Intervention Approaches To Driving And Dementia For Health & Social Work

Impact of Dementia on the Aging Populace

Intervention Approaches to Driving and Dementia for Health & Social Work?

The aging population is at risk of developing dementia and the life expectancy is amplifying worldwide as per the (Menne, Judge and Whitlatch, 2009). The population of dementia has annually rising as projected (see figure 1.1), and in UK, approximately 850,000 people are living with dementia in the year 2014. According to the (Ravelin, Isola and Kylmä, 2011) , the cost of caring for people with dementia has increased to £26.3 billion in a year at UK.

According to (Ravelin, Isola and Kylmä, 2011), the functional ability that gradually disabled a person to maintain the social life that affects the cognitive performance and the functional ability, this syndrome is called ‘disease of the brain’. With the help of this attributes one person can live independently and carry out their daily activities (Soderlund, Norberg and Hansebo, 2011). The Alzheimer’s disease of dementia is the most commonly disease (AD) (Yang et al., 2014). In order to deviate from onset and progression (See figure 1.2) there are different types of dementia. There are three stages of dementia according to Alzheimer’s Society (2015). The disease has powerful effects like the person used to become more forgetful, confused, disoriented in his/her daily life so for that the patience needs more encouragement. The verbal, and physical aggression, repeated questioning, sleep disturbance, apathy or psychosis, depression, wandering these are the behavioral and psychological symptoms in dementia (BPSD).

It delays or prevents unnecessary admissions into hospital or an institution as it diagnosed early, as per the National Dementia, strategy establishes the rising awareness (DH 2009). With the help of the rising awareness, it can improve the people health and it is cost effective (DH 2007). For the patient and their careers, the NH vision and the clinical governance impetus has increased the growth in improving the outcomes as it ensures by the paramount and commitment for policy development (Adler, 2007).

The increase use of antipsychotic medication in dementia care that has been control to endow with patient safety and the quality of life, this is an increasing concern (Blais, Zolezzi and Sadowski, 2014). The person-centered approach of care outlining the guide and the principles by negate NICE and SCIE (2006). The drug of this disease is counter-productive originated high number of death rates and cerebrovascular events. The Antipsychotic medication disease is treated in UK over 180,000 people (Cayton, 2004). When non-pharmacological interventions is employed by staff in concurrence with the management of medication categorized by cholinesterase inhibitors and analgesia (paracetamol), then the possible reduction on the use of antipsychotic drugs is needed (ceur-ws.org, 2015). According to the NICE (2007) guidelines the use of anti-psychotic medications should consider first before except the enduring is very anguish and at danger of self-harm or others (Khan and Curtice 2011, 1000 lives plus 2012). The purpose of patient’s care is to endorsing health and avoiding ill health and for that, the nurses should be accountable and answerable for their actions (i.e. administering drugs).

Costs of Caring for People with Dementia

The Roper’s nursing model is the central component that ensures the patient individualized care safety NICE (2006, 2010). LSW should indentify the patient’s individual needs and preferences so that they should have the personalized care plan. Regardless of cognitive symptoms, the dementia patient’s are offering to engage activities in a structured form of recollection. The dementia patient should have the opportunity to share their thoughts and memories with the people that have been defined by the LSW as biographical approaches in health and social care settings (Chanti-Ketterl et al., 2014). There will be some concerns for the patient’s who can be identified in the group of vulnerable individuals (fons.org, 2015). The confidentiality, preference of the patient, their interests should be take care by the nurses. As NMC (2015) in order to identify the patient with dementia and the preserving dignity, that is effective means by LSW, as states by the equality and human rights commission (2011).

The utilization of the role of a nurse can augment PCC with the dementia patient that will evaluate by the author.

Nursing index, CINAHL, PUBMED and the Cochrane are the online nursing database, these is used to search the most consistent and applicable information. These are the main keywords that were considered in order to search the most relevant data (Hamill, Smith and Rohricht, 2011). The Boolean operator ‘OR’ and ‘AND’ are commonly used synonyms that were combined to use earlier. The keyword like ‘biography’ or ‘storytelling’, ‘dementia’ or ‘elderly’, ‘enhance care’ or ‘patient centered care’. The inclusion and the exclusion criteria against the combined results were screened (see Table 1.4). In the research article, it was mentioned that the back/forward chaining for searching are used in the reference list.

In order to include the searches that had access to the full article, an advance search of these results that was carried out and it was published between the 2000 and 2015. The search results that are specified specially in UK are very fewer than anticipated and it was decided to leave the search results from all the geographical locations. The five investigations that were performed in UK, for the interview six appropriate articles are selected and the remaining one was completed in Sweden (Appendix 1). Communication and relationship, preservation of identity, patient centered care was included in the six articles that were identified to take into consideration.  

