This article discusses the health risks and impact of dementia on older Indigenous Australians. It highlights the importance of nurses in preventing and managing dementia and provides information on treatments and risk reduction strategies. The article also emphasizes the need for awareness and understanding of dementia among healthcare professionals.
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Health & Illness in the Older Person
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Table of Contents INTRODUCTION...........................................................................................................................1 PART 1............................................................................................................................................1 Covered in Poster...................................................................................................................1 PART 2............................................................................................................................................1 INTRODUCTION...........................................................................................................................1 BODY..............................................................................................................................................1 Why is dementia an emerging health risk/ Rationale for health risks....................................1 Why do nurses need to know about dementia / Rational for audience..................................2 What do nurses need to know about dementia/ Rationale for content...................................3 CONCLUSION................................................................................................................................4 REFERENCES................................................................................................................................5
PART 1 Covered in Poster PART 2 INTRODUCTION Dementia is present in almost all Indigenous Australians that are above the age of 55. This needs to be addressed by nurses that work in Australia as they will be able to help prevent and decrease the chances of illnesses caused by dementia. The main aim is to understand dementia as a persistent illness in Australian first peoples and how its affects their health, especially in the older age groups. This study will analyse why dementia is an emerging health risk and why as well as what is important for nurses to know about it. Various treatments and risk reductions will be given as well and how changes occur in nursing care during different situations. BODY Why is dementia an emerging health risk/ Rationale for health risks As per the views of Parker (2014) Australian first peoples experience dementia more than other Australians and it has been consistent for the past few years. This generally occurs between the age of 45-64 years and there are many factors that cause dementia such as high rate of obstetric complications in young mothers and malnutrition of children. Indigenous Australians do not get the proper education that is required, which creates a risk of developing dementia when they get old.Lindeman et al. (2017) statedthat there was lack of awareness about dementia within the Australian first peoples. This was mostly common in rural and remote areas of Australia. These places had 12.4% cases of dementia in the age group of 45-65 years.Clapham and Duncan (2017) argued that73% of Indigenous Australians suffer from dementia and Alzheimer's disease. These people who were over the age of 45, had to be admitted in public hospitals but some of them were unable to survive due to extreme stress. These cases keep increasing every year. It is important to take certain estimates and measures as this risk is becoming chronic and the older age group of Australian's first peoples have to be taken care of (Smith, Ali, & Quach, 2014). 1
There have been many cases of dementia in hospitals and treatments were not given on time. This is because patients do not regularly visit their doctors, mainly due to the lack of healthcare facilities in areas where they live. The socio-economic and psychosocial factors play a big role in health risks of Indigenous Australians as well. Parker (2014)states that they are not aware about their environment and the harmful risks associated with it. 66% of them are overweight and suffer from obesity, while 20% of them have high blood pressure and most of them are not even aware about it. 36.5% have uncontrolled high blood pressure, over the age of 50. Diabetes is another risk associated to dementia and 11% of Australian first peoples have it, which is 3 times more than non-Indigenous Australians. This is due to the unhealthy living conditions of these people as they reside in villages and areas where there is lack of social culture and presence of a negative environment. As perFlicker and Holdsworth (2014) many Indigenous Australians are unable to perform daily activities and at some point. Traumatic head injury is also a cause of dementia in older persons. Many of them indulge in smoking, which increase the risk of Alzheimer's, vascular diseases and cognitive decline.Alzhermer's Australia(2007)argued that Australian Government recognises that one of the biggest health problems in the country is dementia and it is 5 times higher within Australian first