People with Dementia on Family-Free-Samples-Myassignmenthelp.com

Question: Discuss about the Self-Management of Client with Dementia. Answer: Introduction Dementia is a neurodegenerative disorder that affects the brain. The symptoms are the memory loss, difficulties in thinking, problem-solving. This affects the person coordination movements and the abilities in everyday activities. Dementia is not a specific disease it is progressive. Dementia is the affect of many other neurological disorders like Alzheimer's, vascular dementia, Lewy body disease, Parkinsons disease (Chen et al, 2016). This report highlights on the self-management strategies perceived by the nursing staff to support their clients with dementia. People with dementia face problems in managing the condition in daily life. Thus the self-management will support the nurses to make effective interventions for controlling the conditions of dementia in the client Pathophysiology Dementia is the symptom of other different structural diseases as well as several system degenerations. Alzheimers disease is the real cause behind the pathophysiological conditions of dementia. There is degeneration of the cortical and subcortical cholinergic neurons and the large pyramidal cells present in the cerebral cortex. This results in the clinical symptoms due to deterioration of the functions of the cortex .The pathophysiological cause of dementia includes the structural lesions in the brain. Sometimes dementia may be caused by the nutritional and metabolic disorders. Neuropathologically the amyloid plaques, pinched off cholinergic nerve endings, lesions in the outer layers of cortical lobes contributes to the outcome. The pathophysiological substrates are the neurofibrillary tangles (Barker et al, 2014). The tangles consist of tau protein which actually functions in the maintaining the structure of nerve cell. The attachment of phosphorus is required in the modification o f tau protein. However, in dementia, there is excessive phosphorylation and it results in loss of function of the protein. The oxidative stress or damage in the cellular structures by the free radicals also lead to dementia caused by Alzheimers disease. The brain inflammation in old people is another pathophysiological reason behind dementia (Fong et al, 2014). The abnormal genes that encode for amyloid protein and the cholesterol bearing protein cause the pathophysiological conditions of dementia. There is primary dementia caused by the irreversible changes of other neurological disorders and secondary dementia caused by chronic meningitis, acquired immunodeficiency syndrome. Looking into the pathophysiological condition of the patient with dementia, the self-management strategies are to be developed that will help the nurses to tackle the problems of the everyday life. The psychosocial interventions are to be served by nurses by teaching the patient with self-management of the con ditions (Ballard et al, 2013). Health maintenance and promotion The patients with dementia face daily cognitive problems like coordination impairment due to loss of memory and perception. Activities of daily life are affected with dementia. The difficulties that arise are due to difficulties in executive functioning like wash hair, dressing, clothing. There are problems related to poor decision making, attention. All of these health issues make everyday life challenging for the clients affected with dementia (Aguirre et al, 2014). Thus self-management strategies adopted by nurses for health maintenance are extremely required. In the health maintenance, nurses should teach some of the principles in self-managing skills to tackle the everyday problems. The adaptive aids can be given to the patient that will define the wide range of memory aids to bathing equipment and that will aim to minimize the impact of physical, cognitive and sensory problems (Khanassov, Vedel, Pluye, 2014). The low-level technologies like computers and telecommunications can be used by the client to remember their task. This provision of adaptive aid given by the low-level technology would involve the person with dementia and the carer in their own environment. The health maintenance can also be facilitated with the modification of their own environment (Lavretsky et al, 2013). The memory aids like calendar, diaries, schedules in books and electronic devices can be introduced. For their health maintenance in self-management, they can be, taught to exercise that will be like memory training. The memory training exercise with memory aid could serve as the powerful tool in health. Thus exercise if done daily it can help them to manage their own mobility problems. The health maintenance strategy that is to be brought to the patients is going to target the quality and enhance the functional performance in improving cognition, mood, and behavior. The health maintenance will also guide the accurate pharmacological interventions that the patients should follow. They must be encouraged for attaining group based therapy mainly that will include recreational and social therapies. . They can use telecare for getting the treatment when necessary easily even if the patient stays in remote areas. In the context of promotion of self-managing strategy for dementia, the nurses can perform specific interventions for promoting independence. The promotional plan should be designed based on the strength and the needs of the clients. The first thing that the nurses can use as a tool in the promotion is the communication (Ducharme et al, 2013). Communication will serve as the core for the psychosocial interventions. The communication skills may be effective in ensuring the least amount of dependence care. This is done by using verbal and body language, communication with pictorial form and memory books. The rehabilitation programs can also be adopted that will teach the persons with self-management of their cognitive, perpetual and mood elements (Trahan et al, 2014). The promotional programs will encourage them in participation that will help the dementia clients to achieve pleasure and will help resist challenging behaviors. A good promotion of the