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HLTH 1173 Exploring Dementia Care

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HLTH 1173 Exploring Dementia Care Question: Distinguish between the different types of dementia, their characteristics, and their symptoms. Your assignment is to write an essay on dementia, the following topics must be covered in your essay:   a Identify the major types of dementia and describe their general characteristics b Discuss who may be impacted by these diseases° c Identify the signs and symptoms of the different stages of dementia? d Identify what causes dementia and describe how each cause affects the brain e Identify how physicians diagnosis dementia, f, Discuss treatment options for a person with dementia, g Discuss the potential impact on family and friends of a person who has been diagnosed with dementia,  Answer: The disease condition of ‘dementia’ implied a collective set of cognitive disorders, pertaining primarily to the geriatric population, and is characterized by a detrimental loss in memory, followed by decreased abilities concerning cognition, such as following linguistics and solving of problems (Dewing & Djik, 2016). The following paragraphs of the essay highlight the key points pertaining to the disease condition of dementia, followed by emphasis on the various types as well as associated signs and symptoms. An additional discussion regarding the various effects implicated upon the brain by the occurrences of various types of dementia, the type of population inflicted with its prevalence, followed by an availability of the various types of treatment disorders, are also highlighted in the following essay concerning the key principles of dementia. The cognitive disorder of dementia is primarily caused as a secondary effect upon the primary implications of Alzheimer’s disease, which progressively leads to the deterioration of functioning principles of the brain, for the daily performance of tasks which require thinking, reasoning and understanding (King & Dwan, 2017). Dementia can be classified into five types. One of the most common types of dementia, is related to the Alzheimer’s type, due to the Alzheimer’s disease being the primary causative effect. This type of dementia is characterized by the presence of abnormal protein-based structures surrounding the brain, such as beta amyloid proteins and tau protein structures (Winblad et al., 2016). An additional type of dementia is the vascular type which is caused due to the distorted of circulatory functions affecting the flow of blood to the brain, especially, due to the occurrences of strokes or haemhorrages ina major or several minor portions of the brain (van Charante et al., 2016). Further, dementia characterized by Lewy bodies form an additional type of dementia, associated mainly with Parkinson’s disease along with formation of abnormalities in the brain cells, known as Lewy bodies. An additional type of dementia is the frontotemporal type which is concentrated mainly in the frontal and side sections of the human brain. Lastly, individuals show casing symptoms pertaining to multiple types of dementia, are diagnosed with mixed type of dementia (Ejlerskov et al., 2015). Based on the presence of current prevalence statistics, dementia has primarily been observed to affect senior citizens in the age group pertaining to beyond sixty five years of age. However, recent research establishing associations with genetics, highlight the possibility of inheriting symptoms of dementia at a young age, due to the presence of familial inheritance of genes. Dementia also affects a minor population consisting of young adults suffering from cognitive disorders such as cerebral palsy (Langa et al., 2017). The stages of dementia can be classified into a total of seven stages as highlighted by the Resiberg Scale, also known as the Global Deterioration Scale for Assessment of Primary Degenerative Dementia. Stage one or the primary stage is characterized by an absence of symptoms pertaining to loss in cognition, and hence is labeled as ‘no dementia’ (Coupé et al., 2015). The second stage of dementia is characterized by the presence of mild levels of forgetting and memory loss which is considered normal for old aged individuals. Such forgetfulness involves shortcomings in remembrance of names or novel locations of objects and are not clearly observed by the surrounding family member of the concerned patient. Third stage of mild cognitive decline highlights increased loss in memory with additional shortcomings in activities pertaining to requirement of greater concentration (van Kooten et al., 2015). The fourth or moderate cognitive decline stage of dementia is characterized by the difficulty of the patient in the performance of tasks with increasing complexities such as managing calculations, financial expertise or performance of difficult tasks alone. Heightened memory loss is prevalent in the fifth stage of moderately severe cognitive decline symptoms of dementia, where the concerned patient is unable to recall personal or residential details and requires significant aid in the performance of tasks pertaining to grooming and toiletry (Choi et al., 2016). The severe cognitive decline stage of dementia is highlighted as the sixth stage