The Challenge of Dementia

Jackie O’Toole RPN, MSc (dementia)

Overview

– The objective of my presentation is to reflect on the complexities of dementia through these considerations:

– Information around dementia

– Best practice in dementia care

– What is needed to provide a person-centred approach in this area

Information– Over past five years we have become more informed about

dementia

– We have listened to the individual on a dementia journey and learned about his/her lived experience

– We have gained a greater understanding about the workings of the brain

– We realise that the ‘personhood’ (or essence) of the person remains

– We know that individuals on a dementia journey retain human capabilities; the ability to feel emotions, to make choices and to live a wonderful quality of life

The Human Brain– We know that the brain has two hemispheres

– Each hemisphere contains 5 lobes

– Each with differing functions

– Currently there are 150-200 different forms of dementia with Alzheimer’s Disease being the most common form.

– The clinical presentation of the differing dementia is caused by the damage to the particular area of the brain.

Dementia in Ireland

Irish National Dementia Strategy

– Better Awareness and Understanding

– Timely diagnosis and intervention

– Education and training for GPs

– Guidance around medication management

– Education around modifiable lifestyle risk factors

– Integrated services, supports and care for PWD

– Training and Education

– Leadership

Independent and Assisted Living

– Retaining independence for as long as possible

– Suitable housing for assisted living

– Adaptations within current residential setting:

signage, re-arrangement of furniture, removal

of hazards

– Appropriate use of assistive technology

Assistive Technology –atdementia.org.uk

Prompting

– Date and Time

– Item Locator

– Medication reminder

– Voice Reminder

– Signs and Notices

– Activity Assessment and activity guides

Leisure

– Computer aids

– TV, Radio

– Books, Photographs

– Reminiscence items

– Games

Assistive Technology –atdementia.org.uk

Communication

– Intercoms

– Telephones

– Other communication aids

Safety

– Personal alarms

– Pressure mats and cushions

– Monitors that measure gas, smoke, lighting, temperature, flood

– Fall and wandering detectors

Best Practice in Dementia

Kitwood-Psychological NeedsRef: Dementia Reconsidered 1997

Best practice– Early diagnosis

– Medication

– Cognitive Stimulation Therapy

– Maintaining life pattern

– Continuance of past hobbies and interests for as long as possible

– Supportive and empowering relationships

– Communication –no contradicting, correcting or lengthy questions

– Understanding around behaviour as form of communication

What is needed?– Recognition of the value of human life

– Recognition of retained abilities rather than emphasis on deficits

– Gathering of Individual’s life-story material

– Acceptance of clinical presentation from those living around us

– Vital for individual to feel respected

– Opportunities to live a wonderful quality of life

What is needed?– Supportive care from home-care providers

– Respite care – day centres, short residential stays

– Care for the carers

– Sharing of the care

– Contact GP, PHN if you are concerned about failing memory

– Contact with the voluntary agencies;

– www.alzheimer.ie

– www.familycarers.ie

What is needed?

– Appropriate residential care when time is right

– Residential care that caters for spiritual needs

– Suitable activities and stimulation

– Continuity of connection with religious community