Tuesday, April 2, 2019

Impact of Ageing on Psychological Health

Impact of Ageing on Psychological HealthIt should be noted that either names of individuals and impersonates in this report contribute been changed in order to cling to the patients confidentiality (Nursing midwifery council 2009). Therefore the patient will be kat oncen as Mrs. embrown.Mrs brownish is an 86 year old peeress who lives with her elderly husband. According to Mrs embrown husband they have two sons unneurotic and 3 grandchildren, they some(prenominal) visit occasionally. She used to work as a secretary until she retired in her early 60s. She clearly had a good holding. She enjoyed change of location abroad, with her husband. For many years she had attended services at the local perform where she was well known .as a kind, warm-hearted popular lady in her town for the good things she did. Mrs chocolate-brown clinical notes written by her community affable wellness nurse states that she was diagnosed with aberration the Alzheimer ailment 12 years ago. Alz heimers is a conceiver disease that causes problems with memory, thinking and behaviour. Symptoms normally develop slowly and disturb worse over time, becoming severe enough to interfere with perfunctory tasks (online www.alz.org/alzheimers_disease 21/02/11). Her husband has been her main cargonr ever since. She attends a day means once a week and has c bers coming in twice a week to assist with soulal c are. The staff at the day summation has also reported that Mrs cook now showed no inte eternal rest and was opposed to comply with activities which showed that she had lost sense of pleasure.Mr Brown stated that before the diagnosing, they were several(prenominal) episodes when she got lost and was picked up by police to be returned at home.Mrs Brown become disorientated ab bug come out where she was because of her delirium. She became confused closely time. She will also leave off her doctors appointments .Mrs Brown couldnt even remember her sons names later on cut he r husband and would lose track of conversations.Mr Brown stated that he do an appointment then to see the general practitioner (GP) who then referred them to the memory clinic where she was diagnosed with Alzheimer.In the last year Mrs Browns mental and sensible health has deteriorated rapidly. She backside no longer do her activities of day by day living and she needs go for with personal care. Her behaviour has gradually become more and more curious that her husband is no longer copying.Mrs Brown was recently admitted to hospital with dresser and urinary tract infection, which would also increase her level of confusion and deficiency of orientation (Adams 2008).Although now discharged from hospital Mrs Browns sleep pattern was disturbed, she now wanders around at night.She has become more sensible and verbally in-your-face towards her husband, Mr Brown has raised concerns that he can no longer supervise with her behaviours to her CPN.The community mental health team hav e been monitoring Mrs Brown condition for some time now and liaising with the family, GP, social worker and head-shrinker regarding her care and support as required by the Department of health (DOH 2001), in relation to older sight (over 65yrs) with mental disorder.Mr Brown was considering looking for permanent placement in a nursing home for his wife.Mrs Brown was prescribed the following for her dementiaDonepezil hydrochloride/Aricept 10 mg once daily at bedtime is a reversible inhibitor of acetylcholinesterase.They are for the adjunctive treatment of entertain Alzheimers disease. Like all other medication donepezil has its side effects which are nausea,vomiting,anorexia,diarrhoea,insomnia,dizziness and agitation just to mention a few.(Source British National pharmacopeia 2007)There is currently no cure for Alzheimers disease. However, they are some medicate treatments are operational that can ameliorate the symptoms or slow drop the disease progression in some people such as donepezil, Exelon ,reminyl and galantamine these drugs maintain the supplies of the acetylcholineThe (National Institute for Health and Clinical Excellence NICE 2011) available online, states that these drugs are recommended as an option for people in the mild-to-moderate stages of Alzheimers disease.Older person presentationDementia is the general term used for diseases affecting the brain, including Alzheimers disease it is characterised by progressive cognitive impairment and the emotional and behavioural problems that dissolver from the cognitive decline (Sungaila Crockett,1993 citied in Tappen,R 1997).There are many opposite types of dementia although some are far more leafy vegetable than others. They are often named according to the condition that has caused the dementia. They are Alzheimer disease which is the most harsh cause, followed by the vascular dementia, dementia with lewy bodies and fronto temporal dementia these are the common ones.To rule out that somebody has dementia test has to be carried out .Winter (et al 2001) states that there are different illnesses that appear to affect the brain in ways that can cause symptoms similar to dementia. Winter (et al 2001) describes these as people with underactive thyroid gland, deficiencies of certain vitamins and general physical illness can give rise to symptoms of dementia, deplorable concentration and poor memoryln the case study Mrs Brown was diagnosed with Alzheimers below the author describes what Alzheimer is and its features which manoeuver to the diagnosis.Miriam (1994) describes Alzheimers disease as a brain disease accompanied by characteristics microscopic structural changes in the brain tissue leading to the goal of brain cells.lt is the most common cause of dementia in the UK.The beginning(a) signs of Alzheimers disease entangle lapsings in memory and problems with finding the right spoken communication (Alzheimer society available on line).In normal ageing memory lapse ar e common as we get older. Also the person temper changes Particularly as the parts of the brain that control emotion becomes change by disease. Memory loss is the most common potential uphold on the psychological ageing. Remembering everyday tasks becomes a chore.People with dementia may also feel sad, frightened or angry astir(predicate) what is happening to them.The person with Alzheimers may start to have communication problems desire inability to recall names quickly, decline in co-ordination and control of linguistic communication and action.Feeling and becoming lost in familiar surroundings. Some of these symptoms where spy in Mrs. Brown.Depression is other symptom for dementia (Tappen R, 1997) states that many individuals in the early stages of Alzheimers disease are also clinically depressed. Some