unit 363 Dementia awareness

1.1 Describe a range of causes of dementia syndrome

Dementia can be caused by damage to or changes in the brain. Alzheimer's
disease is the most common cause this is when there is progressive loss of nerve
cells without known cause. Stroke is the second most common cause of dementia.
Dementia caused by stroke is called vascular dementia. CJD is also a form of
dementia which is caused by prion disease. Prions are proteins which are found in
mammals. When the proteins group together in the brain, they cause brain cells to
die which in turn causes dementia syndrome.
Dementia is a term used to describe the symptoms that occur when there's a
decline in brain function. Dementia is not a single disease. There are different
diseases that can cause dementia.
Many of these diseases are associated with an abnormal build-up of proteins
in the brain. This build-up causes nerve cells to function less well and
ultimately die. As the nerve cells die, different areas of the brain shrink.
● Alzheimer's disease is the most common type of dementia.
● Alzheimer's disease is thought to be caused by the abnormal build-up of 2
proteins called amyloid and tau. Deposits of amyloid, called plaques, build up
around brain cells. Deposits of tau form "tangles" within brain cells.
Neurodegenerative disease is a common cause of dementia which means
that the brain cells known at the neurons either are degenerating therefore the
neuron dies off quicker than that of the neurons of a normal ageing process.
This will lead to a more decline in the persons mental health such as memory,
language and sometimes their physical abilities all depending on which area of the
brain is infected.
These neurodegenerative diseases are known to us as Alzheimer’s, fronto-
temporal dementia, and Lewy bodies are where over time a build up of abnormal
protein deposits in the brain cause the gradual change and damage to the neurons
which will cause the shrinkage of the brain.
Dementia is anything which affects the brain and the loss of function of the
brain in such a way that the things we normally take for granted for e.g. our ability to
remember things such as time, date, events, to place ourselves in a location to use
words, to use language all of these things begin to disappear.
Then there is the blood supply to the brain which is interrupted causing the
brain cell to die, and resulting in brain damage. This is vascular dementia which is
caused by either lots of small mini strokes or one large stroke as the oxygen and
blood is restricted or stopped before reaching the brain cell.
There is other more rare causes of dementia caused by depression, brain
tumours, thyroid hormone, head injuries, alcohol abuse, Huntington’s disease,
Creutzfeldt-Jakob disease, supranuclear palsy and cortico-basal degeneration
1.2Describe the types of memory impairment commonly experienced by
individuals with dementia
Memory covers a wide area of our lives and abilities. Individuals with
Dementia struggle with memory loss in many areas. They can have an inability to
recognise familiar objects; this can be their surroundings or faces of relatives or
friends, remembering recent events or conversations, taking in new information, the
loss of skills to carry out normal activities.
Memory loss can be the inability to retrieve information from long-term
memory. individuals will be able to ‘see’ things, items or people, but will not be able
to make the connection of what those things, items or people are. People who have
damage to the neurons on the left side of the brain tend to be affected by
depression. They will have more organisational problems and will have problems
using language.

1.3Explain the way that individuals process information with reference to the
abilities and limitations of individuals with dementia
Individuals with dementia process information through the main cells called
neurons. When the body is not resting the neuron cell processes information to the
axon where a chemical called neurotransmitters travels over a gap in the brain and
switches on another neuron cell. Individuals with dementia who have damage to the
neurons on the left side of the brain usually suffer from depression. However they
also tend to have problems with being organised and using language. Individuals
with damage to the neurons on the right side of the brain will have difficulty putting
information together.
The abilities and needs of an individual with dementia may fluctuate because
they are having a good/ bad day. Also this may change daily because of stress
levels, if they have not had enough sleep and stress. This can cause the individual to
be frustrated, confused and have added memory difficulties. The individual’s needs
and abilities may also fluctuate because the condition has progressed or is in the
later stages of dementia. Throughout these stages the individual will need more
support on a day to day basis and more encouragement.

