Dementia Conclusion

This concludes that Dementia is an emerging issue as life expectancy is increasing. It requires further funding within the UK to improve facilities that are available to individuals suffering from Dementia and to also increase diagnosis, and to be able to diagnose patients as early as possible. The media has increased awareness of the disease, and the concern that with life expectancy increasing there will be more individuals suffering with it. The media also has a negative impact due to the reporting of the negative issues surrounding Dementia, changing the public’s perceptions of the illness and further cementing the stigma that is attached. It has resulted in the government recognising that new legislation and policy is needed, with the aim of increasing the quality of care and support available for the individual and their family.

What are the major issues that are surrounding Dementia ?

Dementia is a major public health issue in Wales, there are approximately 42,000 people in Wales who have Dementia. It currently affects one in every twenty people over the age of 65, and one in five over the age of 80. As life expectancy increases, there will be more people who will have Dementia. There are many actions in place to deal with the increase of Dementia. The Minister for Health and Social Services announced the action that would be taken to improve dementia services and agreed new funding to support implementation of the dementia action plans.The NHS and the government wish to make available early diagnosis and effective person centred health and social care whether this is provided by statutory, independent or voluntary sectors. 

When an individual is diagnosed with Dementia it is an extremely stressful time for both the person and their families. There are many charities and organisations that are able to offer support and be able to talk to other individuals and families that are in the same situation. Many people find this beneficial as they do not feel like they are dealing with it on their own. With charities and websites such as Alzheimers.org.uk and dementiauk.org/ there are many online support groups, blogs so that individuals are able to write down their feelings and personal experiences. There are also many factsheets available regarding the illness itself for the families to be able to support their loved ones.

The Government issued a policy in 2013 from the Department of Health detailing actions that they want to initiate. They plan to increase diagnostic rates, making sure that doctors give 65 to 74 year olds information about memory services as part of the NHS health check programme, and refer them for assessment if needed. They planned to set aside one million pounds for innovative NHS projects and launching a new toolkit that will improve support for GP’s.

 

How is Dementia portrayed in the Media ?

Dementia has been frequently in the media over recent years, with a 2011 survey finding that 31% of people feared dementia more than death and cancer .A lot of the media coverage regarding dementia is devoted to new developments in our scientific understanding of the disease, what can cause dementia and potential new treatments. There are many different media angles, with some reporting credible and factual information, and others reporting claims that do not have any credible evidence backing the information up.

All of these types of media can have an impact on how people perceive the disease and how much panic is distilled in the reader. There are many factors that can depend on the media effect on society, timing if a celebrity has been in the papers having been diagnosed with a certain disease, other articles regarding the disease may have a greater impact on individuals as it is already in their thoughts. Few spokespeople from medical, research or nursing backgrounds could have the positive impact that such public disclosures by well-known people with dementia have. With high media access such figures enable greater understanding of dementia and its influence on lives, and in doing so they challenge the negative stereotypes that breed fear and shame and instead foster understanding and acceptance. People who have been diagnosed with dementia can read about celebrities or well-known people in the media, and feel more positive about having the disease, and feel empowered.

Dementia within the media is usually portrayed negatively, with newspapers such as The Independent and The Guardian being of more relevance due to them using factual information meaning that their articles are not biased. An article in The Guardian recently released plans that the NHS plan to give General Practitioners cash for diagnosing dementia. This is a terrible disease that is challenging for family members to overcome and for the individual who has been diagnosed, this form of reward that the NHS plan to give GP’s has been criticised as ‘ethical travesty’ and it can lead to many miss diagnosis of the disease. People who are against the scheme claim that the fees risk undermining the bond of trust between doctors and patients.

An article in The Mail on Sunday by Simon Walters based on an Independent Report implements the negative view society has on Dementia patients and care homes. A hospital Glan Clwyd where abuse and neglect was evident, is what the report is based on. There was evidence of patients being restrained with chairs, having broken limbs ignored and not reported, all of this negative press portrays negative views to the public and for individuals to not want to go into care homes, when the dementia has progressed and they need 24 hour care due to the negative views of the general public. The National Service Framework for Older People identified certain concerns which professionals need to address when providing care to older people.

http://www.bbc.co.uk/news/health-20727157

How is Dementia a concern for the public ?

Funding for dementia is incredibly low, despite dementia costing the UK economy £23 billion a year. Dementia also creates a huge amount of cost for individuals and families that are affected by it. Dementia affects over 830,000 people within the UK, with around 23 million of the UK population having a friend or relative with the disease. Worldwide, dementia affects around 25.6 million people, this number is believed to double by 2030, and triple by 2050. It affects 1% of the population by age, the prevalence then doubles every 5 years to affect 30% – 50% by age 85.

Governments and consumer groups worldwide are concerned with how to best provide care for people with dementia. This concern is part influenced by the cost of dementia care. Wilson and Fearnley have described dementia as an ‘epidemic’ costing more than cancer, stroke and heart disease put together in the UK. This is in a sense a return to images promoted in the 1980’s of a ‘rising tide’ of people with dementia, and could be interpreted as a ploy adopted by lobbyists to bring attention to dementia and in turn the need for funding and resources for research and care services; a ploy that has reported success elsewhere, for example in North America.

 Dementia is believed to be come one of the key health challenges for this century, but how to provide the best support and care systems remains a challenge. This is in part due to a lack of theoretical development in the field that would clearly conceptualise dementia and what this means for high quality care delivery and the policy drivers that shape care practices. there are differences in prevalence according to whether a country is classified as developed or developing, with developing countries estimated to have lower prevalence than developed countries; this may be due to lower rates of survival with dementia, environmental factors, as well as higher levels of mortality earlier in life.

http://www.nhs.uk/conditions/dementia-guide/pages/living-well-with-dementia.aspx

What is Dementia ?

Dementia mainly affects older people, but is not a normal part of ageing. It is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. (WHO, 2012). It is caused by progressive, irreversible degeneration and atrophy of the cerebral cortex and results in mental deterioration, and gradual impairment of memory, intellect and reasoning, (Waugh & Grant, 2005) death of brain cells in the cerebral cortex leads to the cognitive impairments that characterise dementia. (Dementia, 2013).

Dementia is a common condition, with the likelihood of developing Dementia increasing the older an individual is. There are many symptoms that are associated with Dementia, whilst it cannot be cured, if it is detected early on, then there are options that can slow it down and maintain mental function. A person with dementia may lose empathy, experience hallucinations and may make false claims or statements. (NHS, 2013).

People who are suffering from dementia may have difficulties performing familiar activities, something that they may have done all of their life without thinking, this can be caused by memory loss, which the short term memory is the most affected, and becoming confused. They may become disorientated, due to them not recognising their surroundings, and may have personality and behavioural changes. Other symptoms that are linked with dementia is neglecting personal care for themselves, language and communication problems and sudden mood swings. Individuals with dementia may have difficulties with abstract thinking and lapse in judgement, even if they have never experienced this before. Dementia is a progressive disease, meaning that the structure and chemistry of the brain become increasingly damaged over time. An individual’s ability to communicate, their memory and understanding will decrease, the period of time differs from individual to individual, there are numerous factors that influence this including support that is available to them, how early the dementia is treated, emotional resilience and physical make-up. As dementia progresses, the person will depend on others to help them, they will eventually need twenty four a day care. If the individual and their families know what to expect in the advanced stages, then they will be able to prepare, and make decisions based on what is in their best interests. If when an individual is diagnosed with dementia they are not able to make decisions for themselves, then with the help from an advocate decisions can be made for their best interests.

The Mental Capacity Act (2005) provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions themselves. (TSO, 2007). Every decision that is made for an individual, has to have their best interests maintained. The Mental Capacity Act (2005) must assist and support individuals who may lack capacity, and aims to protect an individual from harm if they are unable to make decisions themselves to protect themselves as they lack capacity.

