Monday, January 27, 2020

Dementia Symptoms, Causes and Strategies

Dementia Symptoms, Causes and Strategies Symptoms of Dementia Repetitive behavior- people with dementia may say or ask anything same over and over again. Repetitive behavior also occurs when they are unsettled and unsettled. Here are some of the examples of repetetive behavior it includes tapping, rubbing hands asking questions, making same noise, it can be very irritating for some carers and family with people living with dementia. It is usually caused by anxiety separation from loved one cauising consistent asking for their loved one or side effects of medications such us particularly repetitive movement, inability to express needs, trying to express emotion too many unfamiliar objects or sounds and sights that causing anxiety. The best thing to cope with this behavior was asked them to have a walk like in the garden, don’t tell them that they have already asked the same question, use calm voice when approaching them, and when they can still read, use signs like we â€Å"we will have and eat the afternoon tea at around 15:30 pm. Wandering- wandering is the major priority , it is the most common form of disruption with people with dementia. It is also due to forgetfulness and frequent need for stimulation. It is common cause of tension and anxiety for the carer and the people with dementia is the wandering. It can also triggers with medication which causes restlessness and unfamiliar environment assistant to find their way around plenty of reassurance may lessen the problem or if the person bored sad or lonely. It includes to keep the need and make the person safe allowing them some independence and choice can also be challenging for them, this can be resolve depending on several factors involving and including neighborhood environment, personality of the carer plus the coping mechanism. The coping strategy was encourage exercise such as walking, gardening or stacking wood and also provide good exercise and some interest give meaning ful activities such as folding clothes. Consider electronic buzzer, chimes, bell above door or a pressure sensitive mat if the person way out.Ensure gates are lock and also ensure she/he carries that can identify him/her. If unable to find within an hour let the police know and when the demented being found notify the police. Sundowning- it increased confusion and restkessness in person with dementia. It is means progression of dementia and it occurs more frequently during middle stage of alzheimers. People with dementia will become more confused restless or insecure in the late afternoon or early in the evening. They get worse after a change in routine, they become more demanding, become upset and disorientated, attention span during this time is limited they became impulsive they may feel see things that are unreal. The causes is there is a psychological or physiological function during tge day or each day that can increased confusion that leads to agitated behaviors. They become anxious going home and even finding mothers which indicate they need safety and security protection. If surrounding becomes worst early afternoon rest is recommended, offer a drink and do not restrain make them feel safe. Aggressive behavior- it can be due to verbal abuse like physical violence bitting or even scratching. It may trigger may be because of changes in the brain misunderstanding of messages being sent by the carers. It is also causes and lead to emotional harms to others or threatens. It can be reactive it can be overt and secretive. Environmental factors such as noise feeling of failure frustration and poor ineffective communication by staff, talking loudly being bossy, threatening tone and body language can trigger behavior. The coping mechanism involves use gentle approach, remove the person from trigger, smile, use distraction such listening to music, avoid confrontation which may worsen aggressive behavior. Rummaging- rummaging means to search thoroughly by handling turning over or disarranging contents, it also means searching thoroughly. People with dementia intrude into other private spaces and rummage when they are lost searching for purposeful activity, it triggers when the person is feeling of being unfamiliar in surroundings. It may be searching for a purposeful activity. The coping strategy is provide picture of something familiar on the door provide distraction, provide things or objects which can connect a person with their past, provide rummaging box or draw full of familiar items. Have an area or room provide client to rummage. Hoarding- people with dementia may search and find for something they may believe that is missing and they do hoarding and hoard things to collect them for safe keeping.It is a persistent difficulty discarding or parting or possessing because need to save them. A person with this experience distress thought of getting rid of items. It influence and triggers the behavior everytime they may feel insolated and they may feel neglected so hoarding is a common response to this. It can also triggers memories on the past like her sister is tooking her things. The person with this type of behavior has a fear of fear or loss. Catastrophic behavior- it is behavioral and emotional response in a situation which create a stress to people with dementia. It is a caused for a person with dementia and situation its beyond the person’s ability to comprehend. Trigger can lead to too much inform,ation, feeling of insecurity, changes of routine and environment, too much stimuli and unfamiliar noises can be a factor. The coping mechanism is use gentle, calm, slow speech, smiling and touch theraphy may be used , removed the person from the stimuli, and document if dituation may be avoided in the future. Changes in the Brain Changes that taken place in the brain and affect person memory mood and behavior it also depends on what part of the brain has being affected. Plaques and tangles stop communicating between nerve cell and caused them to die. It can trigger challenging behavior such as sundowning hoarding, aggressive catastrophic rummaging wandering etc. anger and agression are often directed to a family member