Supporting Dementia Care
Assignment Brief
Unit 6: Supporting Dementia Care
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Unit code |
F/616/1641 |
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Unit level |
4 |
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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:
- Describe the causes, symptoms, diagnosis and treatment of dementia
- Explain factors that can impact on interactions and communication with individuals with dementia
- Contribute to the provision of dementia care services which are underpinned by a person-centred approach
- 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
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Pass |
Merit |
Distinction |
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LO1 Describe the causes, symptoms, diagnosis and treatment of dementia |
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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 |
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LO2 Explain factors that can impact on interactions and communication with individuals with dementia |
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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 |
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P4 Explain the environmental and physical influences on effective communication and interaction individuals with dementia |
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LO3 Contribute to the provision of dementia care services which are underpinned by a person-centred approach |
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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 |
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Pass |
Merit |
Distinction |
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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 |
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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 |
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Sample Answer
Supporting Dementia Care
Introduction
This assignment focuses on the effectiveness of Cognitive Behavioural Therapy (CBT) in the treatment of patients experiencing depression. The paper will examine how CBT is used within mental health nursing, how effective it has been found to be in research studies, and how this evidence can inform professional practice. The aim is to answer the research question: How effective is Cognitive Behavioural Therapy in treating mental health patients with depression? To achieve this, I will undertake a systematic literature search to identify and critically discuss relevant studies, considering their findings, strengths and limitations, and implications for nursing practice.
The assignment will begin by explaining the concept and importance of evidence-based practice in nursing. Evidence-based practice is central to modern healthcare, ensuring that interventions are not based only on tradition or personal opinion, but rather on the best available research evidence combined with clinical expertise and patient preferences. In mental health nursing, the use of evidence-based practice is particularly vital, as treatments must be carefully matched to the needs of vulnerable patients in order to promote recovery and well-being. By applying an evidence-based approach, nurses are better placed to deliver interventions such as CBT in a safe, effective, and person-centred manner.
Following this, I will describe in detail the literature search process undertaken to locate suitable studies. This will include the search terms used, databases explored, and inclusion and exclusion criteria applied to ensure that only the most relevant and reliable evidence is included. The search strategy will be transparent so that it can be replicated by another researcher.
The discussion section will then critically examine between five and six key articles identified from the search. Each article will be summarised and analysed in terms of its research design, findings, and contribution to answering the research question. This section will also reflect on the limitations of the studies and the strength of the evidence overall.
The assignment will conclude by summarising the findings of the search and discussion, drawing together the key messages about the effectiveness of CBT in treating depression. Finally, the implications for nursing practice will be considered, highlighting what the evidence adds to professional knowledge, any gaps identified, and how this process informs the role of the nurse in delivering evidence-based care.
Search Process
When conducting research in nursing, it is important to follow a structured and systematic approach so that the evidence gathered is both reliable and relevant. For this assignment, the search process was carefully planned and carried out with the aim of identifying the most appropriate studies on the effectiveness of Cognitive Behavioural Therapy (CBT) for patients with depression. The process was based on guidance from research methods in nursing and evidence-based practice literature, ensuring that the approach was transparent, replicable, and academically sound.
The first step was to clearly define the research question. The chosen question, How effective is Cognitive Behavioural Therapy in treating mental health patients with depression?, provided a focused framework for the search. By keeping the question specific, it became easier to decide which studies were directly relevant and which should be excluded. The question also guided the choice of keywords and search terms used when exploring academic databases.
To begin the search, I considered a range of databases that are commonly recommended in nursing and health research. These included CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, MEDLINE, and PubMed. These databases are well recognised for their coverage of peer-reviewed journals in healthcare, psychology, and nursing, making them suitable for exploring both the clinical and psychological aspects of CBT. Using multiple databases helped to avoid the risk of missing relevant studies, as each database indexes different journals and research publications.
Once the databases were selected, the next step was to generate appropriate search terms. I started with the main concepts of the research question: “Cognitive Behavioural Therapy”, “depression”, and “effectiveness”. These were then broken down into possible variations and synonyms to make sure the search was thorough. For example, “CBT” was searched both in its full form and abbreviated form, while “depression” was also searched alongside terms like “major depressive disorder” and “depressive symptoms”. To improve the accuracy of results, Boolean operators such as AND, OR, and NOT were used. For instance, a search string such as “Cognitive Behavioural Therapy” OR “CBT” AND “depression” AND “effectiveness” ensured that the results captured studies combining these core ideas.
Continued...