Discuss about the chronic renal failure,risk factors, prevention and management of CRF in patient with dementia .
Kidney is one of the most vital organs in the body. It performs a wide range of roles in the body such as the filtering of the excess fluids and wastes from the blood and channels them for excretion as urine. However, the functioning of the kidney might be impaired if it is affected by illnesses such as Chronic Renal Failure (CRF). However, just like any other disease, CFR is an illness that can be treated because it has the causative agents, risk factors, and known signs and symptoms that can be relied upon during its diagnosis. The other thing that is worth noting is that as a disease, CRF has a direct link with dementia because it is a disorder whose cause is associated with cognitive impairments. Although the success in the treatment of dementia patients with CRF depends on the effectiveness of the healthcare providers, there have been many cases where these practitioners fail to discharge their duties diligently. There have been many cases where the healthcare providers do not follow the proper instructions for the treatment and management of CRF in dementia patients. This is a very serious problem that must be addressed by equipping such healthcare providers with the right information they need to improve their skills on the management and treatment of this condition.
CRF, also known as Chronic Kidney Disease is an illness which causes a gradual decline in the functioning of the kidney. Urine excretion might be impaired especially if CRF reaches advanced stages where it causes the wastes, electrolytes, and fluids to accumulate to toxic levels. CRF takes place in five stages because its severity advances with time. The purpose of this paper is, therefore, to present a critical and comprehensive analysis of the causes, The purpose of this project is, therefore, to conduct a study to understand CRF, identify its risk factors, early diagnosis, management, and prevention strategies that apply to it (Miranda, Alatriste, Urbina Arronte, Gómez Espinosa & Espinosa Cuevas, 2014). The learning objectives that the project will seek to achieve include to understand what chronic renal failure is and how it happens in short and its effect on normal function of kidney and other organs; to identify risk factors for early prevention; to identify preventive measures in regards to occurrence and further progression of CRF; to understand management of CRF, to understand and implement how our preventive measure could help with dementia patient; and to improve my knowledge in CRF.
Theoretical Framework
The problem of poor management of CFR amongst the dementia patients by the healthcare providers can be best understood by applying the theories of Nightingale and Orlando. According to Nightingale theory of 1860, the healthcare provider should be at the forefront of delivering exceptionally high-quality care that can satisfy the needs of the patients. Orlando’s theory of 1962 states that the healthcare provider should always be committed to delivering satisfactory healthcare services to the patients (Smith & Parker, 2015). This, according to Orlando, can be accomplished by becoming committed towards the provision of individualized care that focuses on the diverse holistic needs of each and every patient. These theories can provide a framework for the provision of safe, individualized, and high-quality care to the dementia patients (Ali, Al-Salam, Al Za’abi, Waly, Ramkumar, Beegam & Nemmar, 2013).
The Causes and Risk Factors of Chronic Renal Failure (CRF)
CRF is a disease of the kidneys. Human beings have got only two kidneys which they rely on to filter the wastes and remove them as urine through the urinary track. However, as already hinted, when a kidney is infected with CRF, it cannot function well. Meaning, such functionalities might be impaired because they are rely on the kidney itself (Popolo, Autore, Pinto & Marzocco, 2013). Having said this, it is worth noting that, as a disease, CRF has been linked to a number of causes as well as risk factors.
The chronic and long-term impair of the kidney might be caused by the presence of certain illnesses including Recurrent Kidney Infection, vesicoureteral reflux, kidney stones, prolonged obstruction of the urinary track, polycystic kidney disease, intestinal nephritis, glomerulonephritis, High Blood Pressure, Type 1, and Type 2 Diabetes. These are the diseases that can make a person vulnerable to CRF. According to research, these diseases can interfere with the normal functioning of the kidneys. For example, diabetes might impair the functionality of the kidneys because it leads to the rise in the levels of sugar in the blood. On the other hand, kidney stones might obstruct the kidney from effectively-discharging its roles of filtering the wastes and directing them from the body (Miranda, Alatriste, Urbina Arronte, Gómez Espinosa & Espinosa Cuevas, 2014). Should this happen, the kidney might fail to discharge its duties well. This, hence, implies that CRF is a disease that is closely-linked with other infections that people battle on day-to-day basis.
CRF has also been linked to a number of risk factors. A risk factor, as its name suggests, refers to the condition that might make an individual or group of individuals to be more susceptible and exposed to a certain illness. People get exposed to risk factors in many ways such as through inheritance, behaviors, lifestyle, or exposure to it due to their interaction with the immediate environment. With this in mind, it is important to express that the risk factors for CRF include old age, abnormal kidney structure, and family history of kidney disease, race, obesity, smoking, heart attack, High Blood Pressure, and diabetes. These are the conditions that can make ne to be more vulnerable to the disease. Here, it can be deduced that the risk factors for CFR range from illnesses, genetics, and behaviors. When a person is exposed to such factors, it becomes risky because the chances of suffering the disease increase. For example, if a person has a history of kidney diseases in their family lineage, it is most likely that they might suffer from the disease (Tbahriti, Meknassi, Moussaoui, Messaoudi, Zemour, Kaddous, & Mekki, 2013). That is a clear proof that CFR has some genetic linkage because it can be transmitted through the genes. Research has also revealed that susceptibility to CRF is also influenced by one’s race. The indigenous communities and the blacks, for instance, are more vulnerable to the disease than the rest of the people like the whites (Caucasians). Meanwhile, the chances of contracting the infection might be increased by behavioral practices such as smoking, physical inactivity, and unhealthy eating habits that might expose one to illnesses like diabetes and obesity.