management of the problems of demen tia may be helpful to prevent the early dementia .The promotion method targets the entire population as a whole. This increases and enables the people to control over the health determinants of dementia. Rehabilitation programs will create supportive environment for health and also develop personal skills in managing the conditions. Cultural safety The clients belong to the culturally different background. Different people have different cultural beliefs. Thus cultural awareness must be present in any strategy the nurses take to support the self-management of the people with dementia. The cultural competence should be maintained. There should be culturally safe dementia care. Suppose the nurses are planning for any study of the recurrent conditions of the clients after they have been guided by the self-managing strategies, they will make questionnaires in such a way that they do not breech the personal beliefs and ethical issues of the old clients. The innovative community-based research program can be formed that will be analyzed by the group of nurses and decision makers to design the programs that will attract all the culturally diverse groups of people (Kirmayer, 2013). Cultural safety in an environment is safe for all the people as there will no denial in the identity and will ensure shared respect and knowledge. The nurse s must first notice all the practices and the cultural aspects of the clients on which the strategies are to be implied. Empowerment Empowerment is a part of an important task to improve the care of the persons with dementia. There are several ways by which empowering can be done for the self-management. This could be done by developing purposeful activities because negative outcome often leads to frustration. The nurses should speak face to face while delivering their teaching session or introducing any rehabilitation programs (Hutchinson et al, 2016). They must try to gain the attention of the person in the procedure. The things that the nurses are going to make notice to the client must be conspicuous that is camouflage of what the nurses wish him to avoid. The items should be plain and must develop positive responses to task. This is because the procedural memory lasts longer. The nurses can establish their empowerment only thorough good communication with the patients. In that case when the nurses wish to establish any points they must validate the emotions they hear. The nurses should remember not to disagre e with the patient's sense of reality .The negative behavior of the client should be decreased while communicating with the patient and making them understand the strategies of self-management in everyday life . It also offers choices and thus empowering environment can be created. An empowering environment is very essential to maintain the fruitful conversation with the clients affected with dementia. The above ways of empowering the patients will be useful for them to live independently and self-manage dementia. The process of evaluation and program based on rehabilitation is going to aim at empowering the elder clients with early dementia. The education and counseling programs can be also made likewise to empower both the patient and the family of the patient (Bhattacharyya Benbow, 2016). Impact on carers The self-management can be established only with the help of the carers. If the carers are tired or stressed then it will become harder for the patients with dementia. It will thus be important for the carers to continue the activities that keep them happy (Hou et al, 2014). The impact of care while handling the patients could result in negative outcomes making them weary at work. At moments carers can experience feelings of guilt loss or anger. The carers must themselves be skilled and relaxed and then teach the patients in self-managing their everyday conditions. They must be very active in supporting the available care and provide the empowering environment with practical assistance to the patients. The caregivers frequently report of experiences of high level of stress. Understanding and supporting a person with dementia could have both emotional and psychosocial impacts on the care givers. The care givers, in this case, must recognize their problems and try to be supportive as p ossible.The support should be sensitive to the person and must aim to focus on promoting the well being. It is entirely dependent on the care givers to create the empowering environment for the patients so that they can learn to self-manage their every-day problems (Moradi-Lakeh, Vosoogh-Moghaddam, 2015). Caregivers can face many obstacles while managing a dementia patient. The impact on care givers is diverse and complex. There are many factors that exacerbate to their impacts. Caregivers often face obstacles related with the problems in household, depression and as a result they might not do their jobs properly. The family conflicts that they face is due to the strains in personality, competence and captivity role. Conclusion This entire report reflects on teaching self-management in patients with dementia. Since the pathophysiological factors show that progressive dementia is ruled with complex cognitive and coordinating disorders, self-management of dementia is the must. There are huge problems associated with the patient in everyday life. Thus the community nursing plan will be made that is going to assign rehabilitating programs and increased communication that is going to make the client competent enough to handle their everyday life situations in dementia. The nurses can ensure the teaching and the promotional programs by mediating an empowering environment. The environment will not only stimulate the clients in learning but will help to cope up with the strategies that are given on them. The promotional program that is developed is not only going to be helpful for the patients but also for the care givers. These programs must be scanned and shielded with cultural safety. The nurses must be well awa re of the cultures of the group of people on which the program will be launched. 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