peoples than other communities.Smith et al. (2014) argues that large numbers of Indigenous Australians have been living with dementia and have not been diagnosed. There are no proper and good quality care facilities available for them. WhileGoldberg et al. (2018)says that there is a crucial requirement to address the illnesses caused by dementia and the factors that encourage it. Understanding the issue can help professionals to promote healthy lifestyles of Australian first peoples so that the risk of dementia can be reduced. Why do nurses need to know about dementia / Rational for audience As stated by Parker (2014) it is important for nurses to be aware about the signs and symptoms of dementia. This will help them to diagnose the type of illness and perform regular autopsy on families of Indigenous Australians. They can prevent the chances of dementia as well (Cahill et al. 2015). Nurses can help patients to reduce the intake of alcohol, as it is one of the main causes of intellectual disability, with 7.4% of Australian first peoples suffer from dementia due to misuse of alcohol.Claphamand Duncan (2017) argued thatnurses have to ensure that they conduct regular check ups of blood pressure, cholesterol and sugar levels (de Souza- 2
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Talarico et al. 2016). They can encourage patients to exercise to keep their bodies active so that their brains remain healthy as well(Hokanson et al. 2018). Nurses can give them mental exercises which will ensure that their intellect remains sharp (Gilroy et al. 2017). Most importantly, they can feed them required foods that will helpin meeting nutrition requirements that is needed by the body (Sullivan, & Theadom, 2017).Flicker and Holdsworth, (2014) stated that diagnosis has to be done on time so that families can be aware about services that nurses can provide to them, which will help in managing the disease. McMillan et al. (2010) states that hospitals and other healthcare facilities can be set up nearby places where Australian first peoples reside. If they are provided with the right treatments for blood pressure, diabetes and obesity, then it can easily reduce the risk of dementia, Alzheimer's and Parkinson's disease in old age of Indigenous Australians. There can be affordable services and medicines that these people can buy as well as provision of caregivers at certain areas can help in overcoming these illnesses. There can be provision of clean housing that is affordable for Australian first peoples. They can gain appositive mind set if they live in an environment in which they are supported socially and where there is no racism as well as a free culture. This can reduce risks associated with illnesses that can lead to dementia as they will be able to live in a healthy environment where they can exercise and eat healthy food that is fresh and affordable to them. Clapham and Duncan (2017)argued that nurses will be provided with information sessions so that they can develop supportive care to persons suffering from dementia. They can learn how to communicate with them, understand their feelings and emotions. It will help them to ascertain how they have to behave with these patients and reduce risks of increasing dementia in them. Parker (2014) contradicted that even after being a wealthy country, there are not much facilities available for Indigenous Australians.According toMcMillan et al. (2010), nurses need to provide attention to their patients through centred care approaches as they will help build understanding within the Indigenous Australians so that they can help in maintaining well being and health of those suffering from dementia (HMRI,2018). What do nurses need to know about dementia/ Rationale for content As per Parker (2014) nurses have to keep in mind that factors such as abnormal health risks including diabetes, cardiovascular and renal disease in Australian first peoples are likely to contribute towards dementia. They will have to analyse and plan treatments accordingly. They 3
can use the Kimberley Indigenous and Torres Cognitive Assessment so that they can conduct screenings in order to diagnose appropriate treatments for patients.Buswell (2014)argued that factors such as population, place of residence, behaviour of individual and culture has to be analysed by nurses so that they can appropriately determine required treatments. According to Wu et al. (2017)there are different healthcare systems that can be used by nurses to ascertain new methods of providing care to patients suffering from dementia. According toLindeman et al. (2017)nurses should be aware about traditions and culture of the patients that they will have to take care of. Analysing and understanding their eating habits, formal education and smoking habits can help them in gaining a better perspective of how they have been diagnosed with dementia (Jones, Jacklin, & O'Connell, 2017). There are more cases of males than those of females and usually depict signs of such diseases at 40 years of age. But it has been argued bySmith et al. (2014)that nurses are required to know about techniques that can prevent and reduce dementia instead of analysing factors as it will take up a majority of their time while diagnosing. They should be creating an environment in which reduction of dementia can take place. According toMcMillan et al. (2010)interventions can be done by nurses so that they can manage as well as prevent factors that cause dementia in Indigenous Australians.Alzhermer's Australia.