Interventions for Older Person with Dementia Living at Home

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This essay discusses non-pharmacological interventions for an older person with dementia living at home, including reminiscence therapy, validation therapy, multisensory stimulation, and physical exercise.
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Running Head: DEMENTIA
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Older person with dementia living at home
Essay
student
9/20/2019
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DEMENTIA
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Older person with dementia living at home
Dementia is the overall term used for the diseases and health condition characterized by a
deterioration of memory, speaking problem-solving abilities, and other thinking skills that
impact an individual's ability to perform daily activities. The most collective cause of dementia is
Alzheimer's. This particular health issue mostly affects older individuals from all around the
world (Livingston et al., 2017). Globally, nearly 50 million individuals have dementia, and there
are around ten million new cases are diagnosed every year. It is one of the main causes of
disability and financial impact, not only on persons with dementia, but also on the home carers
like families, and the community at large. Although there is no treatment has been discovered yet
to cure the health issue to stop the progressive course. However there is much can be offered to
the older patient living at home (Satizabal et al., 2016). In this particular essay, an intervention
for an older person that includes independence, self-determination and purposeful activity will be
discussed.
John is a 68 years old individual living with his wife. He has two sons living in a different city.
He has been diagnosed with type two diabetes 2 years ago and has high blood pressure issues. He
also has a history of Alzheimer's, and recently visited the psychiatrist and diagnosed with
Dementia. He developed some symptoms like memory loss, poor decision making, facing issues
in performing daily tasks, and speaking and writing problems. He is worried about his wife as
she will be alone if something happens to him. The physician prescribed Cholinesterase inhibitor
and Memantine (Namenda) for John.
Although John has been provided with pharmacological interventions, he also needs non-
pharmacological interventions to enhance the recovery process. There are different interventions
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can be implemented in case of John to meet his incorporate independence, self-determinations,
and purpose full activity such as reminiscence therapy, validation therapy, reality orientation,
multisensory stimulation and physical exercise. For John, reminiscence therapy interventions
will be used to address the symptoms he is experiencing. The main aim of these interventions is
to manage the behavioural and mental symptoms of dementia. The healthcare profession like
nurse first observe the patient and recognise the trigger and initial symptoms of distress, and
assess John for pain (Abraha et al., 2016). Reminiscence therapy intervention focused on
memory-related issues. It is considered as one of the highly widespread non-pharmacological
interventions can include life story work, usual or general reminiscence and particular or special
reminiscence. This can help John to reflect his life, either individually or in the group, and
consequently, a book or comparable record of John or his permission developed (Woods et al.,
2018).
The general reminiscences will allow him to share common memories with the family and
healthcare provider. With these interventions, john will be encouraged to be social, and his
recreational and educational objectives will be achieved (Cohen-Mansfield, 2018). This
particular therapy uses open-ended stimuli or multi-sensory stimulators to trigger reminiscence
on the topics probable to be of interest to John and other participants and unlikely to stimulate
the painful memories. The reminiscence therapy is more specialized, additionally individualized
and might have an element of life review or the self-evaluation involved. To implement this
particular therapy is must be considered that it is safe, free of noise, and without any other type
of interruptions. Reminiscence therapy might advance the quality of life, enhance confidence and
boost the self-esteem of the patient (Gilhooly et al., 2016). Reminiscence therapy uses different
cues like internet, music, or photograph albums. The theory of ageing that must be considered
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while implementing this therapy includes disengagement theory. This particular theory refers to
an unavoidable process in which different relationships between a person and other community
members are severed and those residual are changed in the quality. It suggests that withdrawal
from social interaction is the main problem among ageing people and it is initiated by them or
the community and might be partial and complete. According to this theory, it is observed that
elderly people are le engaged in the life they used to be in adult age. As individuals age, they
face greater distance from the community and they develop a new kind of relationships with the
community (Oliveira et al., 2015).
In the validation therapy, the nurses attempt to communicate with the patients by empathising
with their feelings and with the intentions behind the behaviour and speech of an individual. This
particular therapy can be beneficial to develop a therapeutic relationship with John so that he will
support and engaged in the dementia management process. The main aim of this theory is to
make John as happy as possible (Erdmann and Schnepp, 2016). As discussed in the case study
John has different health issues and both husband wife managing things on their own. Therefore
the nurses must provide emotional support to him and use empathy skills while communicating
with john and his wife. John will also be encouraged to take parts in the activities being
performed in the community. This will enhance the communication between John and society
and ultimately reduce the social isolation issues. Activity therapy is another philosophy that
designates the psychological process of ageing. This therapy focuses on the importance of the
current social activity. According to this theory, an person's self-concept is associated with the
roles detained by that particular person that is retiring might not be so damaging if the individual
vigorously upholds his or her roles, entertaining roles, volunteer and society roles. To maintain
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the positive feeling of self the John must substitute his new roles for that are previously lost due
to his age (D’Onofrio et al., 2016).
