social work interventions with alzheimer's patients

Need for Family Intervention. The relatives of these respective patients also face a lot of problems. Feature Flags: { Cognitive stimulation therapy is a group therapy which aims to stimulate and engage patients with mild to moderate dementia. Company Registration No: 4964706. While keeping your interventions functional and meaningful, also keep in mind what is most beneficial for that individual client. Intervention and treatment in Alzheimer’s disease dementia (AD-dementia) can be cost effective but the majority of patients are not diagnosed in a timely manner. 11th Feb 2020 Studies of creative arts-based approaches for dementia are mostly inadequate in terms of systematic study design, measurement tools and methods of analysis, and there is disagreement in terms of methodologies and evaluation (Reference BeardBeard 2012). 41) [Non-Pharmacological Treatment of Alzheimer's Dementia (IDWiG Reports no. 2017. April 2011; Social work 56(2):129-40; DOI: 10.1093/sw/56.2.129. a research supports a structured approach to post-diagnostic support, b Whitlatch et al found that people in the early stages of dementia are often unaware of the diagnosis, c Robinson et al felt that support should be provided for the carer and the person with dementia together, d supporting carers at the start can prevent crises occurring. The role of a Social Worker relating to Older Adults with dementia in the community. Formal services can help relieve some of the burden of caring for an AD patient. planning for emergencies, legal and financial issues), activity planning and environmental design, enhancing support for caregivers (e.g. Vink, Annemieke C. However considering the possible adverse response with deteriorating motor symptoms and dysphasia, antipsychotics should only be used as a last resort. 3399 words (14 pages) Nursing Essay. They can help prevent Alzheimer’s-related apathy. When people have few words, communication can be difficult and the life story book became a tool for engagement that gave Mr K a sense of pride and visibly reduced his anxiety and stress. Interventions with the same name may, in practice, be applied very differently, so treatments even with the same name cannot always be compared. More often or not the caregivers for Alzheimer’s patients are their family members. The time has come to commence large scale studies and experiments on this disease and thereby device a methodology/cure for this. }. Patient with FTD also go on to develop speech and language problems during the evolution of disease, (Neary 1998 Pasquier, Lebert, Lavenu and Gallium, 1999). The present study examined the effects of a person‐centered music listening intervention on mood, agitation and social engagement for individuals living with dementia. Engaging in regular physical exercise. Roy likes music and will play loud music with no concept to others. Occupation is described by Reference KitwoodKitwood (1997) as one of the main psychological needs of people with dementia and by Reference PerrinPerrin (1997) as the severest loss in dementia. Clare & Woods’ review in 2003 demonstrated no significant benefits from cognitive training, stating that it was impossible to draw any conclusions as study quality was limited. Need for Family Intervention. The evidence base is not yet robust enough to clearly suggest which interventions are most suited for which environment. Sánchez-Valdeón, Leticia Non-drug approaches, which should be tried first, are used by families and caregivers in consultation with social … The principles of dementia-friendly environments are now widely recognised. Implementing the Alzheimer’s diet (Mediterranean diet, MIND diet or the FINGER diet). Interestingly, one study in which multisensory approaches were integrated into daily care showed that improvements in certain aspects of behaviour, such as apathy and aggression, were maintained 15 months after the new regime had been introduced. Loma-Ramos, Sara We focus on both the traditional outcome measures of behavioural and psychological symptoms of dementia (BPSD) and the more difficult to measure, but equally important, person-centred outcomes of nonpharmacological interventions, as their properties are distinctly different from those of pharmacological agents. A review of 26 non-pharmacological intervention categories concluded that non-pharmacological therapies are useful, versatile and potentially cost-effective in improving outcomes and quality of life (Reference Olazarán, Reisberg and ClareOlazarán 2010); however, they necessitate staff time, raising issues regarding priorities and risk (Reference Lawrence, Fossey and BallardLawrence 2012). Roy is at high risk of absconding and has a past history of windows and absconding from the previous care settings .Roy is self neglect ,resistive towards personal care , his behaviour can be challenging when staff approach him regarding personal care .He has no concept of risk to himself or others ,he will invade people’s personal space and can become confrontational regardless of any age groups .When people ask Roy questions he will laugh inappropriately, mimic ,or