Evaluation and Management of Oropharyngeal Dysphagia

Questions: 1. Discuss the different types of dementia.(PICK 4TO 5 TYPES OF DEMETIA AND DISCUSS THE DIAGNOSIS AND MEDICATIONS) 2. Exploring the carers roles, responsibilities, functions and adopt their practice to meet individual needs.(IDENTIFY THE DIFFERENT NEEDS) 3. Analyse the impact of dementia on the health, behaviour and quality of life of people with dementia and their families.(PERSONAL LIFE ,FAMILYAND SOCIAL LIFE) 4. Explore the implementation of person centred care strategies with an inter disciplinary multi-agency team.(DEFINE PERSON CENTRE CARE,HOW DO THEY IMPLEMENT IT ) 5. Discuss some of the ethical and legal issues impacting on people with dementia and their carers. Answers: Dementia or senility is a kind of brain disease that remains associated with regular and long term decrease in the ability to think and remember. The decrease in the ability tends to affect the daily functioning of an individual's life (Brroker and Latham 2015). Language problems, emotional problems, and a decrease in motivation are some of the most common symptoms that are seen in case of dementia. Dementia can be of various types, and each type is associated with causing different kinds of cognitive disorder. The disease also produces a significant impact on an individuals caregiver (Prince et al. 2013). Thus, the present assignment will help to emphasize on different types of dementia by identifying the needs and analyzing the impact of the disease on the health, behavior and quality of the patient. Furthermore, the assignment will also help to explore the strategies that need to be implemented for successfully dealing with patients with dementia along with the discussion of the e thical and the legal issues impacting the people suffering from dementia. Different types of Dementia, diagnosis and medication According to Jung (2015), the four most prevalent forms of dementia are: 1) Alzheimers disease, 2) Vascular Dementia, 3) Lewy Body Dementia and 4) Frontotemporal Dementia Alzheimer's disease is the most common and well known form of dementia. The common symptoms associated with the disease include paranoia, memory loss, anxiousness, and confusion (Brooker and Latham 2015). The primary diagnosis method of Alzheimer does include evaluation of the patients medical history. This also includes proper monitoring of the behavioral changes that are observed in case of an Alzheimer patient. Diagnosis of the disease also includes advanced medical imaging that remains associated with computed topography (CT scan) or magnetic resonance imaging (MRI) (Alagiakrihsnan, Bhanji and Kurjan 2013). Memory testing that includes assessment of the intellectual functioning also helps in further characterization of the disease. The conventional medication for Alzheimer involves the use of non-steroidal anti-inflammatory drugs (NSAID's). Donepezil is the most common medicine used for treating different stages of Alzheimers (Alzheimers Association 2013). Diagnosis of vascular dementia includes assessment of the symptoms and the mental abilities that include evaluation of the full medical history and other conditions in relation to the disease that includes high blood pressure and strokes (Andel et al. 2012). It also includes a physical examination and brain scans such as CT scan for detecting the presence of brain tumor or any other shrinking activity associated with the brain. The neuropsychological test helps in better assessment of the people for people suffering from vascular dementia. The most common medication that is used includes a range of antihypertensives, antiplatelets, anticoagulants such as warfarin and antidepressants such as nimodipine, hydergine and others (Moreno-Ramos et al. 2013). Apart from the normal diagnostic methods like CT scan and MRI, diagnosis of Lewy body dementia includes a detailed study of the patient's lifestyle and the medical history. It also specifically includes other pathological and neuropsychological tests as well. Diagnosis also involves the method of postmortem autopsy (Stinton et al. 2015). In certain cases, brain autopsies are also performed for detecting any brain stroking, bleeding or presence of any brain tumor. A large number of cholinesterase inhibitors such as rivastigimine are used as the primary medication for the disease (Andel et al. 2012). In the case of Frontotemporal dementia, the diagnosis method specifically includes brain scans by the method of positron emission topography that helps in visualizing the brain metabolism for identifying the abnormalities present (Moreno-Ramos et al. 2013). Diagnosis also includes neurological examination for obtaining a detailed about the patients history. Diagnosis technique also includes evaluation of the motor functions and other cognitive functioning that includes measuring of memory, concentration, and problem solving ability and language skills. The diagnosis methods specifically include electromyography, spinal tap, CT-scan and MRI (Pressman and Miller 2014). A large number of antidepressant drugs such as fluoxetine, paroxetine and others are used as the primary medication. Secondary medication includes the use of