Database	Search Strategy	Dates	Number of Citation	Relevant abstracts
British Nursing Index	(Life stor*) AND dementia	2000- present	41	9
British Nursing Index	(Biograph*)AND enhance care	2000- present	6	2
CINAHL	Life story AND dementia	2000- present	49	7
CINAHL	Life story books AND the elderly	1999- present	87	4
CINAHL	(Life hist*)AND Enhance care	2007- present	38	1
Medline	Life story dementia	2007- present	66	4
Medline	Dementia AND biographies	2007- present	679	0
Back Chaining	N/A	2007- present	12	0

(Journals.elsevier.com, 2015) opined that the communication as the mutual communicating process through which someone can send a message and can receive the message from another person. It is a process of transferring of messages in between two people or more than two people. If the nurses can develop the interpersonal skills by integrating their good communicating process, then it will help the nurses to get feedbacks from the patients. This process will help the nurses to develop their working skills by getting the feedbacks from the patient. Nurses should use an emotional voice tone and compassion while communicating with the patients to help the patient to make the good relationships with the nurses Russell et al (2009). This help the nurses to establish better relationships with the patients by engaging the patient with various positive activities and communicating capability. By communicating with the patient, nurses can reduce the disturbances among the patients. Better communicating process will help the patients to behave properly. As described by (Kawashima, 2008), better communication can help the patients to get rid of dementia and can help the patient to live better half of their life. The Department of Health also agrees with the experience that the communication is the only treatment of dementia patient to get rid of the disease.

Different Types of Dementia and Stages

It is apparent from the study that the dementia patient can communicate meaningfully with the other people. (Keith Hill, 2015) scrutinized few dementia patients in the hospital who makes a diagnosis to get rid of the dementia disease using research methodology. The haphazard interview was taken by the doctors to collect profuse information and data. While giving interviews to the doctor, the dementia patients always draw stories in their mind and covers the interview sessions. This research study come across many challenges in evaluating the information using signs and secret codes as the problems involved in the communication process may occur during the communication (Lbda.org, 2015). It can be stated that the legitimacy can be debatable during conversion of information. It can be stated that the qualitative communication can give better results while communicating with the patients. This will help the nurses to establish better relationships with the patients by engaging the patient with various positive activities and communicating capability. By communicating with the patient, nurses can reduce the disturbances among the patients. Better communicating process will help the patients to behave properly.

(Lolk and Andersen, 2014) study propose that the communication process with the dementia patient is probably using LSW. This should be at the central part of practicing nursing jobs. It assists the staff to motivate the memories of the patients and discussion (Menne, Judge and Whitlatch, 2009).The related life stories of the dementia patients will give the nurses vast knowledge regarding the dementia patients. As the dementia patients are treated as the unique person to compare with the normal persons. The knowledge of the nurses taking care of the dementia patients are huge regarding the symptoms of the dementia patients (NMC 2015). It has been observed that the dementia patients have more feelings in them and they feel more comfortable while communicating with others. The dementia patients show more feelings and emotions while communicating with the other people and can develop better relationships with the listener and the patients.

As opined by the McKeown, the communicating process gives better outcomes, and if the approach follows LSW method, then it gives far better outcomes. In-depth research study gives better position to discuss and observation power to understand the situation of the dementia patients and will help the nurse to keep the patients under observation/ This will help the nurses to understand the dementia patients better and practicing with LSW method will give them better outcomes to understand the feelings and emotions of the dementia patients Clarke et al (2003). It can be stated that the legitimacy can be debatable during conversion of information. It can be stated that the qualitative communication can give better results while communicating with the patients. This help the nurses to establish better relationships with the patients by engaging the patient with various positive activities and communicating capability. By communicating with the patient, nurses can reduce the disturbances among the patients.

Non-Pharmacological Interventions for Managing Dementia

According to Mckeown et al. (2013) has stated that most of the people enjoys communicating with the dementia patients regarding their lifestyles and many of them shows interest to listen to their personal life stories. If the dementia patients start to disclose their personal matters in front of the people, then they will narrate their stories with lots of feelings and emotions. While giving interviews to the doctor, the dementia patients always draw stories in their mind and covers the interview sessions. This research study come across many challenges in evaluating the information using signs and secret codes as the problems involved in the communication process may occur during the communication. It can be stated that the legitimacy can be debatable during conversion of information. It can be stated that the qualitative communication can give better results while communicating with the patients. As described by (Moniz-Cook, 2006), better communication can help the patients to get rid of dementia and can help the patient to live better half of their life. The Department of Health also agrees with the experience that the communication is the only treatment of dementia patient to get rid of the disease.