because they are closest. The behavior is out of person’s control and they may be frightened by it they need assurance eventho it doesn’t show that way. Communication style of others- as dementia progress ability to communicate decreased and decline in language is lost that leads to frustration and anxiety. If they cant understand what people or carers saying this may cause them to act as a challemnging including aggression. Aggressive behavior may be a person’s way meeting the need attempt to communicate and can result of unmet outcome need. Approach by other people- Never ever approach from behind it can trigger challenging behavior, do not be loud and bossy cause it might upset the client and can make them feel angry and frustrated, different carers with different approach or changes in routine can trigger challenging behavior. Loss of choice- Other people may think people with dementia can not longer do thimgs for themselves and leave them out of decision that affect them. This cause frustrated to people with dementia it can cause angry because they are not being listened and they are being ignored, the person may loose confidence if there is a loss of choice including their ADL;s, activities and meals. They can become stress and have anxiety if they don’t have choice. Environment- The environment may not meet their needs or may be overstimulating too hot or too cold, noisy or bright can trigger their behavior, too much agitation but less stimulation can lead to boredom frustration and apathy. Sensory issues- Impaired vision and hearing can misinterpret sight and sounds in this it can trigger behavior issues. Poor eyesight and loss hearing may lead to anxiety, frustration and communication difficulty. Anxiety- Anxiety causes inability to carry out activity o daily living. Inability to understand words around them , inability to perform previous ability and anxiety can be due to multiple factor causing frustration which caused sense of loss. Cultural factors- In other instances client feels that they are not being understood. Dementia person may revert on their own language, become angry, anxious, and frustrated when other doesn’t understand what they are saying. Service limitation- Services may not be person centered in health changes they are not noted and reported properly. Carers and meals may not be on time which can greatly affecting the client behavior not enough staff on duty which client routines may change due to lack of staff that leads to challenging behavior. Physical health changes- An inability to communicate any pain or health problems may lead to anxiety and feeling of helpless. Infection, pain and constipation may lead to delirium. There may be pain illness infection or physical discomfort including being constipated or thirsty or from sitting for too long. Medication- Some medication can increase agitation and confusion new meds can lead to changes in behavior, side effects for taking too many medication may mean that person becomes more confused and drowsy. Challenges toself esteem and dignity- Need to accept personal cares may lead to loss of dignity and loss of independence, loss of privacy may lead to embarrassment sometimes person with dementia may feel useless and as unable to so such activity may feel burden to family. Loss of independence- person may becaome frustrated for not being able to complete the task.(e.g dressing up and feeding herself). Aggression may occur due to frustration with own inability to carry out previous task. Strategies for Dementia Care Behavioral strategies (diversion)- it can be a very effective way to challenging behavior it means distracting from present situation. Take them for a walk smell flowers, look at the garden, use of CD, playing music of their music song, encourage to do household task with a client who is capable of folding clothes. Etc. Individualised service plan- Services should be safe, and services providers shall ensure that a patient receives best possible care available and that patient is safe from harm for both themselves and others. Safe social and physical environment- when a person starts to wander and become dangerous to themselves it may be necessary to assessed as required stage 3 residential care. this is where all external gates to the facility are blocked and residents are unable to leave their own desire. As dementia progress person with dementia is vulnerable safety issue and requirements and protection is important not only from physical injury but also from exploitation and abuse. Individualised activity plan- Activities should be safe voluntary, familiar and provide chance of satisfaction and success. Each client have and requires activity plan. Avoidance of triggers- It is the key to management and problem solving consultation with family/whanau. Use of behavior charts and good documentation with times, location, dates and the staff involved. Ensuring that the care being delivered is client not task oriented, assist with ensuring values and self esteem. Timeout- timeout for person with dementia means gently taking their hand and encouraging them to walk away from a situation which causing them distress. Going for a walk, going back to their room or in a quiet area should be assisting in reducing tensions.it should not be necessary toi restrain or shut someone into isolation. Communication techniques- It is provided and acknowledge required that carers should talk in a respectful and calm way to residents and even to staff’s as a sign of respect. Staff education and training- It is ongoing training and monitoring of systems and strategies. Manangement often offer trainings to staff to familiarize and know whats to do when the situation arises example falls, what to do etc. Debriefing- Support workers having regular meeting and discussion to relieve the stress and discuss concerns or just have a meeting and talk to relieve the stress. Having trained support workers such as team leaders to open discussion and assistance to other support worker. Stress management- Stress management is a spectrum of techniques and psychotherapies aimed at controlling a person’s level of stress especially chronic stress. One way to solve and lessen