CU4177 End of Life & Dementia Care
1.1 Dementia is a progressive disease where an individual’s brain functions deteriorate and affects their mental capabilities. This disease is incurable which is similar to another terminal illness such as cancer. Symptoms of dementia will affect an individual’s memory leading to loss and confusing, language/ communication, understanding and judgement. Medication can be prescribed to help slow down the progression of symptoms.
Within the more advanced stages the individual will commonly suffer from incontinence, limited mobility and limited communication usually the individual will not be able to use sentences just limited words. Other symptoms that worsen similar to those with a terminal illness are:
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2.2 In the earlier stages individual’s may be able to express pain through verbal and non verbal communication, together the carer could recognise that they are in pain and a rough area of where this is coming from. This will enable carers to be able to provide medical intervention if needed I.e. Administering PRN paracetamol or seeking medical attention from a nurse/ doctor when required.
Care givers should use clear questions when speaking to someone with dementia as it may take them a little longer to process what is being asked.
As the dementia progresses the individual could be unable to communicate, but they may be able to express pain through noise I.e. screams, but these could be easily misinterpreted by care providers as a “normal” behaviour if these are regular occurrences.
2.3 When pain has been recognised by care providers, communication with the individual is important where possible dependant of their ability to be verbal and how much capacity the individual has to understand their pain. Care givers will continuously monitor and observe the individual for changes in needs and record these within the daily care notes within the care plan.
Dependant on the type of pain will depend on what medical intervention will be best for the individual through advice from other health professionals.
Health professionals offer support to care providers to work as a multi-disciplinary team
Dementia sufferers communicate in many different ways. They may not be able to speak but they can communicate non-verbally with positive or negative behaviour. They can also communicate using body language and through posture.
All forms of dementia can affect the way a person communicates, so in time they may have to find different ways of expressing themselves and their feelings. As a carer your non-verbal communication will become important, your body language, facial expressions, gestures, eye contact and tone of voice will have to be taken into account when you are communicating with a sufferer. In the early stages of some forms of dementia people may have difficulty finding the right word they are looking for, and in the later stages of some forms of dementia the words could be lost completely. As the dementia progresses, it gets a lot
Dementia is a loss of brain function. If affects memory, thinking, language, judgement and behaviour. Dementia is progressive, so the symptoms will gradually get worse. In a later stage of dementia people will find it hard to carry out daily tasks and will come dependant on other people.
Also a person with dementia has very poor or no short term memory at all, so when it comes to making descisions the answer may change quite alot because they have poor memory recall they may say yes one minute then say no to the exact same question because they cant remember what was asked before hand.
The term dementia describes a set of symptoms which include loss of memory, mood changes and problems with communication and reasoning. These symptoms occur when the brain is damaged by numerous certain diseases. Dementia is progressive, which means the symptoms will gradually get worse. How fast dementia progresses will depend on the individual person and what type of dementia they have. Each person is unique and will experience dementia in their own way.
Dementia sufferers communicate in many different ways. They may not be able to speak but they can communicate non-verbally with positive or negative behaviour. They can also communicate using body language and through posture.
Nurses and family members need to speak slowly and clearly, in a low pitched voice, maintaining an open friendly communication manner and also using eye contact and touch. Speaking slowly is very important as it allows patients who can’t have a conversation to understand you better, patients with dementia take longer to process information and sentences, so speaking style such as emotion, sound volume and what you say can be the difference between a patient with dementia understanding you and not. It slowly allows the patients enough time to take the words in and process the sentence. Speaking clearly and in a calm voice will help reassure the patient and help them cope with following your words. Speaking clearly and calmly will help relax the patient. A nurse should avoid speaking sharply or raising their voice, as this may distress the person even if they can't follow the sense of your words. Low pitched voice is used to calm the patient and not bring about any distress or frighten them. Low pitched tone can be used to sooth the patient if in any distress. Gaining eye contact with a patient is very important, if they are sitting down kneeling down at there level can be of benefit so they no you are there. This allows the nurse to get their attention and help them focus on the conversation without scaring them. Maintaining eye contact while speaking with the patient can also be of benefit. Love and affection can
Dementia is a term used to describe a collection of signs and symptoms that happen to the brain when it is affected by the progression of certain diseases such as vascular dementia (when brain cells die due to lack of oxygen) and Alzheimer’s disease (a specific brain disease). Some of the affects these diseases have are on a person’s memory, language and communication abilities, behaviour and ability to make rational judgements.
Dementia is a terminal illness; and patients with advanced dementia suffer from distressing symptoms, just like people with other terminal decease, such as cancer.
Communication - The person with dementia may have problems communicating that they are hungry or that they don't like the food they have been given. They may communicate their needs through their behaviour. For example, they may refuse to eat or hold food in their mouth. Giving them a choice of food, or using prompts and pictures, may help.
Because there are so many different types of dementia the signs and symptoms of these can vary widely, because of this the communicating abilities of the individual will vary greatly each form of dementia will have certain symptoms that may be relevant to that disease but some symptoms may be present in more than one form of dementia.#
1.1 Losing the ability to communicate can be one of the most frustrating and difficult problems for people with dementia, their families and carers. As the illness progresses, a person with dementia experiences a gradual lessening of their ability to communicate. They find it more and more difficult to express themselves clearly and to understand what others say.
2.2 Explain how positive interactions with individuals who have dementia can contribute to their wellbeing
Many dementia patients that are nearing end of life don’t get the care that they need, and this has become an issue. Healthcare personnel need to practice more effective communication, and understand possible “causes of anxiety, fear and resistance to care when carrying out interventions” (Regan, Tapley, & Jolley, 2014, p. 37). Pain relief methods have not been very effective in dementia patients, and in order to provide good end of life care, healthcare providers need to properly assess patients with dementia to adequately treat their pain as they near end of life. It is difficult to tell with dementia patients when they near end of life if they are in pain, which can explain why healthcare providers may not be able to alleviate certain symptoms adequately. Studies have shown that symptom management and the showing of compassion are not as effective as they should be in dementia patients, and this article focuses on ways in which this can be
In the pamphlet Basics of Alzheimer’s Disease, the Alzheimer’s Association adds late onset, traditionally known simply as Alzheimer’s, targets primarily people 65 and older. The disease follows a series of steps from mild decline with little noticed changes to very severe cognitive decline where the final stage of the disease is in progress (Basic 19-21). Throughout the stages, independence becomes lost and family members will become care takers and in the later stages nursing homes or hospice may be needed. One book encourages the care giver to communicate through body language, tone, and written instructions to help alleviate as much stress as possible for those living with Alzheimer’s (Living 47). The book further adds when caring for a person with Alzheimer’s remember to maintain patience and to show respect .