However, (Moyer, 1983) indicated that the LSW helps the staffs, a fresh imminent which helps to remember each and every dementia patient for their individual inimitability. The centeredness of dementia patient requires reorganization power to remember each and every dementia patients for their good communication skills and behavior  (McCabe and Timmins 2006). . Better communicating process will help the patients to behave properly. As described by Potkins (2003), better communication can help the patients to get rid of dementia and can help the patient to live better half of their life. The Department of Health also agrees with the experience that the communication is the only treatment of dementia patient to get rid of the disease.

According to (MV, 2015)the basic feature of a nurse is nothing but to recognize different kinds of tactics in order to handle the patients and availing best possible care for the patients. Patient centric care is nothing but identifying the necessities of the patients, their choice and conveniences that enables a patient to be literally unique in their approaches. The main motto of LSW is nothing but to provide a sophisticated patient focused caring service which engages them to become essentially developed in their approaches.

A study of (Nhqualitycampaign.org, 2015)in different NHS Hospitals on the dementia patients and staff nurses and family members of the patients clearly visualize that approaches of the patients in this aspect is more intrinsic that leads in determining more cohesion. For this particular research study the researchers have collected the required data by interviewing 8 patients who were under treatment in the hospital, there family members and the other group people who have been in contact with these patients. From the findings it is analyzed that patient care approach is literally intrinsic aspect that helps in determining better duality. Building relation between the patient, patient’s family and the group of hospital people who looks after the patient is literally essential. Meeting the psychological and mental approaches for a patient is therefore quite essential. Approach of LSW in this aspect is for enhancing the patient care and letting the patients integrated in their approaches is literally necessary. Credibility of the patient is therefore quite immense in this approach that helps in maintaining persistency. For the study the researcher have paid the nurses for working in the night only to find out what are the issues that the nurse and the patient is facing. It leads to pertain the practical necessities as well. The care workers seem to have stated their experience before the researcher which leads in identifying the issues. They seem to have also shared their experiences of apprehension and restriction of timing. Talking about the heart throbbing memories, painful stories of the patients also seem to cast typical problem on the development of the person. LSW is also helps in pertaining the positive attributes for the patients. It let the nurses work and access to their work positively and systematically. It emerges out from the study that the main motto of LSW is nothing but to determine the challenges. Understanding the behaviour of the patient is literally intrinsic that leads in managing the patient’s behaviour. Proper implementation of these approaches is also quite intrinsic approach that determines in appropriate delineation of the behaviour.

Importance of Patient-Centered Care in Reducing Antipsychotic Drug Use

Findings presented by (Pierce, 2011)states that 4 female patients who were suffering from severe symptoms like BPSD appear to get intricacies. Life approach of unusual behaviour leads to definite and concretise the status of the considering patient. Two of the patients appear not to have projected any unusual behaviour. It seems to be one of the proficient approaches that leads to manage the aggression level managed intrinsically. It appears to be a significant factor in managing better prospect. No significant sign of aggression is defined and presented in this approach. Selection of the candidates always may not seem to be potential approach. The study also projects that approach of LSW is also quite circumstantial aspect that leads in managing better coherence in this approach. It leads to attain better approaches for determining a sophisticated coherence for the person. Number of individuals in order to manage this approach is leading to develop better sophistication. The research projects how the number of participants is responding this approach that delineates the necessary ethics in this research study.

But it is needed to be mentioned that current state of the participant or the patients has not been clarified or managed in this aspect. In some aspects prejudices become one of the point that put its impact on the development of this ethics as a whole.

The theory of Kitwood (1997) states that in dementia the state of a person changes that bestow on the on the social relationship and others. Social approaches are also quite significant approach that leads to attain respect, trust and other significant approaches. The socio political and biological theory of dementia leads in managing a broader prospect. The underpinning factors are also literally underpinning issues that lead to maintain better coherence. It seems to be quite significant issue for managing the crucial elements to attain better cohesion.

McKeown et al. (2010) in their study mentions that semi structured interview process helps in managing and determining some of the intuitive aspects as well. It involves in managing better coherence in the health and safety ethos. Relatives in this approach appear to be keener and heard which henceforth enables personhood approach. Beyond the staffing and challenges the approaches of a patient is more intrinsic that delineates the challenging epoch. It involves in better personhood and involves a person in handling a patient from dementia in better way. LSW involves in care and opportunity development. 

Benefits of Improved Communication and Relationships

The study of Karlsson et al. (2014) projects light on interviewing around nine participants suffering from Alzheimer’s disease. The interview seems to have been lasted four hours. It encourages in attaining better cohesion. Evidence of sustainability proved from this approach is literally immense. Its approaches are literally more impressive to engage the dementia patients suffering from the sense of self motion. The dementia patients are having more coherence in this approach. A clear understanding of the approach of the older people from the past context appears to attain better prodigality. It, however, appears to be better understanding approach applied from both the patients and doctors approaches. It appears to be another important approach that participates in composite development of the patient at the same time. Identifying the identity of the patient leads to maintain more prodigality (Surr 2006, Hydén &Antelius 2011). Promotion in this order of a patient is technically intrinsic fact that ensures better prodigality.

