Unit 6: Supporting Dementia Care

Unit code	F/616/1641
Unit level	4
Credit value	15

Introduction

The term ‘dementia’ describes the different brain disorders that trigger a loss or deterioration of brain function. These changes are often small to start with, but often they become so severe they affect daily life. A person with dementia may also experience changes in their mood or behaviour. These conditions are all usually progressive and eventually severe. The World Health Organisation (WHO) suggest the number of people living with dementia worldwide is estimated at 35.6 million.

This number is anticipated to double by 2030 and more than triple by 2050.

The WHO and Alzheimer`s Disease International highlight dementia as a global public health priority. Their joint report on dementia makes it clear that dementia presents a significant challenge to society in terms of the provision of appropriate care services and support. To address this, it is vital to ensure that the health and social care workforce of tomorrow is knowledgeable, competent and able to provide the specialist care and support needed for individuals experiencing dementia, their families and loved ones.

This unit introduces students to the specialist area of dementia care and the demands which can be faced when managing a person-centred service. The aim of this unit is to explore theories relating to the causes, signs and symptoms, therapies and treatments associated with dementia. The unit will enable students to identify strategies that will facilitate a person-centred ethos in the delivery of effective care services that address the needs of people living with dementia. The unit will also enable students to be aware of the challenges faced when delivering services which are ensure the rights and choices of people with dementia are upheld.

On completion of this unit, students will have developed the knowledge and skills to be involved in the delivery of services which meet the wide and varied needs of individuals with dementia.

Learning Outcomes

By the end of this unit students will be able to:

1      Describe the causes, symptoms, diagnosis and treatment of dementia

2      Explain factors that can impact on interactions and communication with individuals with dementia

3      Contribute to the provision of dementia care services which are underpinned by a person-centred approach

4      Reflect on the challenges involved in implementing services which maximise the rights and choices of individuals with dementia.

Essential content

LO1 Describe the causes, symptoms, diagnosis and treatment of dementia

Causes of different types of dementia-

Alzheimer’s disease Vascular dementia Dementia with Lewy bodies Frontotemporal dementia

Alcohol-related brain damage, e.g. Korsakoff’s syndrome Huntington’s disease

Mixed dementia Young-onset dementia

Risk factors

The effect of ageing Genetics

Lifestyle choices, e.g. exercise (physical and intellectual), diet, alcohol consumption, smoking

Symptoms

Memory loss

Difficulty with planning/preparation Poor judgement

Difficulty performing familiar tasks Problems with language and communication

Problems finding things/constantly losing things Disorientation

Changes to mood or behaviour Changes to personality

Loss of motivation/initiative Challenges with problem-solving Difficulty with time and place

Trouble understanding visual images and spatial relationships Withdrawal from social interaction

Diagnosis

A thorough medical history Physical examination

A review of current medication prescribed Neurological examination

Structural imaging

Mini-Mental State Examination (MMSE) Blood tests

Computerised tomography (CT) scan Magnetic resonance imaging (MRI) scan

Single photon-emission computed tomography (SPECT) scan A positron emission tomography (PET) scan Electroencephalogram (EEG)

Input from carers/family members as appropriate

Referral to neurologist, doctor in geriatric medicine or psychiatrist

Treatment

No current cure

Drugs and non-drug treatments that can lessen an individual’s symptoms Drug treatments:

cholinesterase inhibitors, e.g. Donepezil, Rivastigmine and Galantamine, antipsychotic drugs such as Risperidone, Haloperidol, Benzodiazepine- Lorazepam, Memantine.

Non-drug treatments:

e.g. cognitive stimulation activities, life story work and/or reminiscence therapy, cognitive rehabilitation, cognitive stimulation therapy (CST), counselling, psychotherapy, music and creative arts therapies, complementary therapies.

LO2 Explain factors that can impact on interactions and communication with individuals with dementia

Environmental and physical factors

Anxiety

The impact of certain medication on awareness and the ability to interact The environment and how it facilitates communication and interaction Sensory impairment

Pain or discomfort

The use of body language Distractions

Increasing use of gestures

Intellectual and emotional factors

Anxiety

Interactions and communication-cognitive ability Understanding and comprehension

Misunderstanding of communication from both parties Use of jargon/terminology/dialect

The communication approach used

The individual repeating themselves, struggling to find the correct words Confusion

Failing to understand what is being said Confidence

The individual losing their train of thought The individual communicating less often

Strategies to support effective communication and interaction with individuals with dementia

See the person first, not the condition

Adopting a non-judgmental approach in communication Make eye contact if the individual is comfortable with this Give the person time to respond