Prevention and Management of CRF in Patient with Dementia
Dementia is a mental disorder which results into the loss of memory, thinking skills as well as other mental capabilities of human beings. It is a collective term that refers to different kinds of ailments -including vascular dementia, Alzheimer’s disease, Mixed dementia, Wernicke-Korsakoff Syndrome, frontotemporal dementia, parkinson’s disease, normal pressure hydrocerophalus, creutzfeldt-Jakob disease, and huntington’s disease. These are diseases which impair the people’s mental capabilities hence making it challenging for them to lead normal life and undertake day-to-day activities constrain-free. Alzheimer’s disease is one of the most common types of dementia that accounts for up to 60-80% of dementia cases in the society. Its signs and symptoms include depression, apathy, and difficulty to remember names, past events or conversations (Ali, Al-Salam, Al Za’abi, Waly, Ramkumar, Beegam & Nemmar, 2013). Vascular dementia, on the other hand, is a type of dementia illness that does account for approximately 10% of the dementia cases. Its signs and symptoms include inability to organize, make plans or make decisions. The dementia disorders are caused by a combination of physical and cognitive factors.
Research has established that there is a close relationship between the CRF and dementia. According to several findings from the neuroinmaging, anatomy, and pathophysiology studies, there exists a strong association between dementia and CRF. On certain occasions, CRF can be a risk factor for dementias. The two diseases have direct impact on the decline of an individual’s cognitive health. That is why there have been many cases of dementia in the patients diagnosed with CRF. Meaning, there is a direct correlation between them. The correlation might be caused by the fact that the two ailments share some risk factors such as the presence of certain cardiovascular diseases like High Blood Pressure and any other damaging of the blood vessels. The damages caused to the blood vessels in the brain might impair the cognitive functioning in the body hence exposing a person to dementia (Ali, Al-Salam, Al Za’abi, Waly, Ramkumar, Beegam & Nemmar, 2013). This occurs because such impairments deprive the brain of oxygen and foods that it needs to get in normal volumes for it to function normally. If such changes in the blood vessels persist for long, they may cause severe effects on the cognitive functioning of an individual.
The connection between CRF and dementia implies that the two diseases can be prevented and managed using more or less the same intervention strategies. The most important thing to do when managing these conditions is to seek for medical check-up in time so as to be diagnosed when the diseases are still in the initial stages. As already hinted, CRF is a disease that occurs in stages (Guida, Germano, Trio, Russo, Memoli, Grumetto & Cataldi, 2014). Appendix one demonstrates that, in its life cycle, CRF goes through five main stages. Hence, to be on a safer side, the people who are at a higher risk of contracting the disease should be diagnosed early enough. If this happens, it can be possible to manage the disease before it becomes severe and disastrous (Richardson, Lee, Berg-Weger & Grossberg, 2013). The same approach should be adopted when handling dementia because it also needs to be diagnosed earlier enough to enable the patient to manage it well.
Prevention Strategies
Just like most of the illnesses, CRF and dementia can be prevented if appropriate measures are taken. In the earlier discussion, it was expressed that the two ailments have got risk factors which make people vulnerable to them. For example, the risk factors for CRF are old age, abnormal kidney structure, and family history of kidney disease, race, obesity, smoking, heart attack, High Blood Pressure, and diabetes. These are some of the risk factors for dementia. Hence, to prevent the two diseases, it should be upon each person to keep-off such risk factors and not to expose themselves to them.
Although it might not be possible to run away from old age, it is very possible for any person to keep-off from obesity, diabetes, heart attack, and hypertension because these are diseases whose causes can be prevented by taking a number of measures. For example, to keep these cardio vascular diseases at bay, an individual should adopt the required behavior change such as engagement in physical activities, adoption of healthy eating culture, and stoppage of smoking and cigarette smoking (Little, Rohlfing, Tennill, Hanson, Connolly, Higgins & Roberts, 2013). These strategies can also be applied when preventing dementia because they can be of great contribution towards the improvement of cognitive and physical health. For instance, the maintenance of a healthy body weight and leading a smoking-free life can help in the prevention of dementia since these strategies can be instrumental in keeping the body’s blood pressure, blood sugar, and cholesterol levels at the recommended limits. These are the strategies that should be effectively applied in order to ensure that the two diseases are prevented from attacking people and causing unnecessary troubles. It is possible to achieve that since dementia and CRF are preventable diseases.