of the bearing exhibited by Mrs. Brown may have been caused by that she was depressed.Some of these features direct to the diagnosis that Mrs Brown was suffering from Al zheimer as she was exhibiting these problems. Once a diagnosis of dementia has been make, the next stage will be to assess its cause.Mrs Brown had a series of tests and test to exclude disease in the rest of the body and to rule out some other brain conditions. The persons memory will be assessed, initially with questions about recent events and past memories. presumption these problems Mrs Brown was exhibiting, and the in-put from the community nurse it was agreed that she required further sound judgment to determine her level of cognitive impairment. This was done by using the miniskirt mental state examination (MMSE) developed by Folstein et al (1975), with accord Mrs Brown scored 12, which indicated severe cognitive impairment. According to Miller (1999) to examine particular(prenominal) cognitive impairment a Mini Mental state examination is used .The National institute of health and clinical excellence (2011) recommends that this implement be used for determining a pers ons suitability for the anti-dementia drugs such as Aricept which was prescribed to Mrs Brown.Aronson M,k (1994) suggests that it is appropriate to include a short list of carry through beginning count, vitamin B12 level, thyroid function test and brain scan as MMSE may not offer clues to their presences.A brain scan may be carried out to give some clues about the changes taking place in the persons brain. There are a number of different types of scan, including computerized tomography (CT) and magnetic resonance imaging (MRI).Vascular dementiaAlzheimer society (2010) describes vascular dementia as a type of dementia caused by problems in the supply of blood to the brain. There are two main types of vascular dementia one caused by stroke and one caused by wee vessel disease. It is the second most common form of dementia The lay on the line factors associated with Vascular dementia, as indicated ,are those associated with cardiovascular disease and includeHigh blood pressureDiabe tesDeficiencies of certain vitaminsHigh cholesterol levelsDieses in arteries elsewhere in the body and rhythm abnormalities(Soucers Martin 1998, Gould 2002, Taylor 2006).People with Vascular dementia may puzzle these symptomsproblems concentrating and communicatingdepression accompanying the dementiasymptoms of stroke, such as physical weakness or paralysisepileptic seizuresPeriods of acute confusionhallucinations (seeing things that do not exist)delusions (believing things that are not true)physical or verbal belligerencerestlessnessIncontinence.Dementia with Lewy bodiesDementia with Lewy bodies (DLB) is a form of dementia that shares characteristics with both Alzheimers and Parkinsons diseasesPerson with lewy bodies may have these symptomsA person with DLB will usually have some of the symptoms of Alzheimers and Parkinsons diseases.fall asleep very easily by day, and have restless, disturbed nights with confusion, nightmares and hallucinationsFaint, fall, or have funny turns.(So urce Alzheimer society 2010) licit and estimable issues surrounding people with dementiaDementia raises difficult ethical issues for people with dementia, for their formal and informal carer and for society in general. Formal carers are paid and trained to perform their lovingness role those involved in Mrs Brown care were GP, community mental health nurse, and social worker. familiar carers usually is yieldd by family and in Mrs Brown case it was her husband and children.Tappen R (1997) states that ethical issues include the often painful decisions that moldiness be made about restrictions on freedom, or end of life decisions and the legal issues include patients rights, abuse, neglect and in talent.Myron F and Wiener M (2004) suggested that legal issues are exceed addressed while patients still have the capacity to understand and impart while ethical issues begin at the time of diagnosis and may include whether to tell patients about their diagnosis.The key pieces of legisla tion surrounding people with dementiaThe Mental health Act 1983 amended 2007-it protects the rights of people who have been assessed as having mental disorder including dementia.lf a person with dementia is behaving in a way that is risking other and his/her health can be detained in hospital using this act.The Mental capacity act 2005 (implemented 2007) designed to protect people who cant make decisions for themselves or lack the mental capacity to do so.Recognised that in some circumstances ,being placed in a hospital or care home may deprive someone of their liberty.Deprivation of liberty safeguards code of practice (2008)-DOLS in practice turn in guidance for professionals involved in administering and delivering the safeguards. The Code is also intended to provide information for people who are, or could become, subject to the deprivation of liberty safeguards, and for their families, friends and carers, as well as for anyone who believes that someone is being deprived of the ir liberty unlawfully (department of health online).Before Mrs Brown dementia became severe, when she still had capacity, they had sat mass with his husband .They discussed about future plan on what to do with everything including her care.Mrs Brown choose her husband to be her abiding power of attorney for all her health care needs and property. Myron F Weiner, M (2005) states that with appropriate durable power of attorney, Mrs Browns husband can consent to her medical care, but the patients wishes if known, must be respected.Mrs Brown capacity was limited to live independently or make her own choices, inorder to respect her autonomy her husband and family were involved in taking active steps to act as advocates and to try and conjure her autonomy.As Mrs Brown diagnosis was early she and her family had time to plan about her preferences on treatment and facilitate support from community organisation.Mrs Brown was hard-boiled or care for justly by everyone involved in her care . Everyone worked unneurotic to create an environment that is safe, sustaining her dignity and optimizing opportunities for independent decision making and functioning. ethical problems carersBalancing risks and freedomAvoiding telling the truth to prevent distressHow to bear away conflict between caring for the person with dementia and other commitments.Those caring for people with dementia face ethical problems in caring out day to day care, these problems are important and stressful, those providing care receive brusque support and providing such support will improve good dementia care.Conclusion

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