicted with more than one of the conditions at the same time. Although often coincidence they are entirely separate conditions.
Delirium is an acute but reversible state of confusion occurring in up to 50 percent of older post-surgical patients. Dementia is an irreversible decline of mental abilities which affects 5-10 percent of the population over age 65, with incidence doubling every 5 years after 65.
Depression is a mood disorder which affects 16 percent of the population although it is often unrecognised.
2.1 Outline the medical model of dementia
The medical model focuses on the impairment as the problem and focuses on a cure, these may be dependency, restriction of choice, disempowering and devaluing individuals.
2.2 Outline the social model of dementia.
This is personal centred, focusing on the rights of the individual, in turn empowering the individual, promoting independence, giving choice and looking at what the individual is able to do.
2.3 Explain why dementia should be viewed as a disability.
Individuals who have dementia are not aware of requirements for living. They can forget to do the essential things that are vital. Taking medicines, hygiene and even eating are often forgotten. They can get lost or hurt and not understand what is necessary to correct a situation. Individuals cannot act in the manner of a responsible adult which is why dementia should be viewed as a disability.
3.1 List the most common causes of dementia.
The most common causes of dementia are –
Alzheimer’s disease – This is the most common cause of dementia. During the course of the disease, the chemistry and structure of the brain changes, leading to the death of brain cells.
Vascular Dementia – If the oxygen supply to the brain fails, brain cells may die. The symptoms of vascular dementia can occur either suddenly, following a stroke, or over time, through a series of small strokes.
Dementia with Lewy Bodies – This form of dementia gets its name from tiny spherical structures that develop inside nerve cells. Their presence in the brain leads to the degeneration of brain tissue.
Fronto–temporal Dementia – In fronto-temporal dementia, damage is usually focused in the front part of the brain. Personality and behaviour are initially more affected than memory.
3.2 Describe the likely signs and symptoms of the most common causes of dementia. Dementia is a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal aging and are severe enough to impact daily living, independence, and relationships. With dementia, there will likely be noticeable decline in communication, learning, remembering, and problem solving. These changes may occur quickly or very slowly over time. The progression and outcome of dementia vary, but are largely determined by the type of dementia and which area of the brain is affected. Diagnosis is possible through advanced brain imaging, clinical examinations, and diagnostic testing.
3.3 Outline the risk factors for the most common causes of dementia.
The greatest known risk factor for Alzheimer’s is advancing age. Most individuals with the disease are age 65 or older. The likelihood of developing Alzheimer’s doubles about every five years after age 65. After age 85, the risk reaches nearly 50 percent. One of the greatest mysteries of Alzheimer’s disease is why risk rises so dramatically as we grow older. Another strong risk factor is family history. Those who have a parent, brother, sister or children with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. In general, the risk factors for vascular dementia are the same as those for heart disease and stroke. Risk factors for vascular dementia include: Increasing age. History of heart attack, stroke or mini strokes. Atherosclerosis. High cholesterol. High blood pressure. Diabetes. Smoking and Atrial fibrillation. Although the cause of Lewy body dementia isn’t clear, several factors appear to increase the risk of developing the disease. They include: Being older than 60. Being male & having a family member with Lewy body dementia.
Many degenerative neurological diseases do not have a strong genetic component, but Fronto–temporal Dementia is believed to be an exception, with a high familial component compared to other instances of dementia. Unlike in other forms of dementia, however, there are no nutritional deficiencies or other habits that increase the likelihood of developing Fronto–temporal Dementia. Instead, risk factors for developing Fronto–temporal Dementia include: Mutations in the MAPT and/or GRN genes of chromosome 17, a family history of Fronto–temporal Dementia.
3.4 Identify prevalence rates for different types of dementia.
The Prevalence’s of Alzheimer’s disease, vascular dementia, Parkinson’s disease dementia, and other dementias – Overall, 72% of the dementias were of Alzheimer type, 16% were vascular dementia, 6% were Parkinson’s disease dementia, and 5% were other dementias.
4.1 Describe how different individuals may experience living with dementia depending on age, type of dementia, and level of ability and disability. Dementia is not a disease but a set of symptoms which decreases the ability to think, memory and communication skills of human beings. It also declines the skills that needed to carry out daily activities. There are many causes of dementia. Few are : · Alzheimer’s disease · Vascular disease · Lewy body disease · Front temporal disorders · Parkinson’s disease · Depending on the form of dementia people’s ability and disability fluctuates. It is not necessarily to think that people with dementia are always forgetful. Like, people with Fronto-temporal dementia are very less forgetful than Alzheimer disease. Their memory remains intact but their personality and behaviour noticeably changes.
Dementia with Lewy bodies interrupts the brain’s normal functioning and affect the person’s memory, concentration and speech skills. It has similar symptoms to Parkinson’s disease such as tremors, slowness of movement and speech difficulties. People with vascular dementia may suffer from incontinence or seizure where other types of dementia may not affect those. However level of ability and disability depend on individual’s age and condition of dementia. People who are living with dementia in earlier age such as 60’s-70’s are less dependable than people living with dementia at the age or over 70’s or 80’s. People have different stamina in different ages. So, their ability and disability fluctuated and level of support are varied as well 4.2 Outline the impact that the attitudes and behaviour of others may have on an individual with dementia
Dementia can have a big impact on a person’s behaviour. It can make them feel anxious, lost, confused and frustrated. Although each person with dementia handles these feelings in their own way, certain behaviour is common in people with the disease. This includes:
• repeating questions or carrying out an activity over and over again
• walking and pacing up and down
• Aggression, shouting and screaming
• becoming suspicious of other people
If you are experiencing these behaviours, or are looking after someone who behaves in this way, it’s important to remember that this is an attempt to communicate how they’re feeling and that they are not being deliberately difficult. If you stay calm and work out why they’re expressing themselves in this way, you may be able to calm them down.