answer inappropriately ,for example ‘don’t be stupid .His short term memory appears impaired to the place and date .Long term memory appears impaired and muddled . Disclaimer: This work has been submitted by a student. A specialised multisensory room may contain items such as coloured lights, water columns and aromatherapy. Research by Reference Whitlatch CJ Feinberg and TuckeWhitlatch and colleagues (2005) demonstrate that people in the early stages of dementia are often as aware of the practical implications and problems as caregivers. Psychosocial Intervention in Couples Coping With Dementia Led by a Psychotherapist and a Social Worker: The DYADEM Trial J Alzheimers Dis. (Dawn Brooker 2007) points out that understanding person’s past history is crucial to providing person centred care, by looking at procedures for how key stories are known about and how these are communicated Person with dementia is central to this process although others such as family or professional carers can also derive considerable benefits from being involved . Interventions included education for caregivers (e.g. A skilled social worker using interventions such as validation—a technique that affirms a person’s feelings—can help normalize a caregiver’s struggle. They can also reduce the need for care. Others who may help you are social care professionals, such as social workers, arranged through your local council. Roy was a lovely person when he married her, after she had four children, he was working as a supervisor for a company for 35 years. (V)The individuality of each person with dementia ,(I),The important perspective of person with dementia (P) and the key role played by persons social environment person centred care involves the integration of these four elements. "metrics": true, In this way, the evidence-based components of validation therapy might successfully be incorporated into other therapies (Reference Neal and Barton WrightNeal 2003). Find out how to discuss cognitive impairment, break bad news and work with families and caregivers. Beyond providing help by using their own knowledge, social workers can also point families to resources that they might not have realized existed. Most of patients with dementia are cared for by family members. Although the physical environment is important, so too is the psychosocial environment, preserving personhood, reducing the need for antipsychotic medication and improving quality of life (Reference Werezak and MorganWerezak 2003). Reference Ueda, Suzukamo and SatoUeda et al (2013) reviewed the literature on the topic and concluded that music therapy had moderate effects on anxiety and smaller effects on behavioural symptoms; thus, they felt that there is evidence that this therapy is effective for BPSD. More complex behaviours such as collecting (garbage, rocks, stamps, plastic figures) wandering a fixed route or counting money, evolve in patients. (2001) issues and innovations in Nursing Practice .How do we facilitate carer ‘involvement in decision making? Mr K was a retired office manager, with a wife and two children, who had enjoyed a successful career and been a keen golfer. Social workers and other providers caring for individuals with dementia in their homes or in residential care, will find a valuable resource in Dementia Care Practice Recommendations, released by the Alzheimer’s Association. He had lots of temporary lady friends; his personality changed, he threatened his wife with a gun one day to find his way. This detailed Mr K’s life, his achievements, his special moments and his family and friends. With respect to behaviour there are conflicting results; some studies show a decrease in agitation, some find no significant difference. Rooted in the principles of reminiscence, maintaining communication and a sense of self, life story work has demonstrated significant growth over the past 10 years. Mr. Roy then isolated himself .He use to visit regularly to the place where the company was and travelled several times in a bus on the fixed route. The reviewers concluded that life story work has ‘far-reaching’ benefits in health and social care, but that high-quality research is scarce. It is and activity that all the largely about the past, takes place in the present .it involves a series of intensive, non threatening highly personal discussions between the person disabled by dementia and responsive appreciative listener .As Roy’s dementia has progressed and is unable to gain any information from him . 