INTRODUCTION
Dementia is a progressive illness which occurs when the brain is damaged by disorders and diseases such as Alzheimer 's disease, Huntington 's disease and Creutzfeldt-Jakob disease (CJD) or a series of strokes.
The term dementia is not the actual disease in its own right but is the collective term used to describe the group of related symptoms caused by the gradual death of brain cells. These symptoms include memory loss, problems with reasoning, perception, communication skills and physical ability. (NHS Choices, 2014)
It is estimated that by 2015 there will be approximately 850,000 people living with dementia in the UK. (Alzheimer’s Society, 2014)
CAUSES OF DEMENTIA
In most cases, the exact causes …show more content…
of dementia or dementia like symptoms are unknown due to there being various possible causes.
When someone has dementia, brain cells are damaged and die faster than they normally would, causing physical changes in the brain. Dementia is not a natural part of the ageing process.
Cell damage in particular regions of the brain are associated with different types of dementia. (Alz.org (2014)
Types of dementia
There are many different types of dementia although some are far more common than others. They are often named according to the condition that has caused the dementia. (Alzheimer’s Society 2014)
Alzheimer 's disease - This is the most common type of dementia. This disease causes the brain to shrink and tiny deposits of clumps of protein, known as plaques, begin to develop and form around brain cells, disrupting the normal workings of the brain. As the disease progresses, the brain gradually becomes more and more affected.
The most noticeable symptom with Alzheimer’s disease is memory loss. People with dementia will have difficulty remembering recent conversations, recently learned facts, difficulty recalling particular words, names, objects or events and the inability to acquire and retain new information. As the disease progresses, they will experience difficulty with communication, need help with personal care and display behaviour changes such as wandering, difficulty speaking, swallowing and loss of mobility.
People with Alzheimer’s can lose track of dates, seasons and the passage of time. Sometimes they may forget where they are or how they got there, even becoming lost in their own homes.
(Wikipedia, 2014)
Vascular dementia - also known as blood vessel dementia, is the second most common type of dementia with symptoms similar to that of Alzheimer’s, so much so that it is commonly confused with Alzheimer 's disease. Vascular dementia occurs where problems with blood circulation result in parts of the brain not receiving enough blood and oxygen.
People with Vascular dementia will experience memory loss, difficulty speaking or understanding speech and difficulty concentrating. Similar to Alzheimer’s, they will also find it difficult to remember words and names. Other common symptoms include episodes of confusion, disorientation, mood swings, displays of aggression, feeling depressed or hallucinations.
Sometimes there are physical problems, for example difficulties with walking or incontinence. (Royal College of Psychiatrist, 2014)
Dementia with Lewy bodies - occurs where abnormal structures, known as Lewy bodies, develop inside the brain which leads to a decline in thinking, reasoning and independent function. Similar to Alzheimer’s disease, individuals with Dementia with Lewy Bodies also experience memory loss, difficulty planning and organising tasks.
In addition, they will also display symptoms which distinguish this Dementia with Lewy Bodies from other types of dementia such as vivid hallucinations, fluctuating states of confusion throughout the day and some Parkinson’s symptoms such as tremors, muscle stiffness, falls or difficulty with walking. (NHS Inform, 2014)
Frontotemporal dementia (sometimes called Pick 's disease or frontal lobe dementia) – is where the frontal and temporal lobes (two parts of the brain) begin to shrink. Frontotemporal dementia is much rarer that other types of dementia and usually develops in people who are under 65 (Alzheimer’s Society, 2014)
Frontotemporal dementia - affects the front part of the brain which normally affects personality and behavioural changes. Examples of these behavioural changes include inappropriate behaviour in public, loss of inhibitions, loss of interest in personal hygiene, depression, lethargic etc.
Frontotemporal dementia also has symptoms similar to that of dementia with Lewy bodies and Parkinson’s disease because it affects certain muscle functions resulting in shakiness, lack of co-ordination and muscle spasms and stiffness.
Creutzfeldt-Jakob disease - is the least common form of dementia, caused by the build-up of abnormal infectious protein in the brain called a prion. Prions are misfolded prion proteins that surround brain cells and causes the brain cell to die, releasing more prions to infect other brain cells. This causes the rain tissue to develop holes and take a more sponge-like texture. (NHS Choices, 2014)
Symptoms of Creutzfeldt-Jakob disease (CJD) sometimes resemble those of other dementia-like brain disorders, such as memory loss in Alzheimer 's, but Creutzfeldt-Jakob disease usually progresses much more quickly with rapid decline in thinking and reasoning as well as involuntary muscle movements, confusion, difficulty walking and mood changes.