There are no cures available, or treatments to stop progression for dementia. The treatments that are available for people with dementia and their caregivers focus on postponing cognitive decline as long as possible, alleviating behavioral and psychological symptoms during the course of the disease, and alleviating stress of caregivers and family members. (McNamara, 2011). There are also many psychosocial interventions that are effective treatment for symptoms and problems that are related to dementia. Many professional workers within the health and social care sector benefit from clinical guidelines that are in place to decide which is the best treatment for an individual and which is the most suitable according to the situations in each specific case. When the disease progresses interventions should focus on meeting the individual needs within each case, regarding the social activities, self-care and daily structure.

Dementia blog – Introduction

The topic area that has been chosen for this digital portfolio presentation is Dementia. The blog overall will reflect upon the information relating to health delivery that may give rise to issues of concern to the public. It will critically analyse and demonstrate an understanding of the complexities of how Dementia is presented within the media. The aim of this blog is to evaluate current thinking and its possible impact and influence on health and well-being of the individual, society, health delivery, policy and legislation.

As average life expectancy is increasing, the amount of people being diagnosed with Dementia will rise. A report by the World Health Organisation and Alzheimer’s disease International in 2012 suggests that as many as 35.6 million people live with Dementia currently, with this figure expected to be tripled by 2050.

This will have a direct impact on the costs of caring and treating individuals diagnosed with Dementia on the NHS, social services and their families.

With the amount of people being diagnosed on the increase, the aim of this blog is to research the current funding, research and facilities that are available within the UK, compared to other countries. The Human Rights Act is in place to protect each and every individual. People know their Human Rights, but as a person with Dementia deteriorates and becomes more vulnerable, they may not be able to protect themselves. Are their Human Rights being breached? Who is responsible for overseeing this?

Article in Mail on Sunday (2014) reports that within a unit at Glan Clwyd Hospital in Rhyl, patients with Dementia had their Human Rights breached by being restrained with chairs, broken limbs going untreated and unnoticed. Compared to Dementia, there are 46 times as many trials under way into cancer drugs, and 5,755 trials are in progress around the world into new cancer drugs, even though both can prove fatal. The portrayal of the illness within the media is that ‘it’s worse than death’ and ‘ticking time bomb’. This creates fear and anxiety within society.

As a society, we are taught to treat our elders with respect as heads of families, who have provided for their families all of their lives. Some individuals have had important jobs, have been looked up to by others, and look forward to enjoying retirement. When is it right, to then forget these same individuals, when they are an unfortunate statistic that is diagnosed with Dementia? How is it right for these individuals to have their Human Rights breached, and be forgotten by society?

http://www.dailymail.co.uk/news/article-2798576/is-shaming-hospital-care-scandal-dementia-patients-restrained-broken-limbs-ignored-swearing-staff-claimed-expos-desperate-relatives-breach-human-rights.html

Conclusion to Internship

I have learnt many new skills and developed as a person throughout my internship as a support worker. Each day was different, with different scenarios and different tasks that was expected of me. 

Throughout the internship I had to realise the importance of confidentiality, and to adhere to the Data Protection Act 1998 at all times. I had access to each of the service users that I worked with medication details, support plans and care plans. I was included in clinical’s for some of the service users that realised their needs, and what would be needed to be done in order for them to be realised.

I have gained knowledge on the organisations policies and procedures, my manager ensured that I understood them and what was expected of me through regular one to one supervisions.  

i can work independently and together as a team to a high standard, the role has improved my own personal development such as teamwork, ICT, communication, PBM training and listening skills. These skills are important and have helped to develop me as a person. These skills I will take forward and use in the future in my career. 

Through this placement I have realised that I would like to work with people with learning disabilities in any future career prospects that I have. Through my involvement in clinical meetings with the service users Care Managers, Psychiatrists, Occupational Therapists and the organisations clinical team, I would be interested in focusing on becoming an Occupational Therapist in the future to work with the other members of the team to enable a persons’ individual needs to be recognised. 

Reflection and Self Evaluation

The use of reflection through everyday life is important to develop yourself further, and to be able to analyse how we learn from our own individual experiences. it is the process of evaluating how effective we learn from these experiences and progress further throughout life.

