Effect of Noise in Dementia Care

This assignment focuses on the psychological healthcare setup dealing with dementia patients and their current problems regarding the ambience noises. The literature review is based on the impact of noise on the psychological condition of a patient of dementia. An action plan will be planned in order to make a suitable recommendation for organizational modification of a mental health care organization namely Aspire.

Running head: DEMENTIA CARE
Effect of Noise in Dementia
Name of the Student:
Name of the University:
Author Note:

1DEMENTIA CARE
Table of content
Introduction................................................................................................................................2
Literature Review.......................................................................................................................3
The causes and symptoms of Dementia.................................................................................3
Care needed by the Dementia patients...................................................................................3
Current situation in Australian healthcare regarding the treatments available for the
Dementia patients...................................................................................................................4
Action Plan.................................................................................................................................5
Discussion..................................................................................................................................8
Achievement..........................................................................................................................8
Unachieved factors.................................................................................................................8
Future scope...........................................................................................................................9
Conclusion................................................................................................................................10
References................................................................................................................................11
Appendices...............................................................................................................................14

2DEMENTIA CARE
Introduction
In any healthcare facility, one of the essential parts is the environment of the premises
that helps to regain the healthy physical and mental condition of the patient by direct and
indirect influences. In this assignment, the primary focus will be the psychological healthcare
setup dealing with dementia patients and their current problems regarding the ambience
noises. Dementia is a group of mental problems that affect the personal as well as social life
of an individual. One of the major disorders in this dementia group is Alzheimer’s
(Alzheimer's Association 2013) which is also very highly sensitive problem in terms of
effective ambience. In most of the cases, older people are found victimised by this
psychological condition that distorts their thought process, increases the confusion, decrease
the ability to remember, and reduces concentration. Being a group of multiple mental
disabilities, the Dementia is also founded in younger people.
The assignment will critically analyse and recommend suitable environmental
modification needed for caring patients with Dementia for the organisation named Aspire.
Aspire is a health care non-government mental healthcare organisation having the head office
at Scolz Avebue, Nuriootpa, Australia. Due to its multiple impacts on patient's everyday
activities, Dementia needs sincere care and assessment for the patient with adequate
environmental support (Dobson-Stone et al. 2013). In this assignment, the environmental
requirement will be discussed with the help of literature review based on the impact of noise
on the psychological condition of a patient of dementia. Additionally, an action plan will be
planned in order to make a suitable recommendation for organisational modification of a
mental health care organisation namely Aspire. A summary will be evaluated to summarise
the criteria of needed changes.

3DEMENTIA CARE
Literature Review
The causes and symptoms of Dementia
Dementia is a broad category of brain diseases involving distorted thought process,
lack of short time memory, disability to interact with social components, impairment of
cognitive communication, distorted visual perception, disputed auditory functions and others
(Prince et al. 2016). All of these disabilities cause the significant imbalance in daily activities
and social interactions. Majority of dementia patients belong above 60 years of age.
However, unexceptionally dementias are also found in young people. Some of the significant
causes of dementia are vitamin B12 deficiency, Lyme disease, neurosyphilis and most
importantly Alzheimer's (Matthews et al. 2013).
Repetitive conversations, difficulties in finding the route, forgetting necessary daily
activities are the major early symptoms of the Dementia. Often patients forget to make a
proper sentence while having a conversation (Jung 2015). However, Dementia does not cause
long time memory loss with helps patient to remember their life, identity and close relatives.
On the other hand, the patients keep forgetting about a bath, taking medicine or other daily
activities. Dementia with severe symptoms of Alzheimer’s can cause permanent
psychological disability.
Effect of noise by the Dementia patients
Both psychological and physical care is required for Dementia patients. People with
dementia often find themselves extremely restless or angry due to the ambience of their
surroundings. This acoustical distraction and additional auditory disturbance also causes