which shows prevalence of emotional and behavioral disruptions in the patient such as delusionary thoughts followed by loss of remembrance of names and familiarities of close family members. The stage severely cognitive stage of dementia, pertains to the final worst case where there is a complete absence of speech and cognitive activities in the concerned patient, and there is utmost requirement of complete caretaker assistance for the performance of life care tasks (Huang et al., 2015). Alzheimer’s disease continue to be one of the major causative factors pertaining to the occurrences of dementia, which is characterized by the presence of abnormal tangles in the brain, known as beta amyloid structures of protein. Such structures exist as clumps in the internal regions of the brain, and caused disturbances in impulse and neurological transmissions amongst associated neurons (Gijselinck et al., 2015). Another causative factor of the dementia is associated with vascular disruptions, such as the occurrences of stroke. Such distortions in the flow of blood to the brain, often results in mild temporary episodes highlighting symptoms of dementia in the concerned patient (Cai et al., 2014). Individuals with Parkinson’s disease are susceptible to dementia, caused due to the presence of abnormal protein structures known as Lew Bodies, which is unique due to the presence of severe disruptions in the motor activities of the human body, especially pertaining to movement (Howlett et al., 2017). The management of any disease condition is of utmost importance pertaining to the treatment and betterment of the individual. For the purpose of treating individuals with dementia, it of utmost importance for the concerned clinician to perform, adequate diagnostic activities, which would be of beneficial impact to the concerned patient, through the availability of clarified notions regarding the signs and symptoms and the resultant specification of the type of dementia the concerned individual is suffering from (Booker et al., 2016). A multidisciplinary approach may be adopted for the diagnosis of dementia, which may involve the participation of a geriatric specialist if the patient is old, a specialist concerning nervous system disorders such as a neurologist and a psychiatrist in order to deal with the mental health disorders pertaining to the patient (Struyfs et al., 2015). The diagnosis would involve conductance of several steps such as the obtaining of the historical or precious case details of the patient, in order to understand the course of development of the associated symptoms of dementia and the trigger factors. There may be conductance of physiological or biochemical examinations involving testing of the blood of the patient in order to find out the presence of any characteristic which may lead to the prevalence of dementia (Garcia-Placek et al., 2014). Tests pertaining to assess cognitive and mental functioning of the concerned patient may be conducted in order to assess the present levels of reasoning and thinking abilities displayed by the patient, followed by further radiological diagnostic tools such as scans of the brain, which may highlight abnormalities in patient brain structure (Boraxbekk et al., 2015). Upon diagnosis of dementia, the stage in which the patient is presently suffering from may be determined by the usage of several diagnostic tools such as Global Deterioration or Resiberg Scale for the Assessment of Primary Degenerative Dementia, the Clinical Dementia rating and the Functional Assessment Staging test (Pujades-Rodriguez et al., 2018). The treatment options for dementia can be characterized into various types mainly through the usage of pharmacological as well as non pharmacological treatment options (Gibson et al., 2016). For the usage of treatments which do not require medicines, methods such as cognitive stimulation therapy, conductance of counseling sessions, rehabilitation activities pertaining to cognition as well as cognitive behavioral therapies can be used. These enhance patient cognitive functioning through the conductance of interactions which will provide stimulatory advantages allowing the patient to recollect previous as well as recent event through trigger factors (Lloyd, Patterson & Muers, 2016). Drug based treatment options may also be utilized which may involve usage of antidepressants or blood pressure reducing medications for patient suffering from vascular dementia, along with the additional usage of drugs such as Galantamine, Rivastigmine and Donepezil (Huntley et al., 2015). Initial diagnosis of especially severe symptoms of dementia, will lead to considerable stress and tension amongst the family members of the concerned patient, due to the consequent isolation pertaining to the loss of memory and remembrance of close relationships. However, usage of adequate familial as well as care taker support will aid in sufficient alleviation of symptoms. Family members can be actively involved in the care process of the patient, through stimulation with the usage of pictures, notes or tools, or the provision of assistance to the concerned patient (Mitchell, McCormack & McCance, 2016). Hence, it can be conclude that the disease condition of dementia, causes detrimental effects on the cognitive, behavioral