Speak clearly and at an appropriate pace

Show that you have heard the person, encourage them to say more Give the person simple choices

Use short sentences

Acknowledge what they have said

Use a variety of forms of communication, according to the person’s need

Use questioning appropriately including rephrasing questions where necessary Encourage the person to join in conversations with others

Let the person speak for themselves where possible

Familiarise self with the person’s case history or biographical details Demonstrating empathy, e.g. appropriate self-disclosure

Adjusting methods of communication to suit the person’s mood, needs and preferences

Avoid patronising or ridiculing what the person says, avoid infantilising the individual

Ensure the environment is conducive to effective communication, e.g. appropriate light, air, space, privacy

Offering, not insisting on, support where possible

LO3 Contribute to the provision of dementia care services which are underpinned by a person-centred approach

 

Types of service provision and levels of support required

Services in the individual’s own home or in a supported living home Services in residential or nursing homes

Services in hospital and primary care

Services available in the community e.g. adult day care services Multidisciplinary approaches to service provision

Fundamentals of adopting a compassionate approach to care

Dignity Respect Empathy

Further considerations for person-centred practice

Offering choice according to the person’s ability, recognising that-too much choice may be overwhelming but some is vital

Providing an inclusive environment where individual differences are respected and taken into account

Legal and ethical considerations when planning and providing services Adherence to confidentiality protocols

Safeguarding and/or protection Empowerment and supporting independence Respect for individuality

Communicate using individual’s preferred approach, e.g. the use of pictures, symbols and memory aids

Partnership working: with the individual, their family and social networks, additional services the individual may require

Identification of needs in relation to all aspects of care and service delivery

e.g. gender, ethnicity, diet, personal care

LO4 Reflect on the challenges involved in implementing services which maximise the rights and choices of individuals with dementia

 

Challenges

Staff skills, knowledge, understanding and competence Resource allocation

Communication difficulties

Ongoing changes to individual’s abilities and condition The effect of medication on individual’s abilities

Carer input, risk

Access to limited resources Partnership working and collaboration

Addressing challenges and providing compassionate care

Staff training and development Adherence to dementia quality standards Reflective practice

Supervision, mentoring

Advocates or interpreters to support individuals Psychological interventions

Positive risk taking

Adopting appropriate communication strategies throughout own interactions

Provision of information in the preferred language and/or in an accessible format

Use of befriending services

Referral to a speech and language therapist

The use of technology/ augmentative and alternative communication Ongoing assessment and review

Currency of knowledge and practice

Identifying preferred and effective methods of communication

 

Capacity

Provisions of Mental Capacity (or other related) legislation and regulations applicable to own home nation

Involvement of relatives and carers, as appropriate Integrated working

Staffing allocation and named responsibilities Access to memory assessment service

Learning Outcomes and Assessment Criteria

Pass	Merit	Distinction
LO1 Describe the causes, symptoms, diagnosis and treatment of dementia
P1 Describe the causes, risk factors and symptoms of dementia and their use in supporting clinical diagnoses of the different types P2 Explain different approaches to treating dementia and effect on the condition	M1 Analyse the drug and non-drug approaches to treating different types of dementia and their impact on individuals with dementia	D1 Critically examine the complexities of diagnosing and treating different types of dementia using case study examples
LO2 Explain factors that can impact on interactions and communication with individuals with dementia
P3 Describe intellectual and emotional factors impacting on the effectiveness of communication and interaction with individuals with dementia	M2 Analyse communication and interaction considerations when supporting individuals with dementia	D2 Evaluate factors impacting on effective communication and interaction with individuals with dementia
P4 Explain the environmental and physical influences on effective communication and interaction individuals with dementia
LO3 Contribute to the provision of dementia care services which are underpinned by a person-centred approach
P5 Explain how to ensure health and care services promote the rights and choices to support the capacity for individuals to live independently with dementia P6 Actively participate in a period of effective person-centred practice in the provision of services for individuals with dementia	M3 Assess different approaches used to meet the needs of an individual living independently including the levels of support required from different services	D3 Reflect on own role as a part of the wider multidisciplinary team in effectively supporting independent living for people with dementia

Pass	Merit	Distinction
LO4 Reflect on the challenges involved in implementing services which maximise the rights and choices of individuals with dementia		D4 Critically reflect on the effectiveness of different strategies to maximise the quality of compassionate and appropriate care for individuals with dementia
P7 Explain the challenges to be addressed when delivering services which promote the rights and choices of individuals with dementia P8 Describe strategies to uphold the rights and choices of individuals with dementia during service delivery	M4 Analyse the challenges faced when delivering services which meet the needs and preferences of individuals with dementia