antipsychotics in small doses such as olanzepine, risperdine, ziprasidone (Noel-Storr et al. 2013). Identification of different needs A caregiver needs to develop a better understanding of the patients suffering from dementia. It is very much essential for the caregiver to understand the behavioral changes. The care giver shall also need to assess the causes of the difficulties in communication that the patient is having (Moreno-Ramos et al. 2013). In the case of severe dementia, the caregiver also needs to understand the feeling associated with the patient and develop suitable strategies for dealing with them. Thus, it is very much essential to comprehend and analyze the underlying pathophysiological and neurological problems associated with for attaining improvement in the status of the patients. The care giver must understand the needs of the patient that will help in restoring the decline in the mental functioning of the patients (Pressman and Miller 2014). It is also essential to provide the family givers with proper training, education, and knowledge regarding the ability for a better understanding of the con dition of the patient suffering from dementia. Development of effective communication style is also an important aspect as it helps in better understanding and interpretation of the patient's therapeutic process. It also helps the caregiver to effectively monitor the movements and the actions that are shown by the patients. Patients suffering from dementia are also associated with changes in the emotional responses. According to Noel-Storr et al. (2013), patients with dementia have less control over their self-expressing power and thus have less control over their feelings. These changes are primarily due to the damage cause in the brain. Hence, the caregivers shall need to understand the behavioral changes in patients effectively in response to the reaction shown by the patients in accordance with a particular situation (Brooker and Latham 2015). The caregivers need to effectively figure out the needs and, therefore, meet them where it is possible. Understanding the needs of the pa tient also includes the understanding of the sleeping habits, memory loss, and extent of the damage caused in the brain (Jung 2015). Thus exploring the carer roles involves the ability of the person to deal with the patient. This includes setting up a positive mood, provide a better platform for understanding the needs of the patients, and break down the activities thus implemented in a series of steps that includes a response to proper affection and assurance (Andel et al. 2012). This includes exploration of the additional problems as well that includes an approach for identifying the cognitive capabilities in a systematic way by the implementation of a standardized set of performance-based assessments. Impact of dementia on health, behavior and quality of life of people with dementia and their families People with dementia gradually lose their ability to think and remember things especially concerning the events and the conversations (Alagiakrishnan et al. 2013). As a result, they are not able to reason out things effectively which leads to inappropriate behavior. Since dementia is a slow disease, loss of brain function occurs with the progress of the disease. Thus, patients will dementia gradually lose their ability for solving problems, get surrounding by familiar surroundings, develops poor decision making abilities and also develops a poor emotional control (Stinton et al. 2015). They respond very slowly to the situation and behave in a confused manner. They also develop problems like agitation, cognitive disorder, delusions, and anger. This causes a loss of the ability and difficulty in performing the daily tasks. They also seem to lose interest from the activities and at a later stage might not even recognize their family members as well (Chiong et al. 2015). Dementia also sh ows an intense effect on the person's quality of life which makes them feel isolated, embarrassed, frustrated and confused. In general, the impact of dementia on an individual's daily life is broadly classified into four main categories: Functional effects (problems involving social issues, slower interactions) Cognitive effects (short term memory loss, confusion, hallucinations, poor concentration) Psychological effects (anxiety, depression, motivation loss) Behavioral effects (verbal aggression, inappropriate responses) The most common feelings that the family experience include grief, loss, guilt, and anger. Guilty may rise regarding the fact that the family members may be embarrassed for not providing the right care to the patient during proper time. Grief is the most frequent form of an impact that has been seen among the family members (Noel-Storr et al. 2013). People caring for the patient experience grief for the loss of the patient that may occur in the near future. It also hampers the relationship between the patient and the family as because patient suffering from dementia shows anger and may remain associated with the feeling of isolation (Pressman and Miller 2014). Under such circumstances, the communication between the family members is also