the stress was to d solving the problem which causing to stress thinking intervention how to deal with it remove yourself from the stimuli, listening to music watching movies and talking to friends to lessen and cope with the stress. Care Worker Strategies Personal restraint- it means that the service provider uses their own body to intentionally limit the movement of client upper body and arm that can be held to allow for a bloodtest, and a body and legs might be restrained for insertion of a catheter. Physical restrain- which limit a person normal freedom of movement mostly applied directly to a person’s body. Strap and lapbelt are used in a bed chair. Vest restrain-vest crosses body at the front and strap to secure at a chair or bed to decreased forward or sideway movement. Mitten restrain- restrain person hand to restrict the ability to use finger thumb. Wrist ankle-limit movement of legs/arm . Elbow restrain- preventing elbow from bending. Environment restrain- Reduction of social contact or intentionally removing environment stimulation, it is a change to a person surrounding that restricts or control movement example bed rails can be raised on side of the bed some are padded which make them suffer. Locked doors- locking doors to a room and certain area. It can stop people who are wandering to go into a place they are not supposed to. Seclusion- can be reduced if they are at risk of injury for themselves or other. It means locking a person in a particular room, it should be used in mental health and intellectual disability to prevent violent behavior compromising safety. Fences it can be used as a restrict on outdoors area, Indoors can be used in a corridor or at a top of staircase. Furniture portable tables or reclining chairs can be used as form of environment restrain. Important Factors for Dementia Care 2.2 Dignity- Restrain reduces dignity when our choices are diminished and we rely on others to meet our needs such as fluids,toileting bathing, etc. Person or support worker should make sure that they are continually aware of dignity am person. Privacy- Person al information should be stored securely and should not be visible to people who are not authorized to see it. Support- positive communication is essential to reduce agitation and anxiety. Should be within the person’s understanding and it may be repeated. Touch are useful ways to communicate with the person. Be sure touch is culturally acceptable for demented client. Communication- use simple short clear sentences as the person my be having difficulty understanding because of dementia, speak politely this will decreased client stress. Safety- document the use of restrain example progress notes, Make sure that it is culturally accepted, during restrain monitoring forms and if a new restrain it can be check every 15 mins, then it can become less if a person get used with the restrain. Process of Dementia Care Approval process- This is the first step before it needs to approved, before restrain full restrain can be used, any risk desired ourtcome, person age, gender, current treatment, recovery plan, possible alternative, hoe the person will be affected, and the possible effect of this like confusion response on future treatment. Documentation- document sufficient detail and the intervention and outcome that is being done. Documentation is a legal proof of what is being done. It consist if details of advocacy, intervention and observation, and monitoring, type of restrain being used the time, the risk and the cultural considerations. Document it on restrain form which can be checked and fillup every 2 hours for the notes. Assessment is needed before the treatment is being started, it includes here the clients health gender, culture, if experience trauma, being abuse in the past , how long should be in place and what factor should be considered and what is the expected outcome on this. Informed consent- Informed consent is a process of involving indivisual and or their representative if the individual does not have the capacity to consent all involves needs to be appropriately involved and are willing to agree on what is being suggested.consent must be obtained before doing retrain. The ffg should be explained like what is the restrain being used, the risk and benefits, alternatives on the use of restain and the outcome of its use. Planning- The decision to approve for restrain on a client should be made only as a last resort, to maintain safety for the clients workers and others. It is also based on the information that is being gathered during the assessment process and the organisation policies and procedure. Care and Monitoring- The need for continuous use of restraint is continually monitores and regulatly reviewed to ensure it is applied for the minimum amount of time necessary. To minimize the risk of harm to the patient during anby period of the restrain the patient safety, comfort, provision of all are support and treatment must met at all times. Must check the color- the skin may also feel cool if blood flow is restricted the circulation restricted blood floew affects circulation which they may feel tingling sensation especially in fingers, hands and feet and toes. Sakin breakdown may occur especially in the area where the restrain is it can become red and will develop sores. Breathinh- The person should breath normally when the restrain is in the place if the person having difficulty of breathing the restrain may be too tight.Posture- if the person is uncomfortable the restrain may be too tight or incorrectly placed. Degree of restriction- there should be enough two finger space b etween restrain and person body. Comfort- make it comfortable to keepthe injury on its minimum.Personal needs- Ensuring that needs are met and opportunities to eat and drink go to toilet is being prioritized and being given to decrease the impact of restrain. Reporting and recording- A restrain is being registered or equivalent process is established to record sufficient information to provide audible record of restrain use. Organisation policies will describe what observation monitoring and unexpected changes you need to record and how often this needs to be done.

