Person-Centred Care: Skills And Knowledge

Assessment Tasks: Criteria and Best Practices

Caring for the People Living with Dementia

A1. Person Centred Approach to Care

Person-centred care refers to the philosophical method of service delivery and development that seeks to provide services in a manner that is responsive to and respectful of the values, needs, and preferences of those being cared for and those who provide the care.  This approach is guided by key principles which encompass the outstanding relationships, life experience, valuing of people, environment and autonomy. This type of care mainly emphasises on considering every patient as an individual (Brooker and Latham, 2015).

A2.1. An Individualized Plan

A care plan or an individualized plan always involves providing care to the patients while considering all the facets of their lives. The aspects to be taken into account while providing the care include medical compliance, spiritual and cultural beliefs, mental and physical needs among others. Individual care plans contain personal care requirements and how the care providers can achieve them (Ackley & Ladwig, 2014). Also, the plans should recognize the exceptional qualities and strengths of every patient and how to enhance them. Therefore, frequent reviews of the plans should be done to accommodate for the dynamic changes in care needs.

For instance, in the case of people living with dementia, the care providers should include food, clothes, activities, likes, and dislikes in their care plans.

A2.2. Assisting People Living with Dementia to Lead Good Quality Lives

The following effective care examples should be adopted when caring for demented patients in order to ensure that they lead a quality life. They include the provision of adequate food and drinks, maintenance of personal care such as personal grooming and washing, engagement of the patients in preferred group activities, provision of social opportunities and maintenance of relationships with friends and families outside the care facility (O’Rourke et al., 2015).

A3.1. Stable Environment for Demented Patients

A homely environment that contains things such as pictures and puzzles often helps stimulate the interest of the demented patients. The environment also presents opportunities for the patients to participate in if desired. Such opportunities include household tasks.

Also, a clearly labelled environment assists the confused patients. Moreover, the environment should include easily accessible outdoor areas for the patients to relax and perform regular exercises at will.

An environment that has readily available staff that responds to the issues and concerns of the residents is very important in creating a pertinent relationship between the patients, staff, and management.

Person-Centred Approach to Care

A3.2. Identification of Individual Needs for A Familiar and Stable Environment

By considering behaviours that are often triggered by the unfamiliar environments such as withdrawal, psychosis, and aggression, the care provider is able to identify the individual needs of the client and think about the ways of addressing such needs (Fortinash & Holoday-Worret, 2014).

Also, the care providers should review the individualized or care plan since it can indicate the information about the needs of the patient. Another way of identifying the needs of the patient in regards to stable environment involves the engaging the patient in a conversation that ultimately leads to the establishment of a good relationship. Consequently, the care provider gets to know the patient and learns about the most comfortable and familiar objects and places preferred by the patient (Fortinash & Holoday-Worret, 2014).

A3.3. Considerations for a Stable and Familiar Environment

For one to address stable environmental needs of the patient, the following considerations have to be taken into account.

First, familiar objects and items such as photographs, furniture, and ornaments should be taken from their homes and brought to the care environment. Also, a familiar routine such as eating, sleeping and waking time should be maintained. Familiar and favourable food should also be served while regulating the number of different care providers in a patient’s personal care. Lastly, regular visits from family members and friends should be encouraged.

A4.1. Response to the Abuse of the Rights of the Elderly

Witnessing the abuse of the rights of the elderly people will prompt me to listen to both the care givers and elders, take action in case of any suspected abuse and finally create awareness though the education of others on identification and reporting of abuse of the elders to.

A4.2. Definition of Elderly Abuse

Elderly abuse refers to any circumstance that involves someone taking advantage of elderly people. Someone can take advantage of the elderly by exploiting them financially, physically, emotionally and sexually abusing them, and abandoning or neglecting the elderly.

A4.3. Signs of Elderly Abuse

The signs of general abuse include personality change of the elderly people, odd behaviour and frequent arguments between the care provider and the elderly person while the signs of physical abuse include unexplained injuries such as dislocations and broken bones and broken glasses. The indicators of emotional abuse encompass threatening or bullying behaviours from the care providers and dementia related behaviours such as thumb sucking and mumbling while the signs of sexual abuse include unusual anal/vaginal bleeding and bruises around the private parts. Neglect signs include untidiness and dehydration, malnutrition and weight loss while financial exploitation signs include suspicious withdrawals from the accounts of the elderly and the missing of cash or other items from the houses of the elderly. Finally, signs of healthcare fraud include the duplicated or doubled medical bills and the insufficient care in regards to the paid amount.

Individualized Plans: Essentials for Proper Care

A4.4. Responding to Elderly Abuse

In case I suspect that an elderly person is being financially exploited by a relative, I would report the matter to the relevant authorities such as the supervisor of a care facility, a senior management member of the facility, care provider, health professionals, law enforcement officers or other relevant external agencies.

A5.1. Active Listening and its Importance in the Care for Demented Patients.

Active listening also referred to as empathic listening, is a communication form that involves the listener paraphrasing and feeding back what they hear from the patient in their own words. This form of communication helps both the patients and the care providers to clarify and confirm the communicated information. Moreover, this communication form eliminates misinterpretations and assumptions while showing high levels of understanding as it encompasses non-verbal and verbal communication.

A5.2.Verbal and Non-Verbal Communication Strategies in Engaging Demented Patients

The first scenario involved a seventy year old man living with dementia and had problems with a verbal expression as he could not speak fluently. He had gradually lost the ability of self-expression that led to substantial changes in his personality. He has social withdrawal symptoms because he does not speak often. He is always agitated due to his incapability to resolve issues and express his anger. He does not talk to anyone but instead, he shouts at anybody who attempts to engage him in a conversation. He claims that no one understands what he experiences.

In this case, I apply the following non-verbal communication strategies to engage the man in a conversation and establish a rapport with him. First, I maintained eye contact while greeting him with a gentle handshake (gentle touch). Also, I did not stand too close in order to avoid invading his personal space and used a positive tone while establishing rapport. This was necessary basing on the yelling and social withdrawal symptoms of the man.

I also used verbal communication strategies such as making short and simple statements while speaking clearly and slowly to avoid confusing the patient. I was patient and avoided interrupting him when he was speaking during the conversion. Moreover, I used different communication approaches such as visual communication and rephrased what I said in situations where he appeared not to understand what I was saying.

The second scenario involved a ninety year old woman who was diagnosed with advanced dementia and had stayed in a nursing home for six years. The woman could neither moved nor talked. In this case, I utilized the intensive interaction approach which revealed that the woman had a range of vital communication skills which encompassed facial expressions, movement, sound, and eye gazing. Also, she had the ability to start interactions, imitate communication partners, participate in communication turns and express her desire to engage in communication with others through her behaviour. A fifteen minute non-verbal communication dialogue with her made the woman to exchange head rubs, laughing and smiling.

Creating a Stable and Familiar Environment for Patients

Therefore, the interaction with the woman indicated that intensive interaction has the ability to establish open communication links between the dementia patients who have lost their speaking potential and the care providers. The most important aspect of this communication approach is that expressive emotional communication between the care providers and advanced dementia patients is achievable even without the use of speech. Therefore, this second scenario exclusively proved that non-verbal communication is very important when engaging patients with advanced dementia who lack the ability to talk and walk.

A6.a. Reality Orientation

Plan for a Reality Orientation Session

The planning of a reality orientation session involves reminding the patients of the time, day, occasions and relationships. Also, the plan should also embrace the use of body language phrases and reassuring words. Using this technique we encourage the dementia patients to communicate more freely and feel comfortable and safer. Such techniques include praises, smiling, jokes, and maintaining eye contact with the patients. The plan should also include activities such as playing word and memory games and engaging in discussions.

Materials, Skills, and Participants

Reality orientations aim to improve the skills such as self-esteem by decreasing confusion, memory loss, and psychological disorientation. To achieve this, the approach involves discussions where information pertaining to time, day, occasions and locations, and names of different residents are presented on whiteboards. Besides, the approach involves the engagement of patients in activities that aimed at stimulating their mental abilities. The participants of the reality orientation sessions include the dementia patients, care givers, and family members or friends. The materials encompass the different types of games such as memory and word games, whiteboard and calendars.

A6.b. A Case of Bill

Reality orientation will mentally stimulate Bill’s delusional mind and make him sadder. Instead, validation therapy which involves accepting the reality beliefs and values of the dementia patient, then diverting him without his knowledge will be favourable.

A7. A Script between Chloe and the Carer

Chloe (Visibly distressed and agitated): “Where’s my bag? I need my bag!”

Carer: “Your bag is missing?”

Chloe: “Yes, my phone is in the bag.”

Carer: “You need your phone?”

Chloe: “Yes, I need to call my husband and remind him to get some groceries.”

Carer: “You are out of groceries?”

Chloe: “Yes, I have checked my fridge and there is none left.”

Carer: “I have some in my fridge, I can get them if you don’t mind.”

Identifying and Responding to Elderly Abuse

Chloe: “Oh yes please, that will be so kind.”

A8.1. Activities that Help in Maintaining Independence

Diana is a 57-year-old lady who was recently diagnosed with dementia. Her daughter observed that Diana expressed symptoms of helplessness and memory loss. In consultation with the doctor, Diana was advised to embrace a care plan that encourages routine activities based on her preferences. After the development and involvement in routine activities, Diana was able to regain some independence in grooming, dressing, personal hygiene, drinking, and eating, as well as participation in social activities. Consequently, her daughter noticed that the activities helped Diana to regain a sense of control and identity.

A8.2. Activities for Maintaining Appropriate Individual Cultural Needs

Martin prefers to personalize the activities to specific people by celebrating the special occasions and considering their cultural backgrounds. One of the patients he provides care for has an Irish cultural background. In regards to the patient’s cultural heritage, Martin does a special favour on St. Patrick’s Day for his patient. He dresses in green outfits and designs a banner that displays four leaf clovers with the celebratory phrase “Happy St. Patrick’s day”.

A9.1. Risks Associated with Dementia Patients

Some of the risks associated with dementia patients include the capability of the patients to identify their own way, the capacity to negotiate traffic, the ability to operate home appliances, the competence of financial management, and ability to identify danger in their surrounding and to ensure the safety of others.

A9.2. the Case of Beverley

Being creative and thinking carefully helps in increasing the independence of dementia patients by managing the risks based on their choices. For instance, in the case of 87-year-old Beverley who is no longer stable on her feet but likes to cook, it is important to allow her to cook while managing the risks associated with her choices due to old age. In such a case, fitting of surveillance cameras within the kitchen where Beverley prepares her meals will be vital in ensuring that she is monitored. Also, smoke and fire sensors should be installed in the kitchen in order to signal her attention and that of the carer in case of any fire risks. In this case, Beverley who loves to cook will be able to prepare her meals while the risks associated with such activities will be well managed by the care givers. Therefore, the care givers should constantly observe the surveillance cameras and also be on standby in case of any indications of any danger.  Lastly, the floor finish of the kitchen should be made of non-slippery materials such as the non-slip ceramic tiles to avoid the danger of slipping since Beverley is not so stable on her feet. Also, the work top finishes should be made of non-slippery materials to enhance grip.

Effective Communication Strategies with Demented Patients

A10. Examples of Reminiscences and Routine Activities Important to the Patient

Domain	Reminiscences significant to the patient	Routines significant to the patient
Health	Learning about the individual’s past medical records	Attending to the patient’s personal hygiene
Accommodation /Home	looking at past photo albums	Maintenance of household features such as repairs, décor, laundry, and cleaning.
Community	Talking about past and warm memories	Attending to the patient’s religious needs
Recreation	Games	Accessing sporting and recreational activities.
Leisure	Holiday,	Craft and creative activities

A11.1. Problems Affecting Family, Care Givers, and Others

Caring for dementia patients can be very beneficial. However, this activity lays a burden of obligation on the welfare of others. Examples of the problems related to caring for dementia patients include resentment, social isolation, financial problems, emotional exhaustion, depression, and physical exhaustion.

A11.2. Guidance and Support for the Primary Carer

To support and guide the daughter who was the primary carer of the dementia patient, I would encourage her to join a local support group, advise her on matters relating to care and suggest necessary environmental and equipment adoption.

A12.a. Behaviours Displayed by Dementia Patients

Some of the recognizable behavioural changes of dementia patients include depression, anxiety, aggression, agitation, hallucinations and wandering.

A12.b.Triggers for Behavioural Changes

Some causes of the behavioural changes may encompass routine changes, frustrations due to communication problems, unfamiliar environments, humiliation feelings and non-comprehension of what happens.

A12.c. How not to react to Behavioural Changes

In cases of behavioural concerns, the carers should not become upset or angry because these changes are neither intentional nor aimed at the carers. Therefore, it may just be due to the fact that the carer may be the only one present when the trigger causes the change in the behaviour of the dementia patient.

A13. Matters of Discussion in a Meeting for a Dementia Patient

The main issues to be discussed in a meeting for a person living with dementia include the elimination of stressful instances, maintenance of a stable environment, avoiding of confrontation, identification of any medical causes, the creation of a planned and consistent routine and identification of the physical discomforts. The following table indicates a sample agenda draft for the meeting of a dementia patient.

Time	Matters of Discussion	Results
1.00 PM	Ask whether any member has corrections to the minutes of the last meeting
1:15 PM	Discussion on the possible medical causes of the behavioural changes of the dementia patient
1:30 PM	Discussion on the possible physical discomforts of the patient
2:00 PM	Discussion on side effects and medication
2:30 PM	Discussion on keeping the environment stable
2:50 PM	Discussion on ensuring that the patient is comfortable
3:00 PM	Review of the improvements and achievements
3:20 PM	Identification of topics for the next meeting.
3:30 PM	Adjournment

A14. Psychological Strategies for Reducing the Impact of Behavioural Change

Psychological strategies can be very important in managing a range of behaviours exhibited by dementia patients. They encompass validation therapy, exercise therapy, multisensory stimulation, aromatherapy, and spirituality.

Validation therapy involves the acceptance of the patient’s beliefs or “reality” regardless of how weird the beliefs may be. Validation therapy eliminates frustration and stress reactions. The therapy also depends on non-verbal and verbal communication forms.

Exercise therapy enhances the wellbeing and improves the health of the patient. It also improves the movement quality and adds social aspects hence improving the quality of life of the dementia patient. The carers should ensure that the residents are safe during exercises.

Multisensory stimulation, on the other hand, involves the stimulation of senses such as smell, taste, touch, hearing, and sight. This technique uses scented objects, lighting, and music to promote the wellbeing, alertness, and concentration of the dementia patients while carefully avoiding the over stimulation effect.

Aromatherapy is another psychological strategy that uses necessary oils such as lavender and lemon balm to calm the patient. The carer should ensure that the oil does not affect the current medications of the patient.

Lastly, spirituality is a strategy that encompasses traditional and alternative beliefs that can help eliminate anxiety and make the patient comfortable.

A15.a. Observation Information to be recorded

Event samples are important in the evaluation of behavioural changes. Therefore, it is vital to record information such as the date or time, event number, the situation context such as family visit, participant and incident or dialogue.

A15.b. The ABC Method

The ABC approach addresses different aspects when evaluating the causes of the behavioural changes of the dementia patients. A stands for antecedent which represents the event that happened and upset the patient while B stands for the upsetting behaviour. C represents the consequence which is the reaction to the behaviour after the event happened.

A15.c. Evaluation of the Strategies

Strategies

In the case of behavioural changes, the carer should try to identify what went wrong in order to avoid such incidents in the future. In such cases, the carer should not argue but instead remain calm.

The carer should also try to recognize the initial warning signs associated with behavioural changes and examine the surrounding environment for any potential causes. By doing so, the carer can eliminate the causes at an early stage to prevent the development of the behavioural change.

In the case of behavioural changes, the carer should also discuss any potential triggers with the colleagues. Additionally, the carer can talk with the dementia patients to know the problems that upset them.

Evaluation

The above three strategies work best at the initial development of behavioural changes. However, if the behavioural changes have developed and advanced, the best method of evaluation will be the ABC method. This method enables the carer to analyse the behaviour of dementia patients by addressing the three different aspects that cause the reaction of the patient. The carer should assess the antecedent which refers to events that occurred and upset the patient. Thereafter, the carer narrows down to the specific upsetting behaviour then lastly, the care provider analyses the consequence of the events in terms of behavioural response from the dementia patients.

It is also important to analyse as many environmental aspects as possible. For instance, one should focus on the completed tasks, interactions and communication between different people while considering issues from the client’s perspectives and preferences.

A16.A. Organization Reporting Requirements

The following are the reporting requirements for both the verbal and written reports of any organization.

First, the documentation should be done in time. Therefore, this activity should be prioritized after any event. Also, since the progress notes act as legal records, it is a requirement that they must be made in standard ways such as printing in black ink, avoiding the use of correction fluids, drawing a line over the mistake and rewriting the correct information when making corrections, including time and dates in all the notes and providing the name, status, and signature of the documenter.

Progress Report

Medical Record Number: 3078

Surname: Chloe First Name: Thompson

Received a call from the resident at 1300 hours and on exploration discovered Mrs. Thompson sitting on the floor next to her bed. Pressed call alarm to seek help as there was blood on the floor. Mrs. Thompson stayed with the carer. After an initial examination by a registered nurse, Mrs. Thompson was assisted to bed.

The registered with Mrs. Thompson at the time of the report.

Reviewed Mrs Thompson. Six centimetre laceration at the back of the neck. Same.

Dressed with Steris trips a quarter hourly and then half hourly observations done. Overall and neurological observations acceptable. Conscious. Pain killers administered for a headache at 1600 with positive effect. Family notified. General practitioner notified.

Reviewed Mrs. Thompson. In a pain free state. Conscious and socializing with the other residents. Ate some snacks for the evening meal.

A17.a. Completing and Maintaining Documentation

Documentation should be done basing on the reporting requirements. Thus, one should ensure documents are safe, easily accessible and backed up for future reference. Also, it is important to update and amend the existing documentation when necessary. Backing up of the documents involves digitizing of the current records. It also encompasses the storage of the documents in new servers. For instance, cloud storage has become more common in recent times. Change of formats requires updating of the older documents in order to conform to the new systems. Therefore, organizations should hire a competent registrar who will be tasked with updating the documents.

It is also important to maintain a checklist of important things to recall in the documentation. The checklist facilitates the minimal maintenance process of the documents. The organization should also create a procedural manual that outlines the full process of documentation and eliminates any doubts and omissions associated with the process. Lastly, document filing is very important for any organization. Filing should be done basing on the protocol and policy of the organization to ensure strategic location and ease of access.

A17.b. Making Records Identifiable

Making records identifiable is a very important activity that seeks to eliminate errors when treating dementia patients. The process can be done by including the full names of the client, age or date of birth, sex and unique identifiers such as Medical Record Number (MRN). For instance, some of the organizations may use printed labels that contain all the information listed above.

A18.a. Signs and Management of Stress in Caregivers.

The signs of stress in caregivers include denial, anger, depression, anxiety, social withdrawal, sleeplessness, exhaustion, irritability, health problems, and concentration difficulties.

Management of stress in caregivers involves the development of a consistent schedule, avoiding the blaming of dementia patients for their actions, caregivers educating themselves on the impact of dementia and management strategies, talking to friends, family or other persons in the same situations, caregivers managing their diets, engaging in regular exercises and maintaining positive social lives, and care providers being aware of doing their tasks as required.

A18.b. Evaluation of Personal Stress

Over a period of two weeks as a caregiver of dementia patients, my personal evaluation indicated that I had several signs and symptoms of stress which encompassed denial, anger, depression, sleeplessness, and anxiety. Apparently, I did not seem to accept the reality and effects of dementia as I really sympathized with the patient. Furthermore, I was anxious and worried that the same thing might happen to me in the future and a result I was depressed and spent most of the nights awake. I was too worried to relax due to a lot of thoughts that raced through my mind while in bed. Also, anger could set in most of the time due to the fact that there is no cure for dementia and people diagnosed with the condition would have to suffer for the rest of their lives.

As the symptoms progressed, stress also increased proportionally especially during the time when there were behavioural changes exhibited by the patients. For instance, there were times when some of the patients would yell and refuse to be attended to. These occasions made us as caregivers to be stranded as we didn’t know how to respond to such cases.

As a result of increased stress levels, I felt it was necessary for me to incorporate stress management strategies. First, I decided never to blame the dementia patients for their actions and educated myself on the impact of dementia and the techniques to counteract the effect. I also talked to my family, friends, and colleagues who were going through the same situation. I also managed my diet engaged in daily exercises and led a positive social life while being realistic about my ability to complete my tasks without a lot of stress. Finally, I developed a constant schedule that guided me when carrying out the daily activities.

A19. Self-Care Strategies for Managing Stress

The four examples of self-care strategies that I can use to manage stress encompass crying, talking, performing relaxing behaviours and rediscovering my sense of humour.

Section B

B1. Latest Research Findings of Dementia

According to Richards, Robertson & Kastner (2018), a new research carried out by scientists in the U.S and Australia indicates that clinical trials of medications that reduce protein levels in the brain that were previously considered to be the cause of dementia have failed. The study has paved ways for possible new treatment methods by use of new medications. Ideally, many scientists believed for a long time that inflammation increased with increase in dementia associated diseases. However, the research by Richards, Robertson & Kastner (2018) revealed that inflammation is actually a cause and not just an effect.  Therefore, this new finding changes the previous thinking as it implies that inflammation occurs before the damage of brain tissues sets in.

The most important part of this finding is that by reducing the aspects associated with inflammation it can be likely to reduce the symptoms of dementia. If the research holds, the new understanding of dementia will allow for the clinical trials of current anti-inflammatory medications for their efficiency in treating dementia patients.

According to Gheysen et al. (2018), the findings of a meta-analysis study indicate that physical activity programmes for the elderly could incorporate problematic cognitive activities to enhance their cognitive health. The combination of both physical activities and cognitive activities should be encouraged as they act as an integrated strategy that prevents and treats cognitive reduction in elder people. They conclude that enough cognitive exercises seem more significant to achieve desirable cognitive impacts than the high amounts of intervention actions (Gheysen et al., 2018). Therefore, the findings of this study prove the opinions that the brain of human beings has a lifelong retention capacity that changes and reorganizes. Also, the study findings argue that cognitive functioning can be enhanced even at old age.

B2. Manifestations of Dementia

The research on the disease and its different manifestations include younger onset dementia, Huntington’s disease, Parkinson’s disease, fronto temporal lobar degeneration (FLTD) such as the Pick’s disease, Korsakov Syndrome or excessive intake of alcohol, Lewy bodies, multi-infarct dementia or vascular dementia and Alzheimer’s disease (Ismail et al., 2016).

B3. Progressive Neurological Conditions of Dementia

Under these conditions, dementia encompasses pathological features which include connection loss between cell death and cells, neurofibrillary tangles and amyloid plaques (Miller and Boeve, 2016).

The loss of the link between cells and the ultimate death of cells which are very important in learning, communication, and memory affects their respective roles. When the communication paths of the neuron are destroyed, the cells cannot work effectively and hence their consequential deaths (Schore, 2015). The resultant effect of such situations is the development of brain atrophy which results from the contraction of brain tissues.

Neurofibrillary tangles are fibres that are insoluble and twisted which cause internal blockage in the brain. The nerve cells of the brain convey molecules, nutrients, and information through microtubules (Villemagne, Fodero-Tavoletti, Masters and Rowe, 2015). In the case of Alzheimer’s disease, the microtubules are tangled.  Eventually, this condition leads to the disintegration of the tau microtubules which in turn hinders the transmission of information. Consequently, a state of memory loss sets in.

Amyloid Plaques, on the other hand, are thick, insoluble protein clumps that deposit a harmful material around the brain neurons. In the case of Alzheimer’s disease, these deposits are normally found in the hippocampus area (Selkoe and Hardy, 2016). This area is important in memory functions and that is why people with the disease get lost as a result of having troubles in remembering short-term memories.

B4. Indicators and Symptoms of Dementia

The common symptoms of dementia include depression, brain infections and tumours, hormone and vitamin deficiencies, and overmedication or medication clashes. The general symptoms of the early stages of the disease include confusion, personality changes, gradual memory loss, apathy or withdrawal and the inability to perform daily tasks (van der Linde, Dening, Matthews & Brayne, 2013).

B5. Behaviours of Concern

They refer to the inevitable behavioural changes that accompany dementia and which are manageable and acceptable. Examples of behaviours of concern include verbal disruption, social withdrawal, repetitive questions, psychosis, physical aggression, hesitation to personal care, wandering and sleep interferences, eating problems, sexually inappropriate actions and resistance to services (Feast et al., 2016). All of these behavioural changes may be indicators of dementia and if detected the victim should be examined by medical experts and diagnosed if necessary (Feast et al., 2016).

B6. Impact of Dementia on the Patient and the Family

The progression of dementia can have several impacts on the patient, the family and other related people. These impacts may include despair, anger, social devaluation, isolation, the social embarrassment of family members, financial implications on the family members, depression and the eventual loss and grief (Kasper, Freedman, Spillman & Wolff, 2015).

B7. Principles of Person-Centred Support

According to Brooker and Latham (2015), person-centred support has four key principles which include valuing both the dementia patients and their carers, treating the patients as individuals using the preferences or perspectives of the patients to address their needs and ensuring a positive relationship and social environment of the patient.

B8. Enhancing Self Esteem and Pleasure of Dementia Patients

Dementia patients should be engaged in activities that enhance the self-esteem and eventually bring pleasure to the lives of the patients. Such activities include discussions or debates, memory games, word games, outdoor activities, music, and other creative activities (Skovholt & Trotter-Mathison, 2014).

B9. Verbal and Non-Verbal Communication Strategies

It is very important to engage dementia patients in both verbal and non-verbal communication because it helps to stimulate them mentally. Also, communication helps to establish a mutual relationship with them. Communication enhances respectful, dignified and normal treatment of the patients (Stanyon, Griffiths, Thomas & Gordon, 2016).

Verbal communication involves speaking slowly and clearly, making simple statements, being patient for their responses, avoiding interruption, encouraging them to participate in a conversation with others, rephrasing for clear understanding, and avoiding speaking on their behalf to encourage self-expression (Stanyon, Griffiths, Thomas & Gordon, 2016). Non-verbal communication, on the other hand, involves the use of a positive and friendly tone, use of gentle touch, avoiding invasion of personal space and maintaining eye contact during conversations.

References

Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook. Maryland Heights, Mo.: Mosby.

Brooker, D., & Latham, I. (2015). Person-centred dementia care: Making services better with the VIPS framework. Jessica Kingsley Publishers.

Feast, A., Orrell, M., Charlesworth, G., Melunsky, N., Poland, F., & Moniz-Cook, E. (2016). Behavioural and psychological symptoms in dementia and the challenges for family carers: Systematic review. British Journal Of Psychiatry, 208(05), 429-434. doi: 10.1192/bjp.bp.114.153684

Fortinash, K., & Holoday-Worret, P. (2014). Psychiatric mental health nursing. Mosby.

Gheysen, F., Poppe, L., DeSmet, A., Swinnen, S., Cardon, G., & De Bourdeaudhuij, I. et al. (2018). Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. International Journal Of Behavioral Nutrition And Physical Activity, 15(1). doi: 10.1186/s12966-018-0697-x

Ismail, Z., Smith, E., Geda, Y., Sultzer, D., Brodaty, H., & Smith, G. et al. (2016). Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimer’s & Dementia, 12(2), 195-202. doi: 10.1016/j.jalz.2015.05.017

Kasper, J., Freedman, V., Spillman, B., & Wolff, J. (2015). The Disproportionate Impact Of Dementia On Family And Unpaid Caregiving To Older Adults. Health Affairs, 34(10), 1642-1649. doi: 10.1377/hlthaff.2015.0536

Miller, B., & Boeve, B. (2016). The behavioral neurology of dementia (2nd ed.). Cambridge University Press.

O’Rourke, H. M., Duggleby, W., Fraser, K. D., & Jerke, L. (2015). Factors that affect quality of life from the perspective of people with dementia: a metasynthesis. Journal of the American Geriatrics Society, 63(1), 24-38.

Richards, R., Robertson, S., & Kastner, D. (2018). Neurodegenerative diseases have genetic hallmarks of the autoinflammatory disease. Human Molecular Genetics, 27(R2), R108-R118. doi: 10.1093/hmg/ddy139

Schore, A. (2015). Affect Regulation and the Origin of the Self (1st ed.). New York: Routledge.

Selkoe, D., & Hardy, J. (2016). The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Molecular Medicine, 8(6), 595-608. doi: 10.15252/emmm.201606210

Skovholt, T., & Trotter-Mathison, M. (2014). The Resilient Practitioner Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals [Ebook] (2nd ed.). New York: Routledge.

Stanyon, M., Griffiths, A., Thomas, S., & Gordon, A. (2016). The facilitators of communication with people with dementia in a care setting: an interview study with healthcare workers. Age And Ageing, 45(1), 164-170. doi: 10.1093/ageing/afv161

van der Linde, R., Dening, T., Matthews, F., & Brayne, C. (2013). Grouping of behavioural and psychological symptoms of dementia. International Journal Of Geriatric Psychiatry, 29(6), 562-568. doi: 10.1002/gps.4037

Villemagne, V., Fodero-Tavoletti, M., Masters, C., & Rowe, C. (2015). Tau imaging: early progress and future directions. The Lancet Neurology, 14(1), 114-124. doi: 10.1016/s1474-4422(14)70252-2