“To reflect is not enough, you then have to put into practice the learning and new understanding you have gained therefore allowing the reflective process to inform your practice. Taking action is the key.” (Gibbs, 1988)

To be able to reflect successfully, Gibbs suggests that the individual formulates an action plan, to see your own individual behaviour currently, to be able to see what we can change for the future, and how we would develop and improve ourselves. 

This blog is beneficial to record posts to enable me to reflect and identify possible future career opportunities in the Health and Social Care Sector. 

Gibbs reflective model consists of six stages that include description, feelings, evaluation, analysis, conclusion and the action plan. 

The descriptive stage is where an event will be described to be later reflected upon. Feelings, which is the second stage lets the feelings an individual will feel about the event that was being reflected upon. The third stage which is the evaluation looks at the positives and negatives of the event and then reflection will be used again.

The fourth stage is to analyse the event, and to identify what went wrong and ways to improve for the future. The conclusion is to gather all this information and establish what can be improved upon for the future and the positives.

Having gathered all this information an action plan will then be put together to reflect on the information as a whole, and sum up the event as a whole.

Gibbs, 1988. Learn by Doing: a guide to teaching and learning methods. Further Education. London 

 

Confidentiality within the Health and Social Care sector

Within the Health and Social Care sector it is extremely important that confidentiality is maintained. The International Charter defines confidentiality as “ensuring the information is accessible only to those authorized to have access and is protected throughout its lifecycle”. (2011).

Organisations within the Health and Social Care sector that handle confidential information must ensure that it is held securely.

There are a number of legislation that governs what organisations do with the confidential information that they hold on individuals.

The Data Protection Act 1998 “controls how your personal information is used by organisations, businesses or the government” (gov)

Every organisation that has access to confidential information such as an organisation within the health and social care sector and banks has to adhere to strict rules called ‘data protection principles’. It ensures that confidential information is not in the hands of anyone that is not necessary and used fairly and lawfully.

Part of the induction training for the Community Lives Consortium they explain the importance of confidentiality, and this is one of the very first training days that we have. We as support workers have access to a lot of confidential data of the service users which is beneficial for us to provide them with the best service as possible, as we are able to identify their individual needs through having access to the information.

Hscic.gov.uk. A Guide to Confidentiality in Health and Social Care. Accessed on 19/5/14 

PBM Training & Challenging Behaviours

Some people with learning disabilities display challenging behaviours, some of these behaviours are displayed by individuals who do not have learning disabilities.

There are many types of challenging behaviours that can occur, which can be self-harm, destruction of objects, exposing ourselves, smearing and physical aggression towards another person.

“Some children and adults with severe learning disabilities typically display behaviour which may put themselves at risk, or which may prevent the use of ordinary community facilities or a normal home life. The behaviour may include aggression, self-injury, stereotyped behaviour or disruptive and destructive behaviours. These behaviours are not under the control of the individual concerned and are largely due to their lack of ability to communicate” (Challengingbehaviour)

Emerson describes challenging behaviour as “Culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities” (1995)

Many of the service users that I have come across display one or more of these behaviours. This can occur when an individual finds it difficult to communicate whether they are not feeling well, hungry or does not want to a particular task.

PBM training stands for Positive Behaviour Management and “focuses on the prevention of behavioural incidents, proactively working towards reducing the use of restrictive interventions” (positive-response)

Every employee of the Community Lives Consortium has to complete PBM training which consists of a day of theory and a day of practical followed by a yearly refresher which is a day of practical.

The training will run through a number of role plays that could happen within the homes of the service users. It will also run through what an employee is supposed to do to get themselves out of danger, with no harm being inflicted on the service user.

 

Challengingbehaviour.org.uk, 2014. What do we mean by ‘challenging behaviour’? accessed on 19/5/14

Emerson, 1995. Challenging Behaviour: Analysis and Intervention in People with Learning Disabilities. Cambridge University Press.

Positive-response.co.uk. accessed on 19/5/14