Saturday, January 18, 2020

Health Issues in the Philippines Essay

Like any other third-world country, the Philippines have been struggling in some health issues and one of it is illegal drug use. A lot of Filipinos are addicted to prohibited drugs. However, the Philippine government has dealt with this issue and although there are still some recorded incidents of drug abuse, the number of drug dependents in the Philippines has gradually decreased. One major health issue in the Philippines, is malnutrition. There have been studies conducted and accordingly, most of the Filipinos that suffer from malnutrition are the poor ones. The Philippine government, thru the Department of Social Welfare and Developments along with the Department of Health has provided projects to help poor Filipinos from starvation. Other health issues in the Philippines are dengue cases, but then, these health concerns are only happening in the rural area of the country. Most of these cases are properly attended to by the Philippine government Health issues in the Philippines The Philippines have been struggling with some healthcare issues, one of the most noticeable being illegal drug use.There are a number of Filipinos who are said to be addicted to prohibited drugs. However, the Philippine governmenthas concentrated on this issue and although there are still some recorded incidents of drug abuse, the number of drug dependents has gradually decreased.Another serious health issue is malnutrition. Unsurprisingly, the poorer citizens are the ones who suffer from thiscondition. The Philippine government, through the Department of Social Welfare and Development and in conjunction with the Department of Health, has initiated projects to help its poorer citizens who suffer from starvation.Cases of dengue are also notable. However, most of these cases are properly attended to by the Philippine government.