1.4Explain how other factors can cause changes in an individual’s condition

that may not be attributable to dementia
Brain injury - Injuries to the brain can be caused by external trauma such as a
blow to the head, or internal factors such as a result of a stroke or aneurysm.
Medication - Some prescription medications can have side effects which can
affect somebody’s memory.
Lack of sleep/insomnia -People who have difficulty sleeping may experience
various health problems including memory difficulties.
Diet - Some foods can have an effect on a person’s memory. It is believed
foods such as those containing vitamin C and sugars can have an effect on memory
1.5Explain why the abilities and needs of an individual with dementia may
fluctuate
Needs and abilities of an individual with dementia may fluctuate due to
numerous reasons such as loss of independence, loss of companionship,
depression, anxiety, mental health issues, and stages of their dementia.

2.1Describe the impact of early diagnosis and follow-up to diagnosis

The impact for most people receiving the diagnosis of dementia is very
distressing and upsetting for both the individual and their family. People presume
that dementia is a condition that causes people to go mad. These negative images
can add unnecessary distress to the individual and their family. Diagnosis of
dementia can be difficult to make due to the symptoms can develop slowly. The
individual's GP or health professional will be able to monitor any patterns and take
tests over a period of time.
When monitoring a person’s health and wellbeing or their condition it is
important to record any findings using your company's policies and procedures. It is
important to record possible signs or symptoms of dementia because this can show
a pattern and then you are able to get advice from their GP.

2.2Explain the importance of recording possible signs or symptoms of

dementia in an individual in line with agreed ways of working
The importance of recording signs and symptoms is so as to get facts about
the individuals functional and cognitive abilities to be able to make relevant decisions
with himself, their relatives and carers. Another importance is to able to make sure
their nutritional and hygiene needs are met.

2.3Explain the process of reporting possible signs of dementia within agreed

ways of working
The process for reporting possible signs and symptoms of dementia includes
monitoring occurrences of the signs and symptoms, keeping a record and firstly
making a GP appointment. Dementia is generally not diagnosed after the individual’s
first GP appointment. However health care staff should consider making a referral to
NICE (National Institute for Health and Clinical Excellence) when the individual is
showing any signs of mild cognitive impairment for an assessment.

2.4Describe the possible impact of receiving a diagnosis of dementia on:

a} On the individual. The individual may become: shocked, anxious , stressed,

disoriented, frightened, may have to retire early and have financial implications, lose
socialisation, be in denial, or anger, bargaining, depression, acceptance, fear, need
for information, need for sources of support, including financial, and counselling.

b}On the individual’s family and friends: they may feel in denial, anger,
bargaining, depression, acceptance, fear, need for information, or in need of sources
of support. They may feel guilty and get angry because they are in need to balance
commitments, be afraid or embarrassed by their new situation and increased
financial needs.

3.1Compare a person centred and a non-person centred approach to dementia

care
Person centred approach is about caring for the person rather than the illness It's
about enabling choice, social relationships, inclusion and value the individual.
Non Centred approach care does not recognise the individual uniqueness and
needs, lacks choice, exclusion, not allowing participation in decisions making and
responding to behaviour rather than looking at the unified whole.

3.2Describe a range of different techniques that can be used to meet the

fluctuating abilities and needs of the individual with dementia

To know the person-by having background knowledge of the individual including

knowing their previous life and history one would be able to understand why the
personnel behaves in certain ways hence being able to design the care and support
to meet their specific needs.

Stable and familiar environment- a known trigger for agitation and confusion for
people with dementia is when their daily routine and environment are constantly
changing. Is it therefore important that people with dementia have consistent staff to
follow their daily routine and live in a stable and familiar environment.

Providing support- people with dementia have been known to wander, be agitated,
have incontinence, be paranoid and show repetitive behaviour and actions.it is
important that these specific needs are net in way such as activities reducing noise
levels, clear indications of bathrooms and aid incontinence provided.

3.3Describe how myths and stereotypes related to dementia may affect the
individual and their carers

Myths and stereotypes affect people with dementia as they may be viewed as
needing pity which brings down their self-esteem making them feel isolated.
Assumption of automatic loss of independence in people with dementia makes them
feel inadequate or useless.

3.4Describe ways in which individuals and carers can be supported to

overcome their fears

Is by gaining information and advice from others, reading booklets or leaflets, going
online for discussion forums through friends and family and through respite care.