LSW is the basic means of preservation of identity and personification of people with dementia. Story telling is a good option for them to revive their identity providing an opportunity to remind them ‘who they are’. It is a great process for injecting a extrinsic drift in their memory for remembering their past as well as their experiences (Murphy 2000). Their voice works out better in the case that might make them nostalgic in a way. It is also helpful in treating the people to know more about the past of the patients. According to McKeownet al. (2006), it indicates to treat the people rather dementia as dementia patients need attention much. This process is popular in providing the patient an identity whereas it also encourages the caregivers to treat the patient individually (PINNER, 2000).

Conclusion

In this context, the review of the literature aims to provide information on usage of LSW in treating patients with dementia. The role from the caregiver may enhance the PCC among the patients as depicted from various past researches among the patients and treatment centers. The method of intervention has provided a strong affinity towards positive yield from the current method for the patients, nurses and the families of the patients (McKeownet al. 2006). LSW uses the simple method those are the out of context of pharmaceuticals treatment of dementia patient; however, has been resulted as positive effect on them.

The caregivers can demonstrate their whole ability for treat the people with dementia while relationship creation helps the nurses to communicate with patients effectively. It helps the nurses to understand the requirements of the patients with a proper communication among them retaining a care towards personal level. The process of telling the story of a life of a patient might be useful in retention of their memory for the old people (Karlsson, E. et al. 2014).

The commonality in method of intervention of dementia is to provide every patient separate treatment as it has showed useful result in treatment. The process is quite submerged with the historical analysis of the patients in describing their personal life of the patients and analyzing the ongoing process repeatedly. The treatment method of LSW is useful mainly for the old people to make them nostalgic as well as to remind them their past (Kunz & GraySoltys 2007). This process also allows the old people to reminiscence of previous life context for recapitulating the past life grieves and other incidents mainly. It helps in reconciling the past life due to remembering the history.

The different studies have yielded the same concurrent results in deducing the topic as usage of LSW can help the patients in treating dementia. The past researches also have deduced that intervention method of LSW is helpful in making relationship with the patients. It becomes helpful in drawing decision for the style of treatment for the caregivers as the stories of life tell the details action of the patients. Further, the insights of the patients also provide the patients a chance of gaining a cognitive communication among the patient and the caregivers (Moore and Hollett 2003). The phase of the caring-schedule from the caregivers become different for the different patients after knowing their past life as the treatment style of those patients become unique. The better understanding of behavioral approach and gestures of the patients may provide a better line of treatment for the patients – thus resulting in decrease of aggression and enhancing of PCC (Spittel2011).

The researches present in the case of dementia patient treated with LSW, the section is far behind to develop any good piece of qualitative research while different races and ethnicities. The sample of the research were not properly adjudged according to the sampling method as followed in statistical distribution. The qualitative research would follow the method in details and more inquisitively to understand the observation of the experience of the caregivers and development of the patients. Thus, it can be concluded that more research is necessary in this case to understand the science of LSW entirely.  Further, the staff engaged in this care giving process needed to be treated well due to getting the best effort from them. The research also identified that nurses have minor to spend with the patients due to huge pressure of dementia patients in the clinics.

While reading the literature, I have got evidence that support me in case of treating different patients regarding to the needs of the individuals and also the psychosocial and physical need are supported which is essential in case of protecting their identity. I got more enthusiasm in case researching the real beneficial of the LSW and also the process that are required in case of implementing in several setting of care and if the positive effect is noticed on the attitude of the nurse.

While working regarding to the activity of the nurse, the necessarily of time management is also reminded so that the time that are got free can be spent with several patients and develop regularly the relationship that provide benefits to the efficient and effective management regarding to the environment and patients.

There are several lessons that I have learned which includes how the applicable articles can be effectively found on the basis of appropriate data. Regarding to the assignment and the practice that I am going to do in future, this knowledge will become very helpful. Regarding to the research, there are several comparison and contrasting in the research that help me to identify the efficient and the importance of the quantitative and the qualitative research and all the role in the practices regarding to the evidence. All the evidence will be helpful to the nurses that are all done in the practices as all the reading is required in their actions.

 According to this literature review, the importance of the patients of dementia are regarding to the individuals and in the practices that will be implement in the future is involved in the family practice. All are different regarding to the patients according to the review and they have right regardless to the cognitive injury of caring individually and how the documents that is written can employ in case of improving PCC.

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