4DEMENTIA CARE
personality changes that can trigger both high anxiety and panic attack. Usually, patients get
angry or irritated about every simple thing. Therefore patients should be treated with
emotional support and persistence with adequate arrangement that can ensure low amount of
distracting noise (Kontos and Martin 2013). The caregiver should be aware and trained about
the effect of sudden or irritating unusual sounds on the behaviour of patients. Along with that,
both internal and external environmental component should be arranged in a way that can
reduce the amount of noise especially before and after the bed time.
Environmental arrangement and scheduling are other important things to be
implemented by the care giving facilities on daily basis. Both internal and external
components of surroundings can reduce the communication power of the dementia patients
by producing high amplitude of sound or noise (Prince et al. 2013). On the other hand, strict
and aggressive attitude of caregivers can also cause unnecessary vocal noises that reduce the
environmental adaptability of the patients. It is the major duty of the caregivers is to make
sure that patients are experiencing low amount of unnecessary loud sound and noises
especially before and after the sleep (Lichtner et al. 2014).
Current situation in Australian healthcare regarding the noise reduction
procedure for the Dementia patients
As per the global report of the dementia patient, in more than 45% cases the major
cause of dementia symptoms is Alzheimer's disease, which has been induced by noise
problem. More than 80% of the patients are usually found within the age group of above fifty
(Hsieh et al. 2015) who are highly noise sensitive. From the international report of dementia,
it can be said that Australia has the most stable situation in the growth rate of dementia
patient from 2005 to 2015 (Achterberg et al. 2013). However, the number of aged patient
suffering from Dementia has been increasing last few years where the number of patient

5DEMENTIA CARE
suffering from acoustical disorder is higher (Bail et al. 2013). As per the estimation formed
from the previous growth of patient count within Australia it has been predicted that in 2020
the number of Dementia patients can be increased up to 1 million where the inadequate
arrangement for reduce the ambient noise would be the major cause (Scandol, Toson and
Close 2013).
On the other hand, most of the mental health care organisations do not change their
conventional assessment structure to provide more effective treatment (Onoda et al. 2013).
Aspire assessment facility is not situated very far from the crowded and sound polluted area.
In current case scenario, the success rate of Aspire mental health care organisation is falling
because of their environmental situations and assessment structure. To improve the efficiency
and effectiveness of the assessment process the organisation needs to implement some
essential environmental changes.
Action Plan
Brief Description of the aspect to be modified and the current impact on people with
dementia
Dementia patients are becoming anxiety prone due to high amount of ambient noise. Noise
comes from TV and Radio reduces the relaxed ambience before and after the bed time.
Additionally, inadequate noise reduction arrangement is decreasing the psychological
stability of the patients. Turned on TV and Radio are hindering the soothing ambience that
impact highly on both conscious and unconscious mind of the patent as well as their
temperament.
Aims of Goals

6DEMENTIA CARE
1. Keep the patients calm and stable by making soothing ambience.
2. Equip some external components that can reduce the effective noise that can penetrate to
the inside of the premises.
3. Improve the relaxed ambience by reducing the noise from various electronic equipments
Key steps and activities to be taken to achieve aim/goals (include timescales and others
who can offer support).
Key steps and activities
Resources (including
personnel)
Timeline
Putting signs all over the
surroundings to make aware
passerby about the noise level
Facility Department
20 April to 12 May,
2018
Reduce the ambient noise by
repairing the noise making motor,
generators, doors and windows.
Facility Department 30 April to 20 May,
2018
Equipping special noise reduction
buffer around the outer wall of the
premises to reduce sound
Facility Department 12 May to 28 May,
2018

7DEMENTIA CARE
penetration
Switching off the TV and the Radio
one hour before and after bedtime
and monitoring the outcomes.
Caregivers 2 April to 18 April 2018
Criteria for Evaluation (identify up to 5 aspects by which you can measure your
success; one of which should be around people with dementia)
1. Keeping updated tracker for the regular action performed by the responsible persons.
2. Monitoring the functionality of all responsible persons through surveillance camera
3. Strictly maintain a checklist that includes all of the changed practices
4. Keeping close observation over resultant improvement of patients due to noise reduction.
5. Focusing on regular mood swing, irritation and emotional outburst of individual patients.