Creutzfeldt-Jakob disease is usually diagnosed by the marked rapid mental deterioration, usually within a few months. (Mayo clinic, 1998 – 2014)
Huntington’s disease - Unlike most other causes of dementia, the onset of Huntington’s disease can be as early as the mid-thirties and can continue to deteriorate for approximately 20 years or so.
The main symptom of Huntington 's disease is uncontrolled movement of the body. Similar to dementia, Huntington 's disease also causes a decline cognitive ability such as thinking and reasoning skills, including memory, concentration, judgment and ability to plan and organize. Behavioural changes include depression, anxiety, anger, irritability, obsessive-compulsive and repetitive activities. (Alz.Org, 2014)
MEMORY LOSS
The most common symptom of dementia is memory loss and the loss of cognitive abilities.
The ability to process information is dependent on the use of our memory. This is the process in which information is acquired, stored, and retrieved.
The loss of memory and cognitive abilities causes difficulties with communication because it requires processing skills that the individual no longer has. As the disease progresses, the individual’s ability to process information gets weaker and their responses can become delayed due to difficulty processing words. They will then experience difficulty performing certain familiar actions such as using equipment or following verbal directions due to language confusion.
The memory loss is followed by many other and behavioural symptoms. Eventually, over many years, the person loses many mental and physical abilities and will require 24 hour care and assistance. As dementia progresses, the ability to communicate deteriorates and the individual will have difficulty expressing their views and, so will withdraw from social activities. (Wikipedia, 2014)
The effects of Dementia symptoms
“Symptoms vary between Alzheimer 's disease and other types of dementia, but there are also broad similarities between them all” (Alzhiemer’s Disease International, 2014)
The impact of dementia on individuals, family and friends can be physical, psychological, social and economic can be the cause of great stress to all concerned.
The early symptoms of dementia often go unnoticed by the individual and those closest to them because they are often mild and, are usually considered to be a sign of ageing. However, as the symptoms progress, the person with dementia will become more and more aware of the decline in their mental abilities and their inability to do and remember things. At this stage of awareness, it is only natural that they will feel anxious, scared and vulnerable. Their decline in ability will be frustrating and upsetting for them, causing them to feel sad and depressed. They may also feel angry about what is happening to them or angry with themselves for not being able to control their symptoms.
The onset of dementia also has a major impact on family members who may have noticed the change in their relative for some time but not fully understood what was happening to them. As their personality and behaviour changes, family members may begin to feel angry, frustrated and depressed.
As the disease progresses those closest to the person with dementia will, unknowingly, may start grieving process as they realise they are slowing losing character and personality of their loved one. (Livestrong, 2014)
Fluctuating Needs:
Dementia is progressive. This means that as the individual 's brain becomes more damaged their symptoms will change and become more and more severe. Although the symptoms of different types of dementia are similar, the progression of the disease will vary from one person to another. Dementia is an individual illness and, therefore, each person will experience dementia in a different way.
People with dementia will have some days that are better than others. The speed at which symptoms get worse and the way that they develop will depend on the cause of the person 's dementia, their overall health and their circumstances. Therefore, their ability to do things can change from day to day, or even hour to hour, depending on the changes brought on by the changing chemistry of their brain. movement has occurred, if a door is opened or where the person with dementia, or other care staff, can quickly summon assistance when needed.
Falls can have detrimental effects on people with dementia, including injuries and loss of confidence. People with dementia tend to be at a high risk of falling therefore, preventing falls for people with dementia is a critical part of their care. Fall preventative measures can include making sure their flooring is safe by removing loose rugs and mats, making sure there are no wet surfaces, trailing cables and that all areas have sufficient lighting.
To help the progressive loss of cognitive ability and minimise confusion, the use of colour coded areas such as hallways, corridors, doors, rooms helpful with movement, recognition and co-ordination.
Changes in behaviour, needs and abilities must be recorded in care plans which should be regularly reviewed and updated with as much input as is possible from the person with dementia, their relative/carer and other health care professionals to ensure a holistic approach is adopted to meeting care needs.
Feeling of isolation and depression can be experienced by individuals with dementia, especially if they were previously active in their community. Community activities should be encouraged either by inviting members of the local community such as schools, colleges, religious communities to visit to encourage continuing of interests and hobbies. This will forge valuable links with the community as well as relieve boredom and isolation. (RCN, 2014)
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