and reasoning abilities of the concerned patient, followed by a disruption in the performance of daily activities and present familial relationships. However, with appropriate diagnosis, treatment and supportive care giving tasks by family and care givers, individuals with dementia do possess the possibility of living sustainable lives. References: Booker, A., Jacob, L. E., Rapp, M., Bohlken, J., & Kostev, K. (2016). Risk factors for dementia diagnosis in German primary care practices. International psychogeriatrics, 28(7), 1059-1065. Boraxbekk, C. J., Lundquist, A., Nordin, A., Nyberg, L., Nilsson, L. G., & Adolfsson, R. (2015). Free recall episodic memory performance predicts dementia ten years prior to clinical diagnosis: findings from the Betula longitudinal study. Dementia and geriatric cognitive disorders extra, 5(2), 191-202. Cai, W., Uribarri, J., Zhu, L., Chen, X., Swamy, S., Zhao, Z., … & Woodward, M. (2014). Oral glycotoxins are a modifiable cause of dementia and the metabolic syndrome in mice and humans. Proceedings of the National Academy of Sciences, 201316013. Choi, Y. J., Won, C. W., Kim, S., Choi, H. R., Kim, B. S., Jeon, S. Y., … & Park, K. W. (2016). Five items differentiate mild to severe dementia from normal to minimal cognitive impairment—Using the Global Deterioration Scale. Journal of Clinical Gerontology and Geriatrics, 7(1), 1-5. Coupé, P., Fonov, V. S., Bernard, C., Zandifar, A., Eskildsen, S. F., Helmer, C., … & Catheline, G. (2015). Detection of Alzheimer’s disease signature in MR images seven years before conversion to dementia: Toward an early individual prognosis. Human brain mapping, 36(12), 4758-4770. Dewing, J., & Dijk, S. (2016). What is the current state of care for older people with dementia in general hospitals? A literature review. Dementia, 15(1), 106-124. Ejlerskov, P., Hultberg, J. G., Wang, J., Carlsson, R., Ambjørn, M., Kuss, M., … & Ruscher, K. (2015). Lack of neuronal IFN-β-IFNAR causes Lewy body-and Parkinson’s disease-like dementia. Cell, 163(2), 324-339. Garcia-Ptacek, S., Farahmand, B., Kåreholt, I., Religa, D., Cuadrado, M. L., & Eriksdotter, M. (2014). Mortality risk after dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry. Journal of Alzheimer’s Disease, 41(2), 467-477. Gibson, G., Newton, L., Pritchard, G., Finch, T., Brittain, K., & Robinson, L. (2016). The provision of assistive technology products and services for people with dementia in the United Kingdom. Dementia, 15(4), 681-701. Gijselinck, I., Van Mossevelde, S., van der Zee, J., Sieben, A., Philtjens, S., Heeman, B., … & Cuijt, I. (2015). Loss of TBK1 is a frequent cause of frontotemporal dementia in a Belgian cohort. Neurology, 85(24), 2116-2125. Howlett, S. E., Stanley, J., Wong, H., & Rockwood, K. (2017). WHAT DOES THE SYMPTOM OF MISPLACING OBJECTS MEAN IN PEOPLE WITH DEMENTIA? FINDINGS FROM AN ONLINE TRACKING TOOL. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 13(7), P725. Huang, H. L., Shyu, Y. I. L., Chen, M. C., Huang, C. C., Kuo, H. C., Chen, S. T., & Hsu, W. C. (2015). Family caregivers’ role implementation at different stages of dementia. Clinical interventions in aging, 10, 135. Huntley, J. D., Gould, R. L., Liu, K., Smith, M., & Howard, R. J. (2015). Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ open, 5(4), e005247. King, A. C., & Dwan, C. (2017). Electronic memory aids for people with dementia experiencing prospective memory loss: A review of empirical studies. Dementia, 1471301217735180. Langa, K. M., Larson, E. B., Crimmins, E. M., Faul, J. D., Levine, D. A., Kabeto, M. U., & Weir, D. R. (2017). A comparison of the prevalence of dementia in the United States in 2000 and 2012. JAMA Internal Medicine, 177(1), 51-58. Lloyd, J., Patterson, T., & Muers, J. (2016). The positive aspects of caregiving in dementia: A critical review of the qualitative literature. Dementia, 15(6), 1534-1561. Mitchell, G., McCormack, B., & McCance, T. (2016). Therapeutic use of dolls for people living with dementia: A critical review of the literature. Dementia, 15(5), 976-1001. Pujades-Rodriguez, M., Assi, V., Gonzalez-Izquierdo, A., Wilkinson, T., Schnier, C., Sudlow, C., … & Whiteley, W. N. (2018). The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. PloS one, 13(6), e0199026. Struyfs, H., Van Broeck, B., Timmers, M., Fransen, E., Sleegers, K., Van Broeckhoven, C., … & Engelborghs, S. (2015). Diagnostic accuracy of cerebrospinal fluid amyloid-β isoforms for early and differential dementia diagnosis. Journal of Alzheimer’s Disease, 45(3), 813-822. van Charante, E. P. M., Richard, E., Eurelings, L. S., van Dalen, J. W., Ligthart, S. A., Van Bussel, E. F., … & van Gool, W. A. (2016). Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial. The Lancet, 388(10046), 797-805. van Kooten, J., Delwel, S., Binnekade, T. T., Smalbrugge, M., van der Wouden, J. C., Perez, R. S., … & Hertogh, C. M. (2015). Pain in dementia: prevalence and associated factors: protocol of a multidisciplinary study. BMC geriatrics, 15(1), 29. Winblad, B., Amouyel, P., Andrieu, S., Ballard, C., Brayne, C., Brodaty, H., … & Fratiglioni, L. (2016). Defeating Alzheimer’s disease and other dementias: a priority for European science and society. The Lancet Neurology, 15(5), 455-532.

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