Nearly 135 million people worldwide will be impacted by dementia by 2050 (Robinson, Tang, Taylor,. 2015). Dementia is not a disease, it is an overall term that describes a wide range of symptoms associated with the decline in memory and thinking skills. Dementia is a progressive illness that results in the loss of one’s sense of self (Burns, Byrne, Ballard, Holmes, 2002). The two most common forms of dementia are Alzheimer’s disease and Vascular dementia. Dementia is progressive and people with dementia experience complications with short-term memory, keeping track of personal items, paying bills, taking care of themselves and daily tasks (Haigh, Mytton, 2016). Due to the rising number of individuals developing dementia, it is causing major challenges in the healthcare systems and society (Angermeter, Luck, Then, Riedel-Heller, 2016). Utilizing psychotropic medications are often ineffective or harmful to the individual, therefore, many patients decide to utilize sensory therapy as a form of treatment instead (Livingston, Kelly olmes, et al., 2014). Caregivers of individuals with dementia can also experience health consequences related to caregiving at the end of life. Spousal caregivers are 40.5% higher odds of experiencing frailty as a result of caregiving (Carr, Dassel, 2017). Dementia does not only affect the individual, it affects those around them, society, and the healthcare system.
At the end of life: Many people can die from dementia; however they can also die with another disease which doesn’t relate to their dementia even though they suffer it. Usually, the dementia will be that far advanced towards the end of life the individual may not even know what is happening or may even be too ‘ill’ to understand. However, it is important as a care worker or any professional that is trained in end of life care (palliative care) to ensure the best quality of life until the end. Each individual should be treated equally, yet individually. These individuals must not be overlooked and still have rights as well as everybody else.
Dementia is an umbrella term used to explain the gradual decline in multiple areas of functions, which includes thinking, perception, communication, memory, languages, reasoning, and the ability to function (Harrison-Dening 2013). Worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year. Alzheimer's disease is the most common cause of dementia and may contribute to 60–70% of cases. (Alzheimer's society 2014). The complexity of dementia presents a number of behavioural challenges to those who live with dementia and their care providers. Aggressive behaviour seems to be one of the most prevalent challenging behaviours in the different stages of dementia (Weitzel et al 2011). As acute care
In conclusion the following factors agitation, depression, patient-caregivers relationship declining, worsening pain, high levels of burden of caregivers were found to be directly increase risk of aggression. Depression and the severity of dementia were indirectly related to the beginning of aggression. The correlation of time and increasing nonaggressive physical agitation was separate of the relationship between psychosocial measures and the beginning of
Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.
Horgas et al. (2009) is an in-depth examination of the various factors that can be used to report pain within these specific groups of patients. The journal is from the American Geriatrics Society, and thus is clearly peer-reviewed. It is a thorough examination into how dementia patients report their own pain, as well as how their pain can be observed within actual practice. The data was then coded according to the American Hospital Formulary Service System (Horgas et al 2009). This clearly shows that the research supports evidence-based practices for it uses real observations from patients actually being in the field today in combination with commonly held patterns from prior research.
Having a dignified approach and respecting elderly patients in a palliative care unit is important because it is enabling them to have control over their care and treatment. This is going to help the patient to feel valued and throughout their last days of life, as they have a choice. (Social care institute for excellence, 2010). By making the patient feel as comfortable and as pain-free as possible, it will help encourage family members to respond in a positive way. This is because they are seeing that their relative is in a comfortable state.
The barriers include lack of information about the mammogram procedure, fear of exposing to radiation, fear of finding something abnormal after having mammogram, the screening will take long time, transportation, finding child care while performing mammogram, high cost and forgetting to schedule an appointment. The benefits include finding breast lumps, early mammogram can detect very small lumps, early treatment for BC will be better and having mammogram decrease chances of dying from BC. The results of this study showed that women who don’t considerate having mammogram has low perceived susceptibility. They suggested that difference in perceived susceptibility only present in women who don’t considerate having mammogram and all other women. They found that women who adopt mammogram screening or thinking about it have higher rate of perceived benefits. This result is consistent with Rakowski et al., 1992 and Rakowski et al., 1993 who found that perceived benefits rate become higher in women while they moved toward action stage. These results are contradicting with Russell M.K. et al. who found that perceived benefits weren’t different across stage (Russell M.K. et al., 2006). They found that perceived barriers to BCS can indicate the stage
In the past, seniors commonly lived their final years in their own homes. Today, however, many senior transition through this stage of life in long-term care facilities. Some seniors enter long-term care for treatment of specific conditions, while others are because they need assistance with activities of daily living. Deciding whether to stay at home or move to
In its brief overview of palliative care (Improving palliative care, August 2003), the Institute of Medicine emphasized purpose: “to prevent or lessen the severity of pain and other symptoms and to achieve the best quality of life for people dying or suffering from a long-term disease” (p. 2). Immediate pain reduction, if not outright elimination, facilitates satisfaction of other, more emotional or introspective end-of-life matters (e.g., working through spiritual issues, resolving family differences).
Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their
The ethical phenomenon, the “Jolie Effect”, receives much publicity about the BRCA 1 gene mutation that raised the actress’ risk and subsequent preventative double mastectomy. As a result, more women have been tested for both the BRCA1 and BRCA 2 gene mutations and choosing bilateral mastectomies for early-stage breast cancers (Weintraub, 2015). Oncologists saw a 50% increase for risk-reduction mastectomy surgery related to the “Jolie Effect”. The impact of an actress, known for her beauty, to willing risk her body image to increase her lifespan survival has philanthropically advanced the issues surrounding breast cancer.
Nurses can improve the quality of end of life care for people with the diagnosis of dementia when they may not have the capacity to make decisions in their best interests and rely on the people around them to see through their
In 2003, the American Nurses’ Association published a position statement regarding “Pain Management and Control of Distressing Symptoms in Dying Patients.” The organization states: