Dementia: Impact of and Support Needs

Task 3

A. People with Dementia

3.1.A In your own words explain the differing consequences of an impairment or type of disability in relation to:

a. Individual

A person with dementia faces a number of different challenges. Apart from the most well known effect of the disease which is gradual memory loss, the most basic of things and or activities are difficult for them to perform. Dementia affects a person’s mental and physical abilities thus manifesting in a demented person’s inability to perform activities of daily living in an effective and efficient fashion.

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Apart from this, a person with dementia also has difficulty with communication. They are not able to effectively communicate what they want to say which often results to frustration and fits of aggressiveness. Furthermore, this also results to poor social interaction with others. They are not able to carry meaningful conversations and they may feel that they are often misunderstood which isolates them and withdraws them from the things which they used to enjoy doing. They may also manifest various behavior changes which they are not aware of.

b. The family/whanau

Taking care of a dementia person is very difficult- especially if they are your family member. The care and support they need will be permanent which means that it may cause various financial problems for the family. In the later stages of dementia, the client will need professional support which will need more finances from the family.

Also, the client will need constant attention and support which may cause stress on the part of the family. They may lose their social life because their time is eaten up by their responsibilities with taking care of the client. Family members may neglect themselves and this may cause various health problems for them. They will be under so much stress and this may most likely lead to burn out.

c. The carers

The carers face a very challenging task when taking care of a dementia client. They have to make sure that the client is watched over constantly, that the medications are given on time and they also have to consider a lot of safety measures because dementia clients tend to wander throughout the day. Furthermore, taking care of a dementia client is a long term task; thus, this may also lead to high levels of stress and eventually burn out for the carers. Dementia clients may exhibit challenging behaviors and this may frustrate carers.

3.2 A The progression/development of the signs and symptoms (conditions/disease pathway) associated with the specific group chosen.

Dementia is not a specific disease. It is a term used for an overall term used for a wide variety of symptoms which are all associated to a progressive loss of memory and or cognitive skills which to an extent affects a person’s ability to perform normal everyday tasks. This disease is caused by damage in the brain. The slow and ongoing damage to the brain is caused by a build-up of abnormal proteins in the brain. This abnormal build-up is different for various types of dementia

Symptoms of dementia usually start slow and gradually get worse which are evident in varying stages of the disease- mild, moderate, severe. At differing extent, clients with dementia experience a progressive deterioration in their cognitive function- to include their memory, cognition, communication and judgment.

3.3.A

– In your own words discuss the way in which the impairment impacts on the diverse dynamics of the family/whanau

A dementia client’s family often faces various difficulties. The impairment affects the family dynamics due to the difficulty of looking after a demented member. They will face financial constraints because they would have to pay for medications and support which the client needs. This task also involves a lot of physical efforts, thus it may lead to high levels of stress and burnout. Family activities may be disrupted and the member’s social life may be affected because their time will be greatly focused on looking after their family member with dementia. Furthermore, the stress of role reversal is also present- the children who were once taken cared of by their parents now have to step up to the role and take care of them.

– The way in which the individual, family/whanau and carers interact and respond to evolving stressors

a. Individual

The client will exhibit more challenging behaviors which may affect their safety. Their forgetfulness may progress and worsen. They may also have more episodes of aggression due to increased frustration from their current situation. They may be irritable throughout the day and be more difficult to handle them. The high levels of stress may also worsen their difficulty in communicating with others. They may find it harder to express their emotions and needs.

b. Family/whanau

Family members may feel higher levels of stress which may lead to burn out. They may feel that the responsibility is too much for them to handle. Family members may seek the help of other relatives or carers in handling the client. They may experience high anxiety and not be willing to engage in social activities with others.

c. Carers

The clients may exhibit more challenging behaviors which mean that the task at hand for the carers become more difficult. They will be under higher levels of stress and anxiety. As a result, they may feel burn out and may need some time off from work. Furthermore, they may also seek the help of their other colleagues to handle the client.

– The way in which the Code of Rights is applied to the specific group of people selected

a. Right to be treated with respect- Even if the client is suffering from dementia, he still has to be treated with respect because he is a human being. Carers must always provide privacy when doing their cares and their choices must also be given proper importance.

b. Right to freedom from discrimination, coercion, harassment and exploitation- Clients should be treated equally. No matter their race or gender, they should receive equal care and support from their carers. They should also not be coerced to do things which are out of their will. For example, if the client refuses to shower, he must not be given false promises just to comply. Measures should always be taken to make sure that their dignity is maintained at all times. Privacy is very important when doing cares.

c. Right to effective communication- It may be difficult to communicate with a client with dementia but it is their right to be communicated to in an effective manner. It is the duty of the carers to make sure that effective ways to communicate with the client is adapted and used when dealing with them. This ensures that their needs and concerns are acknowledged. For example, if the client is slow in picking up things which are said to them, the carer should talk slowly and clearly and if needed, repeat what they are saying to make sure that the client has understood.

d. Right to support- Clients have the right to be visited by their families for support. It is actually a big help to them if they are constantly around people who they trust. Families should be permitted to visit the client openly. Contact numbers of family members should be available in order to easily contact them when the client wants to see them.

e. Right to services of an appropriate standard- Facilities which house dementia clients must provide the appropriate services which they need. The carers must be trained to handle these types of clients to ensure that the care delivered is appropriate and beneficial. Proper equipment should also be used for clients according to their different needs. For example, if a dementia client needs a walker or a hoist for transfers, carers must make sure that these are used and available for them.

-The needs (support and other) which you have identified for the specific group of people selected.

People with dementia have a number of different needs. Some of which are the following:

• Speech and language therapist- to help them in their communicating difficulties.
• They also need support in doing various activities of daily living such as getting dressed, taking a bath and eating because they often cannot do these themselves. However, it is also important to allow them to do things which they can do for themselves.
• Occupational therapist to help and encourage them in participating in various activities which helps them improve their social skills.
• They should also be assisted in engaging in meaningful and positive interaction with other people/residents.
• Support must also be focused on helping clients maintain their quality of life.
• Medication management is also important to help control some symptoms or effects of the disease to worsen such as episodes of aggression/anxiety.
• Their family and carers should also be aware of the support available to them. This can be done by awareness programs and other types of educational support.
• The people handling them should also be aware of the importance of constant check-ups with their respective doctors in order to be aware of the progression of the disease.

3.4.A

References:

• Alzheimers New Zealand; 2012; Progression of Dementia; retrieved from: http://www.alzheimers.org.nz/about-dementia/progression-of-dementia
• Alzheimer’s Association; 2014; What is Dementia?; retrieved from: http://www.alz.org/what-is-dementia.asp
• Alzheimer’s Society; 2014; The Progression of Dementia; retrieved from: http://www.alzheimers.org.uk/progression/
• Alzheimer’s Society; 2014; Caring for a Person with Dementia; retrieved from: http://alzheimers.org.uk/Caring_for_someone_with_dementia/

B. People with autism spectrum disorders

3.1.B In your own words explain the differing consequences of an impairment or type of disability in relation to:

a. Individual

People affected with autism spectrum disorder are often regarded as different from the whole. Although it is not readily admitted, it is inevitable that these clients do face social discrimination at a certain extent especially from people who lack enough knowledge about their disorder. It is often hard for clients to form social bonds because they often behave differently- depending on the type of disorder that they have. Most clients exhibit challenging behaviors such as tantrums, mood swings and aggression.

Clients also face a number of physical difficulties. Most conditions under the autism spectrum disorder cause the individual to not be able to perform daily tasks for themselves, making them dependent on family members and carers.

b. The family/whanau

The family may be under a lot of stress as they take care of a loved one with autism. As mentioned, clients with this disorder often exhibit challenging behavior, thus it can be very tiring and sometimes frustrating to care for them. Family members will have to look after them constantly to ensure their safety and cater to their needs. Financial constraint will also be another problem.

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Because of the task at hand, family members may neglect themselves and their health. They may focus all their time on the client and forget to live a life of their own. This will affect their social relationships and oftentimes, their work as well. Furthermore, parents may also feel self-blame. They may think that their child’s condition is their fault.

c. The carers

The carers will most likely feel stress which may lead to burn out. It is not easy to care for autistic clients. They have to constantly consider safety measures and always help them with various tasks. It will require much patience from carers. However, they may feel frustrated especially during days when clients exhibit challenging behaviors.

It will also be a struggle for them to understand what the client needs because most autistic clients have speech impairments. So, the carers should always be sensitive to the needs of the client because they may not be able to voice these out.

3.2.B The progression/development of the signs and symptoms (conditions/disease pathway) associated with the specific group chosen.

ASD is a developmental disorder which directly affects a child’s communication skills, social skills and behavior. The cause of this disease is still unknown but studies show that it may be caused by several factors. Among these factors may be developmental factors and genetic factors.

Children with ASD think and behave differently compared to other children. They view the world differently. They find it difficult to speak and understand others when they are spoken to. It is also difficult for them to express themselves through proper body language- they can often be misunderstood. They have poor social skills which causes isolation and withdrawal from other people. Children with ASD also have difficulty thinking and behaving flexibly. They may engage in unusual behavior and sometimes may do things repetitive things. Furthermore, they also experience various developmental delays.

3.3.B

– In your own words discuss the way in which the impairment impacts on the diverse dynamics of the family/whanau

ASD affects the family member’s dynamics in different ways. It is clear that having a child with ASD in the family is not easy. They may have to adjust family activities to suit the needs of the client. The family may also face social isolation because other people may not understand what it is like to take care of a child with ASD. Also, since children with ASD are often regarded as different, the family may also experience judgment from other people and this may have a huge impact to their emotional well-being.

Family members also face financial problems because so much is required to take care of a child with ASD. Studies also show that parents who have kids affected with ASD are at a greater risk for mental and physical health problems compared to other parents. Furthermore, with all these difficulties, family members are placed under high levels of stress, which may be the reason why their health is often affected.

– The way in which the individual, family/whanau and carers interact and respond to evolving stressors

a. Individual

The client may exhibit more challenging behaviors such as flapping and rocking; or something more aggressive such as throwing things or biting. They may also throw tantrums more often making it harder for the people who handle them. The client may also experience high levels of anxiety and or depression due to their current situation; because they may feel that they are not being understood by people around them.

b. Family/whanau

Family members will experience physical exhaustion. They will be stressed out and this may lead to burnout. They may not be willing to go out and interact in social activities because their time is eaten up by taking care of the client. Because they will be socially isolated, this may lead to depression. Furthermore, due to the high levels of pressure, they may seek the help of other relatives to support them in looking after the client.

c. Carers

The growing levels of stress will greatly affect carers. They are the ones who will interact with the client most of the time. They have to make sure they always implement adequate safety measures. Their stress may lead to burnout if they are continuously exposed to challenging behavior. As a result, they may be frustrated and appear to be irritable at work. They may also seek the help of other colleagues to assist them.

– The way in which the Code of Rights is applied to the specific group of people selected

a. Right to be treated with respect- Clients must always be treated with respect despite how different they may seem. Clients with ASD are often hard to understand without adequate knowledge of the disease but even then, they should be seen as fellow human beings who have the right to be respected as everyone is. They should not be laughed at and their personal needs should be given importance. When doing cares, privacy should be provided at all times.

b. Rights to freedom from discrimination, coercion, harassment and exploitation- Children with ASD may face discrimination from others and this should not be the case. They should not be perceived as of lower standards. They deserve to be treated as every person will be treated. They should also not be talked into doing things which they do not agree with. Furthermore, they have the right to be protected from any form of harassment and exploitation; especially those of the young age, because they cannot perceive if a person is taking advantage of them.

c. Right to effective communication- Clients with ASD may be hard to communicate with but they have the right to be communicated to in an effective manner. Thus, it is the carers task to make sure that the communication difficulties of the client is assessed and appropriate strategies is used when interacting with them. This ensures that their needs and concerns are taken cared of. The carer must make sure they talk clearly to the client. They have to be patient and repeat sentences for them if the client has not understood what has been said.

d. Right to support- The clients have the right to have support. This may be family or friends or other people who care for them. They should be given the chance to interact with people who they trust. This may lessen their frustrations and episodes of aggression. Family members must also be informed of the importance of their presence and support to the clients. Regular visits should be encouraged.

e. Rights in respect of teaching and research- If a client is to be used for a certain study or research, it is important that they consent to it- or that a family member consents to it. It is also important to treat them with respect when talking about their condition. Even if they are to be used as subjects, it is their right to keep their identity if they wish to do so. Normally, this is more ideal.

-The needs (support and other) which you have identified for the specific group of people selected.

People with autism spectrum disorders (ASD) have a number of different needs. Some of which are the following:

• Speech and language therapist- to help the client improve their speech
• They should be encouraged to engage in behavior modification programs to help develop positive behavior.
• Medication management- carers/family members should make sure that their medications are taken on time.
• They should be cared for in a safe environment. Support people must work towards eliminating possible hazards to the client.
• They should have regular check ups with their physician to assess the disease progress.
• Support must be given with regards to various activities of daily living.
• Clients should also be encouraged to participate in appropriate activities which will help develop their social skills.

3.4.B

References:

• Ministry of Health; 2014; Autism Spectrum Disorder; retrieved from: https://www.health.govt.nz/your-health/conditions-and-treatments/disabilities/autism-spectrum-disorder
• kidshealth.org.nz; 2005-2014; Autism Spectrum Disorder; retrieved from: http://www.kidshealth.org.nz/autism-spectrum-disorder-asd
• Autism New Zealand; 2014; About Autism; retrieved from: http://www.autismnz.org.nz/about_autism
• National Institute of Mental Health; 2014; What is Autism Spectrum Disorder?; retrieved from: http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml

Nur Anne Piccio; SN:14160101; Ageing and Disability Task3Page 1