The Implications for Nursing Care for Dementia Patients

Running head: ESSAY
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Author Note

1ESSAY
Introduction- Dementia refers to an umbrella term that encompasses conditions and
diseases that are characterised by deterioration in language, memory, critical thinking skills
and problem solving, all of which create a negative effect on the ability of the affected person
to accomplish activities of daily living (Ru & Shindell, 2018). According to the World Health
Organisation (2019) worldwide around 50 million individuals are affected with dementia and
each year, there are an estimated 10 million novel cases. Not all patients who suffer from
dementia appear unkempt and dishevelled, and the diverse phases of the disorder create an
impact on the manner in which the patient completes daily activities. This essay will
elucidate the implications for nursing care for dementia patients.
Issues associated- Dementia is progressive in nature caused due to death of the brain
cells, and generally affects higher cognitive faculties like learning capacity, language,
calculation, comprehension, and judgment. During the initial stages of dementia, the signs
and symptoms are not particularly noticeable and characterised by mild cognitive
impairment (MCI) (Devanand, Liu & Brown, 2017). This stage is commonly diagnosed with
the Mini-Mental State Examination (MMSE) and a score of 27-30 helps in diagnosing
dementia (Creavin et al., 2016). Not only do the patients report problems in memory and
finding words and phrases, and confusion, however, are able to handle their life activities and
solve commonplace problems. This is followed by difficulty in completing daily chores
around the house, word-finding difficulties (anomia) and complications with arrangement and
organizational abilities (executive function) (Ramanan et al., 2017).
Other common signs manifested by the patient include getting lost, wandering,
personality changes, repeating things, and social withdrawal. The late stage is characterised
by 24-hour supervision for guaranteeing personal safety, with the aim of addressing the basic
needs. When left unsupervised, the patient is at a risk of fall (Fernando et al., 2017). This is
often concomitant with changes in eating pattern, increase in body weight, decrease in

2ESSAY
appetite and complete mobility impairment. Moreover, the patient also fails to identify
familiar faces.
Impact of dementia on ability of perform activities of daily living (ADL)- Dementia, in
addition to Alzheimer's disease severely affects the activities of daily living (ADL) of a
patient, thereby making it problematic for the individual diagnosed with the disease to
successfully accomplish simple activities such as, doing laundry, bathing, feeding or
grooming. According to Sun et al. (2018) dementia creates a strong impact on the executive
functioning of the patient, thus increasing the challenges while completing simple chores, and
the steps that need to be followed for accomplishing them. Dementia has been found to
impede the capability of the brain to plan, sequence, and organise activities that encompass
numerous steps (Urwyler et al., 2017). For the patient who displays a willingness to continue
living in the comfort of own home, following the dementia diagnosis, there is a need to create
the provision for assisted-living carers who provide the much needed assistance for
maintaining independence of the patient in the comfortable environment.
Loss of memory is one of the most significant indications of dementia and this
disorder affects both short-term and long-term memory. Not only does a dementia patient
forget about own identity or familiar people, but might even forget how to perform the basic
tasks of daily living, like brushing teeth, eating food, or putting on clothes, all of which are
imperative for basic survival (Devanand, Liu & Brown, 2017). Taking into consideration the
absence of adequate nerve impulse transmission in the brain, the attention, decision making
capacity and judgment are notably affected (Duncan, 2018). This in turn poses threat to the
health of the patient by impeding the capability to participate in self-care activities like taking
medications based on the prescribed dosage and frequency, and preparing food according to
the recommendations by the healthcare professional.

3ESSAY
Implications for patient safety- While developing nursing care plan for dementia
patient, it is necessary to provide in a manner that places an emphasis on the exceptionality
and preferences of the patient, rather than the disorder, the anticipated challenges and
symptoms, and the lost abilities of the patient. While addressing problems in completing
ADL, dementia patient must be allowed to access meals-on-wheels that will eliminate the
need of preparing food by themselves (McGovern, 2018). Physiotherapy-led exercise and
walking aids will also promote the patient to participate in different activities, thereby
decreasing burden of care and enhancing quality of life (Hall et al., 2017). Efforts need to be
adopted to use short and simple sentences, while maintaining a calm and gentle tone of voice.
It is imperative to reduce noise and distraction such as, radio or television, in order to assist
the patient to get a clear understanding of the purpose of the intervention and its benefits.
Addressing the patient by name, not interrupting during communication and educating
the patient on all activities and procedures involved in the care plan in a straightforward and
clear manner will also prove effective (Williams et al., 2018). It needs to be recognised that a
dementia patient has the potential of engaging spiritually and socially, and also the right to
lead a meaningful and purposeful life. While demonstrating respect towards the values and
philosophies of the patient, it is necessary to identify the basic areas where the patient has lost
independence. It is essential to address the poor mental functioning of the patient by using
reminiscence therapy that will enhance mood, cognition and communication of the patient
(Woods et al., 2018). Owing to the fact that dementia impairs normal communication, taking
assistance from a speech and language therapist and music therapy will effectively decrease
communication problems as well (Zhang et al., 2017). The care plan will also focus on
display of empathy and support, in addition to valuing social interaction and understanding
the surrounding world from the perspective of the patient.

4ESSAY
Conclusion- To conclude, dementia is a progressive neurological disorder, and during
the initial stage, there occurs changes in the brain of the affected person, and the symptoms
just originate to appear. Nonetheless, the symptoms are not severe enough and do not create
any major impact on the daily functioning. Not only is the dementia patient unable to solve
problems during middle stage, but also manifests impairment in social judgment. Failure to
function outside comfortable and known premises and need for assistance while maintaining
hygiene and performing personal care. Hence, there is a need to implement person-centred
nursing care plan that will delay or improve the cognitive decline, while addressing
communication and ADL difficulties.

5ESSAY
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7ESSAY
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