5 Dementia Care Practice Recommendations for Professionals Working in a Home Setting is the latest in a series of dementia … A commentary by Reference Kolanowski and HillKolanowski & Hill (2013) on the Brodaty et al meta-analysis raises worthwhile points. The range of behaviours encompassed by BPSD (Box 6) (as opposed to cognitive decline or physical dependence on others) has been found to impose the greatest burden on caregivers and predict their decision to seek residential or nursing care for a family member with dementia (Reference Brodaty and ArasaratnamBrodaty 2012). • Be aware of the paradigm shift from managing BPSD to a person-centred approach that focuses on the patient's well-being and quality of life. Such support also gives caregivers the chance to … 2017. As demonstrated, the psychosocial interventions for dementia are vast. Physical exercise features prominently in terms of primary prevention of dementia in reducing vascular risk. Mr. Roy was a supervisor and driver for a company for 35 years, dedicated employee, he married Jane and had four children. View all Google Scholar citations Cognitive training – involving guided practice on a set of tasks and cognitive rehabilitation, individualised techniques or compensatory strategies – is designed to assist memory impairment and other cognitive difficulties. If your patient is a male and never did homemaking tasks, asking him to fold clothes or do meal prep won’t be the best intervention. Journal of advanced Nursing 34(3) , 329-337. She continued to pay back .He had problems with managing accounts, records and names of children. Conclusions: Results of this study show that a feeding intervention can improve food intake, eating compliance and nutritional status in patients with Alzheimer's disease with dysphagia and prevent further decline in swallowing function. However, a few adequately controlled evidence-based studies show favourable results for reducing BSPD. (Dale2003; Williams 2001) possibly posing stresses for family members. Disclaimer: This work has been submitted by a student. It is thought to work partly through sensory stimulation, but can also help trigger positive memories and improve social interaction. Treatment typically comprises three interrelated approaches: 1.) Nursing Essay reducing agitation), although the main focus was on increasing engagement with others. 2019. Thus this disease seems to pose a serious threat to mankind and its social existence. • Have a better understanding of the possible outcomes from given interventions. Reference McKeown, Clarke and RepperMcKeown et al’s (2006) systematic review demonstrated a range of methodological approaches utilised to explore life story work, although studies largely focused on staff perceptions, with patient and carer experience less well explored. 3399 words (14 pages) Essay. Technology is now available that can enable the earlier detection of cognitive loss associated with incipient dementia, offering the potential for earlier intervention in the UK health care system. The Dilemma of Delirium in Older Patients Understand the mechanisms involved in delirium and improved ways to recognize and treat the condition. Make sure the eating area is well lit. He admitted to the hospital due to his difficult behaviour pneumonia Mrs. Jane had to take voluntary retirement due to financial commitment and to look after Roy. Among nursing home residents with major or minor depression, psychosocial interventions that increased patients' control over recreational and other activities were found to enhance problem-solving skills and socialization. Ray, Kendra D Regarding reminiscence therapy and life story work: a the REMCARE trial showed modest benefits for most patients, b the REMCARE trial was neither positive or negative for caregivers, c the REMCARE trial was a cohort-based study, d life story work is based partly on the principles of reminiscence therapy. While keeping your interventions functional and meaningful, also keep in mind what is most beneficial for that individual client. Kolanowski & Hill also report that reliance on randomised controlled trials as the sole source of evidence excludes much available data; this is not the first time that the idea of the randomised controlled trial not being the gold standard in measurement of this particular type of outcome has been proposed (Box 7). Patient: ‘Where is my coat? "languageSwitch": true They range from those that are utilised in practice (with little or no evidence base) to those that are being studied to develop an evidence base, on which more widespread implementation may follow. Reference Forbes, Forbes and MorganForbes et al (2008) state that there is more conclusive evidence regarding aerobic exercise, with National Institute for Health and Care Excellence (NICE) guidance (National Institute for Health and Clinical Excellence 2008) recommending 30 min of aerobic exercise five times a week. 2019. Behavioral and Social Research Areas in Alzheimer's Disease The National Institute on Aging's (NIA) Division of Behavioral and Social Research (BSR) supports research and initiatives on the social, behavioral, and economic factors pertaining to cognitive health and Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD) at both the population and individual levels. You can view samples of our professional work here. Reference Parker, Barnes and McKeeParker et al (2004) recommend that there should be a balance between choice and control, physical support, normalness and authenticity, comfort, cognitive support and personalisation as these are all associated with increased quality of life. Reasons for this include that research funding is largely targeted at biomedical approaches and that study designs are not always a good fit for the outcomes measured. Families must work