Friday, January 10, 2020

How Might Prejudice Develop and How Might It Be Reduced? Essay

A judgment or opinion made without adequate knowledge; to Prejudge, to pass judgement or form premature opinion. We can break the word prejudice down into two parts to give clearer understanding of its meaning, Pre is before and judice is to make judgement, so it is a negative preconceived judgement on an individual or group prior to seeking full knowledge or understanding about them. Prejudice effects many aspects of today’s society. Racism, sexism and homophobia are all examples of discrimination against a group that they may feel does not fit in to their norms in society. This can stretch further to prejudice against single parents, students, the elderly, the disabled, Goths, Emo’s, basically any group can be subjected to a form of prejudice. These negative preconceived ideas affect the way we treat people on a day to day basis. It is fair to say that most people would like to think they are tolerant of others and are not prejudice but it is unlikely that these people have no prejudice at all, it is inevitable that certain groups would not personally appeal to everyone and we may be drawn to other groups for company. There are three elements of prejudice. The cognitive element which are ideas about a particular group which form stereotypes. The affective element involves feelings in relation to a certain group, these feelings could include anger, disgust, intimidation or even hate. The behavioural element involves actions taken to express these feelings, for instance an individual may avoid a certain group or individual belonging to a group, they may become abusive either verbally or physically, in extreme circumstances this discrimination can lead to such atrocities as the Holocaust where millions of Jews were exterminated. The media has a massive impact on our opinions of others. It may not be that someone expressing prejudice has had direct contact or experience of a group or individual from a group but they may have formed opinions based on propaganda, parental influences, authoritative figures, peer pressure or ignorance. The social learning theory suggests that negative thoughts or prejudices are learnt from society, for example parents, friends or colleagues. We are not born with negative thoughts/ preconceived ideas for others therefore it must be a learnt ideation. Psychology gives two main approaches to describe the ‘prejudice’ phenomenon, with many psychologist contributing with studies regarding prejudice for example; The Robber’s cave, Sherif (1956). This looked at whether prejudice could be created within a group. Social Factors of prejudice suggests that prejudice is a result of group interaction. Sherif conducted an experiment in 1956 to promote the theory suggesting that â€Å"when groups interact with one another they will inevitably generate attitudes towards each other†. The Robbers Cave experiment took a group of carefully selected boys, with no known hostile attitudes towards each other, they split the group and introduced competition between the groups to observe the ‘natural and spontaneous development of group organisation and attitudes. ’ This is known as minimal group theory. Individual factors involved in prejudice theories suggests a â€Å"sick person model†, suggesting that prejudice is an individual occurrence relating back to unresolved childhood memories or trauma. Freud’s work with psycho-analysis on this was a major influence, that conflicts in ones childhood creates a damaged adult personality. Also theories of the authoritarian figure by Adorno et al (1950) brought the suggestion of projection of unresolved past (childhood) experiences onto minority group. The down side to this theory is that it does not explain group prejudice, it implies that prejudice is an individual process and isolated to having a sick personality. Reduction of prejudice is vital for social integration and acceptance. Prejudice has reduced over the years in many aspects, as we as a society become more acceptant of others prejudice should reduce, but there will always be a victimised group within society which is outcast. Homosexuals could not be openly gay twenty years ago but now it is seen as an acceptable part of society, although there is still animosity towards minority groups such as homosexuals they are not so widespread and outwardly visible. There are several ways of reducing prejudice within society on both an individual and social level. Ignorance has a massive impact on peoples thoughts and opinions of others as many of their opinions of others are uninformed and uneducated. Education is a vital part of reducing any kind of animosity. Schools, parents and other authoritarian figures can take an active role in educating young people about minority groups to encourage acceptance, cultural awareness within schools can be very beneficial in the acceptance process. Opinions of parents are a major influence on a children’s attitudes towards those who appear to be different to themselves, so education is not only appropriate for young people but re-education of old-school thoughts is a necessary action. Integration with other groups is very important to build understanding and empathy between cultures. Also communication is vital to encourage understanding and time to allow these things to take place, attitudes cannot change overnight. Encouraging the pursuit of common (superordinate) goals, can reduce divisions between groups, if mixed groups have a common goal to work towards they are more likely to pull together and put differences aside for the greater gain of the group. All these are options for aiding the reduction of prejudice but time, effort and desire on the part of everyone is required to achieve this reduction, but it is reasonable to say that even though prejudice can be reduced it will never be extinct; there will always be an element of prejudice within society.

Thursday, January 2, 2020

The Great Gatsby Analysis Essay - 2075 Words

Diction: In the Great Gatsby, Fitzgerald utilizes a heavily elegant and sometimes superfluous diction which reflects the high class society that the reader is introduced to within the novel. The speaker Nick Carraway talks directly to the reader. The diction is extensively formal throughout the novel using high blown language the borders on being bombastic. An example of this formal language is seen when Nick states,The truth was that Jay Gatsby, of West Egg, Long Island, sprang from his Platonic conception of himself. He was a son of GodÂâ€"a phrase which, if it means anything, means just thatÂâ€"and he must be about His Fathers business, the service of a vast, vulgar, and meretricious beauty. The words platonic and meretricious†¦show more content†¦The tone is hopeful and dignified. Much detail is used and even some ironic detail such as Gatsby being gorgeous. Even though one would not normally describe a man with such a word it fits perfectly in this sentence. Th e language is formal and it reveals Nicks positive view on life and on Gatsby. The syntax in this passage is made up of strung-together sentences and clauses. All of the sentences within this passage are complex or compound-complex. These long and airy sentences emphasize the tone of upper-class people speaking as well as the emphasis on a dream. The sentences are extensively poetic and carefully thought out giving it a nonchalant and superior tone. Passage 2: I didnt call to him, for he gave a sudden intimation that he was content to be alone - he stretched out his arms towards the dark water in a curious way, and, far as I was from him, I could have sworn he was trembling. Involuntarily I glanced seaward - and distinguished nothing except a single green light, minute and far away, that might have been the end of a dock. When I looked once more for Gatsby he had vanished, and I was alone again in the unquiet darkness. 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