Dementia Patient and Caregivers
Dementia is a result of disease process that increasingly weakens and damages the brain over time (World Health Organization, 2019)[[[best not to cite so early on…just give general views of the issue]]]]. Dementia is more common in elderly people; however, it affects all group of social class, ethnic groups, gender. According to World Health Organization (2019), The people with dementia does[[[do]]]] not necessarily develop the difficulties[[[in the same way]]] same way, some of the symptoms may only appear at one stage of the disease because of their personality, the type of dementia. The most common types of dementia are Alzheimer’s disease, Vascular dementia, Lewy body dementia, and frontotemporal dementia (World Health Organization, 2019). The growing number of people of dementia is challenging the health facilities as the clinical trials are lacking. Due to this increment, primary care is considered as the first point of contact which provide the largest proportion of care and assessment of specific treatment (ThyrianRene and friends, 2017). According to Rattinger and friends (2016), the psychosocial impact on individuals and families facing dementia is one of the costliest conditions among older adults resulting in a substantial cost with estimates of around $215 billion. [[[ok, but here at the end of the first paragraph you should be showing what the controversies are]]]][[[in other words, I do like this information, but I don’t see how it’s available for some kind of discussion or argument]]]]]
World Health Organization (2019), explains that dementia symptoms start with minor memory impairments, having trouble making decisions but are generally able to function. As dementia progresses, patient might become forgetful and not be able to perform the activities of their daily life such as, daily hygiene and bathing, shopping, forgetting the date and time of appointments. In the late stage, people with dementia may have severe difficulties in memory, struggle to live independently, may not recognize relatives and friends. In the late stage, it is totally in the hands of caregiver with respect to the needs and safety. It is important to find the right person who meets the overall need of the patient and has a right way of personal communication with them as it is extremely difficult to involve patients directly in their own care (Petty and friends, 2019). According to Rundqvist and Severunsson (1999)[[[why put two sources back to back when they are not connected to each other]]], patient and caregivers relationship demands sensitivity and integrity and is bound together by bonds of mutual loyalty and trust which includes consideration, patience, compassion, softness, and caring culture. They further explain that this relationship gives both an opportunity to express their inner desire, needs and problems as caregivers are responsible to perform Activities of daily life (ADL).
According to Chernoweth and friends (2019)[[[wait…please add in more reason and then a direct quotation here]]], personal caregivers address the emotional and physical need and manages[[manage…do you not have auto-correct here?]]] the cognitive and functional deterioration of dementia patient. This type of education is learned by the education and staff support and is becoming more common in residential area. Despite the importance of caregivers, based on the study of certain European Countries, caregiver[[[caregivers]]] themselves are at the risk of developing health problems arising from constant care giving to dementia patient (Karlsson and friends, 2015). Most of the time, caregivers are also required to perform basic nursing tasks for which they have no actual training. This also contributes to the stress and complexity of caregiving. Naganathan and friends (2016), explain that dementia patient often rely too heavily on informal caregivers. This causes the reduction in uptake of available professional support resulting in caregiver burnout. As stated previously informal care contributes to the substantial component of dementia care cost, some factors could be modified to reduce this cost. Caregiver-care- recipient dyads close relationship predicts lower daily informal costs of dementia over time (Rattinger and friends, 2016)[[[these general references are not very helpful…please add in a direct quotation]]].
This arises[[[not clear]]] the importance of caregiver’s well-being being taken more seriously. There has to be an intervene to support the caregivers emotional and physical state such as care management. ThyrianeRene and friends (2017), explains that care management is beneficial for improving care givers wellbeing and social support while decreasing burden and depression. Often caregivers function as a messenger between health care professional and the patients. This also contributes to the existing workload. Karlsson and friends (2015), find that inter-professional and inter-organizational communication with informal caregivers prevents them from being messengers between professionals and organizations. Appreciation of family members also motivates the caregiver. Sense of belonging is always a good emotional strength to keep up with their work.
The relationship between dementia patient and caregiver has therefore been extremely unique. One cannot exist without the other. There are ups and downs in this journey and they have to deal with different physical and emotional issues along this relationship. They both consider each other as an extended member of their family. During this care, different kinds of skills, knowledge, and training are needed. Homecare giving has been evolving over the years which is beneficial for dementia patient as they are able to receive caregiving within their familiar surroundings. Some caregivers are struggling to keep up with the evolution of home-care perception. Different kind of attachment method has been suggested by different studies to address the patient care. However, some detachment might be necessary to reduce the emotional burden that comes along with the personal care. This detachment method might also help to keep some innovative engagement intact. Further studies and research are required to determine the complexity of this relationship.[[[this has the beginnings of a good essay, but does need much more in the way of direct quotation and source work…in other words, try to use your sources more consciously and more obviously]]][[[Right now the grade would be a B/B- but that can obviously go up]]]]
References
Chenoweth, L., King, M., Jeon, Y., Brodaty, H., Stein-Parbury, J., Norman, R., Haas, M., & Luscombe, G. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurology, 8(4), 317–325. https://doi.org/10.1016/S1474-4422(09)70045-6
Karlsson, S., Bleijlevens, M., Roe, B., Saks, K., Martin, M., Stephan, A., Suhonen, R., Zabalegui, A., Hallberg, I., & RightTimePlaceCare Consortium, t. (2015). Dementia care in European countries, from the perspective of people with dementia and their caregivers. Journal of Advanced Nursing, 71(6), 1405–1416. https://doi.org/10.1111/jan.12581
NAGANATHAN, G., KULUSKI, K., GILL, A., JAAKKIMAINEN, L., UPSHUR, R., & WODCHIS, W. (2016). Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives. Ageing and Society, 36(9), 1891–1914. https://doi.org/10.1017/S0144686X15000768
Petty, S., Dening, T., Griffiths, A., & Coleston, D. (2019). Importance of personal and professional experience for hospital staff in person-centred dementia care: a cross-sectional interview study using freelisting in a UK hospital ward. BMJ Open, 9(4), e025655–e025655. https://doi.org/10.1136/bmjopen-2018-025655
POROCK, D., CLISSETT, P., HARWOOD, R., & GLADMAN, J. (2015). Disruption, control and coping: responses of and to the person with dementia in hospital. Ageing and Society, 35(1), 37–63. https://doi.org/10.1017/S0144686X13000561
Rattinger, G., Fauth, E., Behrens, S., Sanders, C., Schwartz, S., Norton, M., Corcoran, C., Mullins, C., Lyketsos, C., & Tschanz, J. (2016). Closer caregiver and care-recipient relationships predict lower informal costs of dementia care: The Cache County Dementia Progression Study. Alzheimer’s & Dementia, 12(8), 917–924. https://doi.org/10.1016/j.jalz.2016.03.008
Rundqvist, E., & Severinsson, E. (1999). Caring relationships with patients suffering from dementia — an interview study. Journal of Advanced Nursing, 29(4), 800–807. https://doi.org/10.1046/j.1365-2648.1999.00955.x
Thyrian, J., Hertel, J., Wucherer, D., Eichler, T., Michalowsky, B., Dreier-Wolfgramm, A., Zwingmann, I., Kilimann, I., Teipel, S., & Hoffmann, W. (2017). Effectiveness and Safety of Dementia Care Management in Primary Care: A Randomized Clinical Trial. JAMA Psychiatry (Chicago, Ill.), 74(10), 996–1004. https://doi.org/10.1001/jamapsychiatry.2017.2124
World Health Organization. (2019). ISupport For Dementia: Training and support manual for carers of people with dementia (pp. 1-10, Rep.). World Health Organization. doi:10.2307/resrep27895.6