8DEMENTIA CARE
Summary Statement of what was Achieved
The overall arrangement of noise reduction has been successfully achieved because of
peaceful cooperation of both patients and responsible persons. Apart from that, putting
alarming signs over corresponding area increasing awareness of the visitors and stuffs.
Discussion
Achievement
According to the latest documented report of the patient’s conditions and
improvement rate, it can be clearly stated that various close monitoring and cross-checking
systems have successfully made the initial changes that are required for the patients. The
strict scheduling and regularity or assessment programs have increased the tolerance level of
the patients. Patients are showing less aggressive mood especially after the daylight because
of regular noise reduction procedure and guidance. The auditory identification and
memorisation power have been improved to some extent. Additionally, patience of most of
the patients has been also improved. Patients have become more calm and cooperative about
their daily routine that is helping them to maintain their psychological temperament. At the
nigh time, most of the patients are showing more calm gestures. Similarly, they are also
finding the Road side signs are showing more usefulness and visitors are trying to produce
low amount of noise as much as possible.

9DEMENTIA CARE
Unachieved factors
Although the patients have improved noticeably, the improvement rate is not as much
as expected. On the other hand, some of the patients are facing problems indoor activities
during the daytime. Some patients are less responsive when they are in assessment
programme for experiencing sudden noise coming from the external sources, such as noise of
larger vehicles, road repairing motors and others. Most of them are still forgetting were their
spectacles while needed. Some of them are avoiding any type of social interaction that also
decreases their patience level. However, situations of extreme anger have been reduced,
though some of the patients are denying cooperating with their caregivers and instructors due
to their extreme argument for listening night time Radio programs. Moreover, the collective
improvement has not been achieved with the moderate exception of improvement. Therefore,
it can be observed that the planned assessment programs and operational changes have made
some improvement within particular patient groups, while for some other patients this
implementation is not working well.
Future scope
After identification of optimum situational solution and appropriate strategic
therapies, the next operational changes can be made for further development of patient’s
cares. From the above mentioned outcomes, it can be said that the each of the patients needs
more support an assessment individually (Kales, Gitlin and Lyketsos 2015). In order to
support and assess the large number of patient Aspire has to recruit more caregivers, trainers
and experts. On the other hand, making the visiting section of the premises away from the
indoor section can help to reduce unnecessary noise. It will reduce the scope to make
unwanted loud sound near the individual room that will allow the patients to sustain their
peaceful state of mind (Hsieh et al. 2013).

10DEMENTIA CARE
After every effective implementation, the patients could be provided adequate support
and assessment according to their performance during the simulation program. The
complexity of this performance tracking simulation programs will be getting harder as per the
scorecard of the individual patient-generated at the time of the previous simulation-based
session (Brodaty et al. 2014). Every patients can also be trained how to control their anger
and sudden restless mood-swings. The will be also informed about the safety measures
regarding their daily activities like using sharp tools, making meals, using electrical
equipment and others.
Conclusion
From the above discussion, it can be stated that the assignment has been critically
analysed and recommend suitable environmental modification needed for caring patients with
Dementia for the organisation named Aspire. In order to improve the efficiency and
effectiveness of the assessment process for the dementia patient’s appropriated environmental
changes has been evaluated as per the requirements of the organisation. On the other hand,
the number of the aged patient suffering from Dementia has been increasing last few years
where the number of patients effected by the excessive noise and unhealthy ambience are
significantly high, which needs serious attention. Additionally, the usual memory loss also of
dementia patients also causes personality changes that usually trigger both anxiety and
depression.
From the situational analysis of a mental health care organisation named Aspire, it can
be clearly found that certain ineffective practices were blocking the expected improvement
process of patient's conditions. Although the patients have improved noticeably after the
implementation of operational changes, the improvement rate is not as much as expected due

11DEMENTIA CARE
to some unexpected external disturbance. From the above mentioned outcomes, it can be said,
after identification of optimum situational solution and appropriate strategic arrangement the
next operational changes can be made for further development of patient’s cares.