toward effectively coping with the disease, decreasing the harmful effects on the family, and keeping family conflicts to a minimum. Loss of insight regarding behavioural changes, diminished empathy for others, denial of depression, changes, diminished empathy for others, denial of depression, apathy, and blunted affect are present, in many patients with FTD and depressive features. Drawing, painting and using arts media has therapeutic potential in itself without using it as a clinical therapy to stage dementia. There are various models of post-diagnostic support for carers, but most are psychoeducational in nature, providing support for 6–8 sessions. The authors concluded that evidence is limited, with no significant benefits of cognitive training, acknowledging the lack of adequate measurement tools to capture benefits. Music therapy has been used for a variety of conditions and patient groups (e.g. Mittelman, Mary S As a result he was becoming very distressed and for long periods would pace up and down the corridors, getting involved in angry exchanges with other people. tive, and social problems arising from dementia-related changes. and Music therapy, life story work, multisensory approaches, light therapy, cognitive stimulation therapy, doll therapy and exercise show promising preliminary results. The doll met some need within him that was not satisfied by other interventions or by prescribed pharmacological agents: he was relaxed, showed pleasure and his periods of distress abated. "isLogged": "0", My case study is about Mr. Roy who is diagnosed with Fronto temporal dementia who has progressive language loss and cognitive decline. people with intellectual disability) and it is only in the past few years that there have been more rigorous studies of its use with people with dementia. "metricsAbstractViews": false, (Lindau 2000) (Miller, Swartz Lesser, & Darby, 1997) states that excessive smoking and alcohol or drug abuse can lead to the misdiagnosis of alcohol or drug addiction, patients with FTD tend to overeat in gluttonous manner. They found that people who used dolls appeared less anxious, more active and more content (Reference James, Mackenzie and Mukaetova-LadinskaJames 2006). The physical environment can help people with dementia achieve their potential, avoid increased disability and enrich life quality (Reference Davis, Byers and NayDavis 2009). Described by Reference Killick and AllanKillick & Allan (1999) as the ‘undiminished possibility’, they encourage participants and staff to see creativity as an opportunity for engagement not provided by other non-pharmacological approaches. Deficits in working memory, set shifting and generation are evident, episodic memory deficits can be prominent, leading to misdiagnosis of AD. An increasing number of structured or therapeutic activity-based interventions exist for people with dementia. They work in your own home as well as in residential care homes. Free resources to assist you with your nursing studies! Total loading time: 0.609 Kitwood was the first writer to use the term ‘personhood’ in relation to people with dementia, he defined personhood as a standing or status that is bestowed upon what human being by other, in the context of the relationship and social being .It implies recognition, respect and trust. Remove clutter/distractions from the eating area. They also reiterate that quality-of-life indicators may be better measures and this appears to be an emerging theme that we have noted. The above study thus explains the severity of Dementia and its consequences if left unattended. Previous musical skills are not required to be able to engage in this therapy. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the website then please: Our academic writing and marking services can help you! Walker E. & Devar B.J. There are a wide variety of services to help people impacted by Alzheimer’s or dementia, ranging from community agencies to city- or state-wide free services to … He has been referred to the psychiatrist and diagnosed of anxiety, depression and he refused to undergo any treatment for 3 years. Johnston, Bridget intervention strategies can improve the quality of life for patients with dementia: 1) Validating the Patient’s Sense of Self; 2) The Relationship between Caregiver and Patient 3) The Impact on Patient’s Daily Routine and 4) Depression and Mental Health. These guidelines help authors improve the quality of their reporting for studies of this type. Reference Brodaty and ArasaratnamBrodaty & Arasaratnam (2012) carried out a meta-analysis of the effectiveness of family caregiver interventions on the management of BPSD in people living in the community. Psychological therapies which are considered as potential treatments for dementia include music therapy, reminiscence therapy, cognitive reframing for caretakers, validation therapy, and mental exercise. 3 P. 18. 