(2007)contradicted this by stating that nurses need to learn how to counsel and provide advice to families of persons that suffer from dementia so that they can work consistently as per Australian first peoples community values aspirations and cultural frameworks. Accordingto Warren et al. (2015)there are many financial barriers that can cause delays in treatments of dementia. For this, nurses will have to adjust with these situations and provide as much help that they can. They need to realise that not everyone has the capacity to pay for their treatments and exceptional cases have to made. CONCLUSION Dementia has been prevailing in Australia and especially among Indigenous Australians. Nurses and patients, both have to understand this disease so that they are able to care, provide and get treatments to reduce risks of death. There is a need to reduce the mortality rate of Australian first peoples so that the overall population is maintained and everyone can live a healthy life. Information about dementia and the diseases that cause it has to be communicated with nurses in the healthcare industry. They need to be aware about the various treatments, side effects and medications that can be used in order to help patients with dementia. Families of 4
people that suffer from Alzheimer's and Parkinson's diseases have to be well informed about the illness, so that they can provide the help required to the suffering ones. It has been presented in such a manner so that it can attract people and make them knowledgable about dementia, its factors and how it can be cured or reduced. 5
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REFERENCES Books and Journals Cahill, S., Pierce, M., Werner, P., Darley, A., & Bobersky, A. (2015). A systematic review of the public’s knowledge and understanding of Alzheimer’s disease and dementia. Alzheimer Disease & Associated Disorders,29(3), 255-275. Clapham, K., & Duncan, C. (2017).Indigenous Australians and Ageing: Responding to Diversity in Policy and Practice.InAgeing in Australia(pp. 103-125). New York, NY: Springer. de Souza-Talarico, J. N., de Carvalho, A. P., Brucki, S., Nitrini, R., & Ferretti-Rebustini, R. E. D. (2016). Dementia and Cognitive Impairment Prevalence and Associated Factors in Indigenous Populations.Alzheimer Disease & Associated Disorders,30(3), 281-287. Flicker, L., & Holdsworth, K. (2014).Aboriginal and Torres Strait islander people and dementia: a review of the research. Australia: Alzheimer's Australia. Gilroy, J., Dew, A., Lincoln, M., & Hines, M. (2017). Need for an Australian indigenous disability workforce strategy: Review of the literature.Disability and rehabilitation,39(16), 1664-1673. Goldberg, L. R., Cox, T., Hoang, H., & Baldock, D. (2018).Addressing dementia with Indigenous peoples: a contributing initiative from the Circular Head Aboriginal community. Australia: Australian and New Zealand journal of public health. Hokanson, L., Quinn, M. G., Schüz, N., de Salas, K., & Scott, J. (2018). A systematic review of Indigenous caregiver functioning and interventions.Quality of Life Research, 1-11. Jones, L., Jacklin, K., & O'Connell, M. E. (2017). Development and use of health-related technologies in indigenous communities: critical review.Journal of medical Internet research,19(7). Lindeman, M. A., Smith, K., LoGiudice, D., & Elliott, M. (2017). Community care for I ndigenous older people: An update.Australasian journal on ageing,36(2), 124-127. Lindeman, M., Mackell, P., Lin, X., Farthing, A., Jensen, H., Meredith, M., & Haralambous, B. (2017). Role of art centres for Aboriginal Australians living with dementia in remote communities.Australasian journal on ageing,36(2), 128-133. 6
McMillan, F., Kampers, D., Traynor, V., & Dewing, J. (2010).Person-centred care as caring for country.Australia: An Indigenous Australian experience. Parker, R. M. (2014). Dementia in Aboriginal and Torres Strait Islander people.Med J Aust, 200(8), 435-6. Smith, B. J., Ali, S., & Quach, H. (2014). Public knowledge and beliefs about dementia risk reduction: a national survey of Australians.BMC Public Health,14(1), 661. Smith, K., Flicker, L., Dwyer, A., Atkinson, D., Almeida, O. P., Lautenschlager, N. T., & LoGiudice, D. (2010). Factors associated with dementia in Aboriginal Australians. Australian and New Zealand Journal of Psychiatry,44(10), 888-893. Sullivan, K. A., & Theadom, A. (2017). Neurocognitive disorders.Abnormal Psychology in Context: The Australian and New Zealand Handbook, 243. Warren, L. A., Shi, Q., Young, K., Borenstein, A., & Martiniuk, A. (2015). Prevalence and incidence of dementia among indigenous populations: a systematic review.International psychogeriatrics,27(12), 1959-1970. Wu, Y. T., Beiser, A. S., Breteler, M. M., Fratiglioni, L., Helmer, C., Hendrie, H. C., ... & Matthews, F. E. (2017). The changing prevalence and incidence of dementia over time— current evidence.Nature Reviews Neurology,13(6), 327. Online Alzhermer's Australia.(2007). Dementia: A Major Health Problem for Indigenous People. Retrievedfrom <https://www.dementia.org.au/files/20070800_Nat_NP_12DemMajHlthProbIndig.pdf> HMRI.(2018). Funding boost for Indigenous Australians living with dementia. Retrieved from <https://hmri.org.au/news-article/funding-boost-indigenous-australians-living-dementia> 7