12DEMENTIA CARE
References
Achterberg, W.P., Pieper, M.J., van Dalen-Kok, A.H., De Waal, M.W., Husebo, B.S.,
Lautenbacher, S., Kunz, M., Scherder, E.J. and Corbett, A., 2013. Pain management in
patients with dementia. Clinical interventions in aging, 8, p.1471.
Alzheimer's Association, 2013. 2013 Alzheimer's disease facts and figures. Alzheimer's &
dementia, 9(2), pp.208-245.
Bail, K., Berry, H., Grealish, L., Draper, B., Karmel, R., Gibson, D. and Peut, A., 2013.
Potentially preventable complications of urinary tract infections, pressure areas, pneumonia,
and delirium in hospitalised dementia patients: retrospective cohort study. BMJ open, 3(6),
p.e002770
Brodaty, H., Connors, M.H., Xu, J., Woodward, M. and Ames, D., 2014. Predictors of
institutionalization in dementia: a three year longitudinal study. Journal of Alzheimer's
Disease, 40(1), pp.221-226.
Dobson-Stone, C., Hallupp, M., Loy, C.T., Thompson, E.M., Haan, E., Sue, C.M., Panegyres,
P.K., Razquin, C., Seijo-Martínez, M., Rene, R. and Gascon, J., 2013. C9ORF72 repeat
expansion in Australian and Spanish frontotemporal dementia patients. PloS one, 8(2),
p.e56899.
Hsieh, S., Irish, M., Daveson, N., Hodges, J.R. and Piguet, O., 2013. When one loses
empathy: its effect on carers of patients with dementia. Journal of geriatric psychiatry and
neurology, 26(3), pp.174-184.

13DEMENTIA CARE
Hsieh, S., McGrory, S., Leslie, F., Dawson, K., Ahmed, S., Butler, C.R., Rowe, J.B., Mioshi,
E. and Hodges, J.R., 2015. The Mini-Addenbrooke's Cognitive Examination: a new
assessment tool for dementia. Dementia and geriatric cognitive disorders, 39(1-2), pp.1-11.
Jung, C.G., 2015. Psychology of dementia praecox. Princeton University Press.
Kales, H.C., Gitlin, L.N. and Lyketsos, C.G., 2015. Assessment and management of
behavioral and psychological symptoms of dementia. bmj, 350(7), p.h369.
Kontos, P. and Martin, W., 2013. Embodiment and dementia: Exploring critical narratives of
selfhood, surveillance, and dementia care. Dementia, 12(3), pp.288-302.
Lichtner, V., Dowding, D., Esterhuizen, P., Closs, S.J., Long, A.F., Corbett, A. and Briggs,
M., 2014. Pain assessment for people with dementia: a systematic review of systematic
reviews of pain assessment tools. BMC geriatrics, 14(1), p.138.
Matthews, F.E., Arthur, A., Barnes, L.E., Bond, J., Jagger, C., Robinson, L., Brayne, C. and
Medical Research Council Cognitive Function and Ageing Collaboration, 2013. A two-
decade comparison of prevalence of dementia in individuals aged 65 years and older from
three geographical areas of England: results of the Cognitive Function and Ageing Study I
and II. The Lancet, 382(9902), pp.1405-1412.
Onoda, K., Hamano, T., Nabika, Y., Aoyama, A., Takayoshi, H., Nakagawa, T., Ishihara, M.,
Mitaki, S., Yamaguchi, T., Oguro, H. and Shiwaku, K., 2013. Validation of a new mass
screening tool for cognitive impairment: Cognitive Assessment for Dementia, iPad
version. Clinical interventions in aging, 8, p.353.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C.P., 2013. The global
prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & dementia: the
journal of the Alzheimer's Association, 9(1), pp.63-75.

14DEMENTIA CARE
Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M. and Karagiannidou, M., 2016.
World Alzheimer report 2016: improving healthcare for people living with dementia:
coverage, quality and costs now and in the future.
Scandol, J.P., Toson, B. and Close, J.C., 2013. Fall-related hip fracture hospitalisations and
the prevalence of dementia within older people in New South Wales, Australia: an analysis of
linked data. Injury, 44(6), pp.776-783.

15DEMENTIA CARE
Appendices
Apendix1:
Growth rate global comparison of dementia patient between 2005 and 2015
Appendix 2:
Percentage gap between of dementia patients according to their age in Australia

16DEMENTIA CARE
Appendix 3:
Estimation of Dementia affected population