2019;68(2):745-755. doi: 10.3233/JAD-180812. Interventions for particular patient groups Elderly patients with disabilities often develop psychopathology that influences their rehabilitation (6,7). The adult population over 65 years throughout the world is rising very fast. Among her daily routines, Mrs. Clark managed the family checkbook, sang in the community choir, and enjoyed caring for her five grandchildren. He was clearly distressed and angry, so his wife brought his life story book to the ward. Have to get my hair cut, pick up the kids…’, Staff: ‘Right, well, you do have a lot to do… It seems you like to run around and keep busy.’, Patient: ‘I always have done. The burden of looking after patients with AD is immense. Patient Care Talking with Your Older Patient Learn to communicate effectively with older patients. "comments": true, He was diagnosed with semantic dementia which soon led to complex problems at home. } In clinical practice because many physicians are unfamiliar with its specific features FTLD is commonly misdiagnosed as AD. This had a huge effect on the ward staff in helping them understand Mr K and his behaviour. for this article. Reference Burns, Allen and TomensonBurns et al (2007) showed that after 2 weeks of light therapy at 10 000 lux from 10.00 h to 12.00 h there were improvements in the Cohen-Mansfield Agitation Inventory (CMAI; Reference Cohen-MansfieldCohen-Mansfield 1986), and it is suggested that individuals with higher initial CMAI scores may benefit the most from light therapy. There are many interventions that have been recently targeted in clinical research studies, aimed at preventing the onset of early Alzheimer’s disease. Johnson, Joana He became extremely frustrated with his deficits in comprehension and expressive language and increasingly frequently he became upset and angry. Even if there is a good degree of matching for patients taking medication, one might argue that it may reduce the patient’s ability to derive benefit from psychosocial interventions or that it may be harder for a psychosocial intervention to show an additional benefit. Although he was dedicated to his job and never had time for his family, Jane was the main carer of the family. This page aims to give people - and carers in particular - a better understanding of what it is like to have dementia. These will be defined questions for future research. and receiving good care .the care worker may feel secure when their job is not under threat . Many studies do not define ‘standard care’, which will be different across studies. E and Jane, B (2001), Fronto temporal lobe degeneration strikes at relatively young age, so the disease often causes dramatic economic and social consequences before patients arrive in the clinic. Reference Buchman, Boyle and YuBuchman and colleagues (2012) concluded that higher levels of daily activity are associated with a reduced rate of Alzheimer’s disease, and Reference Winchester, Dick and GillenWinchester et al (2012) found that for a group of people with early Alzheimer’s disease, walking for over 2 h a week for 1 year led to a significant increase in MMSE score over the control group. In pharmacological research clinical endpoints are requested by drug authorisation agencies. As it is difficult to assess how people will respond to dolls, there are guidelines (Reference James, Mackenzie and Mukaetova-LadinskaJames 2006) about their use which should always be considered before implementation. 12 No. Selective brain degeneration is seen in dorsolateral orbital and medical frontal cortex (Neary).Personality shifts in the direction of submissiveness are typical for FTD. More recently, Reference Hanford and FigueroHanford & Figuero (2013) published a review of 17 studies on the effects of light therapy on sleep, agitation and mood. By Ruth Hardy on March 20, 2018 in Adults. Dementia Interventions And Implications Health And Social Care Essay. and He was admitted to the ward, a smart intelligent man unable to express his thoughts and feelings and unable to grasp what was being said. Registered Data Controller No: Z1821391. 3399 words (14 pages) Essay. Social care workers can help with personal care such as washing, dressing, changing bedding, doing laundry and helping with meals. Furthermore, support groups, such as patient and/or relative groups, can provide mutual support, sense of belonging and any information needed. and In this study, researchers wanted to see if patients’ reported agitation levels could be diminished by having more social interaction. Roy’s inhibitions appears reduced which often results in socially inappropriate behaviours .Physical aggression towards fellow residents, Roy appears to have no insight to his own condition on others illness and safety. A Cochrane review of eight trials (Reference Forbes, Culum and LischkaForbes 2009) revealed that there was inadequate evidence of the effectiveness of light therapy in managing cognition, sleep, function, behaviour or psychiatric disturbances associated with dementia, and that further studies of high methodological quality and further research are required. Caring for people with dementia is challenging; approximately 30–55% of caregivers suffered from anxiety or depressive symptoms. This paper will review six of the most commonly used psychosocial interventions for individuals with demen-tia.

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