Management Strategies
Dementia and CRF are diseases which can be managed if appropriate interventions are adopted. Meaning, despite the complexities involved, a dementia patient who is also diagnosed with dementia can manage the condition as long as the right intervention strategies are adopted. When patients go for medical check-up, they should be diagnosed by performing a thorough analysis of their medical history, physical examination, and blood test (Ali, Al-Salam, Al Za’abi, Waly, Ramkumar, Beegam & Nemmar, 2013). If the diagnosis is positive, the healthcare provider should come up with a care plan that can be relied upon to enable the patient to manage the condition and work towards treating the condition and preparing the patient to recover and regain his troubled health.
The first way through which the condition can be managed is by treatment. Treatment is an effective management strategy because each of the diseases is treatable. A dementia patient diagnosed with CRF has a combination of physical, psychological and mental needs. Once a diagnosis is done, the healthcare provider should prescribe the most appropriate drugs that can be effective in addressing the disease. However, once a prescription is made, the medic must ensure that the patient complies with the dosage without any failures (Brooker, Latham, Evans, Jacobson, Perry, Bray & Pickett, 2016).
The second way through which the disease can be managed is by adopting the behavior change that s recommended by the healthcare provider. Since the two ailments are linked to known risk factors, they can be properly managed if appropriate measures are taken to deal with the risk factors that expose individuals to the condition. For example, the solution to the problems of diabetes, High Blood Pressure, obesity, and other such like cardiovascular diseases can be addressed by embracing behavior changes such as the adoption of healthy diet, engagement in physical activities, and stopping smoking (Lin, Wu, Wu & Wu, 2015). Each of these strategies, if appropriately applied, can play a significant role in the management and treatment of CRF in the dementia patients.
In order to achieve all these, the healthcare providers should be at the fore front of empowering the patients. After conducting a thorough assessment and diagnosing the condition, the healthcare provider should come up with an effective care plan for the patient. The care plan should encompass two issues (Heinrich, Uribe, Wübbeler, Hoffmann & Roes, 2016). One, the practitioner should prescribe the most recommended medications which are appropriate for the patient. Two, the healthcare provider should adequately educate the patient on self-management strategies that can be adopted before and after discharge from the healthcare facility.
Proposed Implementation of the Change Process
The problem that needs to be addressed is the enhancement in the management of the CRF in dementia patients. The management of CRF in a dementia patient might be a challenging undertaking. Since these ailments interfere with the cognitive functioning of the patients, it might not be easy for the patient to effectively manage the condition. This happens because it becomes difficult for the patient to remember things and comply with the prescribed drugs. Hence, to address this problem, the best thing to do is to educate the medics and carers to be vigilant on the patient (Ali, Al-Salam, Al Za’abi, Waly, Ramkumar, Beegam & Nemmar, 2013). Once the provider acquires the right knowledge on how to handle and follow-up the patient’s compliance to management interventions, the practitioner should go ahead and teach the carers as well. The teaching should center on how they can support the patient on issues to do with drug compliance, lifestyle changes, physical activity, weight control, and dietary matters. Each of these issues must be addressed because they can be of great contribution towards the management of the condition and eventual improvement of the condition of the patient that might be endangered if such a complex condition is not handled as it ought to.
Evaluation of the proposed Implementation
For any change process to be a success, it must be properly evaluated to determine the extent to which its objectives are accomplished. Having recommended that the best way to address the problem of poor management of CRF in dementia patients is education and training, it is important to assess the intervention to ensure that it is a success. Hence, to do so, the project should come up with strategies to engage in the formative and summative assessment processes (Miranda, Alatriste, Urbina Arronte, Gómez Espinosa & Espinosa Cuevas, 2014). Whereas the formative assessment should be done throughout the process, the summative evaluation should be conducted at the very end of the process to determine if the overall long and short-term objectives are accomplished (Cherry & Jacob, 2016). However, to achieve this, the assessment process should be objectively done.
Conclusion
CRF is a condition that affects many people today. The disease has become quite prevalent because of its numerous risk factors such as old age, abnormal kidney structure, and family history of kidney disease, race, obesity, smoking, heart attack, High Blood Pressure, and diabetes. At the same time, it has been found out that the disease is mainly caused by other conditions such as Recurrent Kidney Infection, vesicoureteral reflux, kidney stones, polycystic kidney disease, prolonged obstruction of the urinary track, intestinal nephritis, glomerulonephritis, High Blood Pressure, Type 1, and Type 2 Diabetes. The association of CRF to such risk factors and the fact that it has a connection with cognitive impairment implies that it has a link with dementia. Nonetheless, the dementia patients with CRF can be enabled to manage and prevent the condition if appropriate healthcare intervention that encompasses medication and behavioral change is adopted. This project is worthwhile because it identifies the problem of mismanagement of the condition and comes up with viable recommendations to ultimately address it.
References
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