hampered because at certain situation the family members may not be able to understand the needs and what the patient is trying to express. This leads to misinterpretation of the emotional thoughts (Miranda-Castillo, Woods and Orrell 2013). The famil y members sometimes also develop a feeling of anger among themselves taking into consideration the fact that they are annoyed by the behavior of the patient. This in turn also leads to a sense of distress, frustration and annoyance as well. Implementation of person centered care strategies Person-centered care refers to the way of thinking and doing things that help in seeing people using social and health services for developing, planning and monitoring care in such a way that the needs of the people are met (Van Mierlo et al. 2012). This specifically helps in viewing individuals and their families as experts working alongside the health care providers. The implementation of the effective strategies includes a better understanding of the person's behavior regarding mood and unmet needs. An effective strategy involves providing care for understanding the social, cultural and individual needs of the patient suffering from dementia (Eggenberger, Heimerl and Bennett 2013). Thus, implementation of the effective strategies includes adaptation and learning of appropriate behavior in a specific way that will help in better understanding of the people suffering from dementia. It is also implemented in a way that it provides proper value to the people who has been given the care regardless of the way the people act, communicate or behave by understanding the position of the patients by providing communication through normal mode or improved social skills (Clay et al. 2013). The implementation also involves improvement in the quality of life of patients for whom the care is provided. The caregiver also needs to implement strategies in a way th at will help them in better learning for tolerating the repetitive, irritating, hurtful and the meaningless behavior from then patients suffering from dementia (Lavretsky et al. 2013). This also includes a better understanding of the sentiment and the responses that come from the people suffering from dementia (Dewar and Nolan 2013). The implementation also includes that the caregivers should have enough information and ideas regarding the care that has been provided for the patients with dementia. The application also includes an introduction of nonverbal communications and providing assistance for independence oriented duties. Ethical and legal issues impacting on people with dementia Some of the ethical and legal issues that primarily affect people with dementia and their carers include the timing and the communication of the diagnosis. It thus suggests that diagnosis of dementia shall need to be done as early as possible and also needs to be communicated directly to the individuals. People suffering from dementia shall need to have a direct access to good quality assessment and also the patients needs to get the proper support from time to time. According to Johnson and Karlawish (2015), the UK Department of Health shall need to initiate more research based on the fact why there exists a huge variation in the diagnosis technique carried out during dementia. The ethical issues also help in highlighting the fact that the doctor-patient relationship during the diagnosis method produces large implications for the patients as well as the on the family members who plays a significant role for information and support. The carers associated with for communicating the di agnosis of the disease shall also need to actively encourage the person with dementia for sharing necessary information by clearing the fact that diagnosis at an early stage is very much required (Mitchell and Templeton 2014). Considering the legal framework, The Mental Capacity Act of 2005 helps provides the legal framework for decision making that can be granted to patients suffering from dementia in England and the surrounding areas. The Act also contains specific provision to make "advance decision" for people suffering from dementia. The act plays a significant role in providing a wider scope for people suffering from dementia based on their concerns and needs. This also helps in extracting a sufficient amount of information that is required for dealing with the abnormal behaviors of the patients (Johnson and Karlawish 2015). The report suggests that in most of the cases people suffering from dementia, always tries to promote their interest in their autonomy and well-to be (Mit chell and Templeton 2014). References Alagiakrishnan, K., Bhanji, R.A. and Kurian, M., 2013. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review.Archives of gerontology and geriatrics,56(1), pp.1-9. Alzheimer's Association, 2013. 2013 Alzheimer's disease facts and figures.Alzheimer's dementia,9(2), pp.208-245. Andel, R., Crowe, M., Hahn, E.A., Mortimer, J.A., Pedersen, N.L., Fratiglioni, L., Johansson, B. and Gatz, M., 2012. Workà ¢Ã¢â€š ¬Ã‚ related stress may increase the risk of vascular dementia.Journal of the American Geriatrics Society,60(1), pp.60-67. 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