He must also be encouraged to include some physical and cognitive activities in the daily
routine. Physical exercises have been shown to advantage people with dementia, especially those
who once had a very active life. An individual with these health issues must also be encouraged
to be engaged in the certain physical activities recommended by the practitioners. In adapting
the activity programmes attention must be given to the individual's abilities, interests,
preferences, and safety requirements (Spears, 2018). Engagement in purposeful activities has
numerous benefits. It inspires the patients to feel positive about them, brings meaning to their
lives, helps them to feel the sense of belonging, delivers chances for applying their forgotten
skills and usually supports their well-being. The advantages of purposeful engagement do not
alter with identification of dementia. Individuals living with this psychological issue can engage
in the purposeful activities at their home and communal groups for example planned activity
groups. To help engagement, it is essential to know the individual behind the dementia issue. It is
the person cantered approach and needs knowledge about an individual’s life story and what
strong point and interests he has to generate actions that has purpose for him or her. An example
of a person-focused approach is Montessori which is to support the engagement which is
purposeful. Some of the sensory experiences that can benefit John are improved mood, better
sleep, and maintenance of motor skills, walking, cycling, gardening, dancing, and aerobics
(Oliveira et al., 2015). The individual with dementia must always control which activity actually
has sense to them and which is unimportant. Engagement or involvement is related to the
experience of being engaged in an activity that positively brings objective and meaning - not the
result. Some of the activities that can be used by John are interests, both the past and present,
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leisure activities he enjoys, remembering achievement he proud of, doing essential roles
throughout his life. John and his wife must also be provided with information about the different
health programs and support being provided by the government and non-government
organisations (Shinagawa et al., 2015).
In conclusion, dementia is not a disease, but a complete term used for different illnesses and
health conditions. John is the elderly patient suffering from this health issue. He has some
symptoms like loss of memory, difficulty in doing routine tasks, speaking problems, and
difficulty sleeping. He has been prescribed with a cholinesterase inhibitor and Namenda. The
interventions that must be provided with the pharmacological intervention will include
reminiscence therapy to manage his behavioural and mental symptoms, validation therapy which
will include communicating with John and his wife to make a therapeutic relationship with them.
The main aim of this therapy is to make John happy. He must also be encouraged to perform
some physical and cognitive activities to manage his symptoms. Some of the physical activities
that can be helpful are yoga, meditation, talking. And physical activities will include walking,
dancing, doing activities that were once enjoyable for him. He must also be inspired to perform
some purposeful activities like better sleep, managing motor skills etc. this intervention is
influenced by the ageing theories.
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References
Abraha, I., Rimland, J.M., Trotta, F.M., Dell'Aquila, G., Cruz-Jentoft, A., Petrovic, M.,
Gudmundsson, A., Soiza, R., O'Mahony, D., Guaita, A. and Cherubini, A., 2017. Systematic
review of systematic reviews of non-pharmacological interventions to treat behavioural
disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ open, 7(3),
p.e012759.
Cohen-Mansfield, J., 2018. Non-pharmacological interventions for persons with dementia: what
are they and how should they be studied?. International psychogeriatrics, 30(3), pp.281-283.
D’Onofrio, G., Sancarlo, D., Seripa, D., Ricciardi, F., Giuliani, F., Panza, F. and Greco, A.,
2016. Non-pharmacological approaches in the treatment of dementia. Update on dementia,
p.477.
Erdmann, A. and Schnepp, W., 2016. Conditions, components and outcomes of Integrative
Validation Therapy in a long-term care facility for people with dementia. A qualitative
evaluation study. Dementia, 15(5), pp.1184-1204.
Gilhooly, K.J., Gilhooly, M.L.M., Sullivan, M.P., McIntyre, A., Wilson, L., Harding, E.,
Woodbridge, R. and Crutch, S., 2016. A meta-review of stress, coping and interventions in
dementia and dementia caregiving. BMC geriatrics, 16(1), p.106.
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S.G., Huntley, J., Ames, D., Ballard, C.,
Banerjee, S., Burns, A., Cohen-Mansfield, J. and Cooper, C., 2017. Dementia prevention,
intervention, and care. The Lancet, 390(10113), pp.2673-2734.
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Oliveira, A.M.D., Radanovic, M., Mello, P.C.H.D., Buchain, P.C., Vizzotto, A.D.B., Celestino,
D.L., Stella, F., Piersol, C.V. and Forlenza, O.V., 2015. Nonpharmacological interventions to
reduce behavioral and psychological symptoms of dementia: a systematic review. BioMed
research international, 2015.
Rodakowski, J., Reynolds III, C.F., Lopez, O.L., Butters, M.A., Dew, M.A. and Skidmore, E.R.,
2018. Developing a non-pharmacological intervention for individuals with mild cognitive
impairment. Journal of Applied Gerontology, 37(5), pp.665-676.
Satizabal, C.L., Beiser, A.S., Chouraki, V., Chêne, G., Dufouil, C. and Seshadri, S., 2016.
Incidence of dementia over three decades in the Framingham Heart Study. New England Journal
of Medicine, 374(6), pp.523-532.
Shinagawa, S., Nakajima, S., Plitman, E., Graff-Guerrero, A., Mimura, M., Nakayama, K. and
Miller, B.L., 2015. Non-pharmacological management for patients with frontotemporal
dementia: a systematic review. Journal of Alzheimer's Disease, 45(1), pp.283-293.
Spears, M.M., 2018. Nonpharmacological Behavioral Interventions for Patients with Dementia:
An Integrative Literature Review.
Woods, B., O'Philbin, L., Farrell, E.M., Spector, A.E. and Orrell, M., 2018. Reminiscence
therapy for dementia. Cochrane database of systematic reviews, (3).
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