Self-Management Of A Patient With Dementia

This article discusses how a patient with dementia should utilize the self-management program to manage this chronic illness at the community level. It includes main causes of dementia and a brief pathophysiology, the impact of dementia on the patient, family, and caregivers, empowerment, cultural safety, health promotion, the formation of partnerships with the health sector among others.

Running Head: SELF-MANAGEMENT OF A PATIENT WITH DEMENTIA 1
Self-Management Of A Patient With Dementia
Author’s Name
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Self-Management Of A Patient With Dementia
Based on the self-efficacy theory, patients have the ability to successfully manage their
chronic illnesses through utilization of self-management programs. The self-management
programs of chronic illnesses involve solving the arising problems, making properly informed
decisions, finding as well as utilizing resources, the formation of a partnership with health care
providers and taking the necessary actions towards the management of chronic illnesses. This
article will discuss how a patient with dementia should utilize the self-management program to
manage this chronic illness at the community level. There is the various factor that supports the
use of self-management approaches in the management of dementia. The most important factor
is the desires of patients living with dementia to manage and control their own care and lives.
The notions of empowerment, partnerships, and control of dementia also contribute to the
championing of self-management of dementia patients (Martin, Turner, Wallace & Bradbury,
2013). Therefore, it can be said that self-management of dementia is the tool, skills, strategies as
well as the connections that persons with the early stages of dementia and also their families
garner in order to control and manage their independence as well as maintain a quality of life.
This paper will include main causes of dementia and a brief pathophysiology, the impact of
dementia on the patient, family, and caregivers, empowerment, cultural safety, health promotion,
the formation of partnerships with the health sector among others.
Main Causes Of Dementia
There are two main causes of dementia which are: brain cell death that results in vascular
dementia and brain injury that causes post-traumatic dementia. However, dementia also has a
genetic undertone and is associated with advanced age. It should be noted that although the
likelihood of one having dementia increases with increase in age, this illness is not part of a

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normal part of aging. Vascular dementia is also known as multi-infarct dementia which occurs
due to the death of brain cells that is caused by various conditions such as the cerebrovascular
illnesses, for instance, stroke. The cell death prevents normal blood flow hence depriving brain
cells oxygen which leads to the development of conditions that result in dementia. The post-
traumatic dementia is caused by traumatic brain injury which causes brain cell death. To a lesser
extent, dementia can result due to prion diseases, damage of the brain cells by HIV infection and
as a result of reversible factors such as thyroid abnormalities, vitamin deficiencies, depression,
and drug interactions.
Pathophysiology Of Dementia
Dementia results from brain cell death due to head injury, stroke, brain tumor, and as a
result of a neurodegenerative disease that causes the progressive death of brain cell that occur
over time. Dementia is a collective word that is used to refer to the various symptoms that cause
a decline in the cognitive functions such as loss of memory, impaired communication, and
thinking. Therefore, it is said to be the symptom of many underlying illnesses and brain
disorders.
The Impact Of Dementia On The Patient
Dementia has psychological, functional, behavioral, emotional and cognitive impacts on
the patient. A diagnosis of dementia causes a huge difference in the life of the patient as one
experiences a range of emotions. The main symptoms associated with dementia include memory
loss, inability to understand and complete familiar tasks, the problem in communication and
language, misplacing things, disorientation, and a problem with abstract thinking. The patient
may also show mood changes, personality changes such that one becomes easily irritable, angry,

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fearful or suspicious, and loss of initiative whereby the patient shows less interest in starting
something new or even going somewhere. Some individuals struggle to deal with some of these
emotions hence may move between emotions in the attempt to adjust. Therefore, these people
may feel terrified about the future, afraid about moments of forgetfulness and confusion, and the
feeling of being upset due to the impact of dementia on their lives. Therefore, self-management
approaches to ensure the support of dementia patients by advocating that caregivers, family
members, and healthcare providers try to understand the feelings of the patient. These parties
should also listen to the worries and concerns of the patients to show them that they are not alone
(Bunn et al. 2014).
The Impact Of Dementia On The Family And Caregivers.
Toms, Quinn, Anderson and Clare (2015) states that dementia often becomes a burden to
the family members and caregivers as the patient requires more attention and resources. This
consumes time as well as resources and can be a difficult experience to the those will low
incomes. However, self-management of dementia reduces the financial burden as the family can
take care of the patient without hospital bills or having to put the patient into a facility (Wimo et
al. 2013). The families and caregivers of patients with dementia can also experience guilt, loss
and grief, and anger. Guilt is commons for the way the person with dementia was treated in the
past, lost tempers and even guilty for not wanting to be given the responsibilities of caring for the
individual with dementia. Grief can be said to be a response to lose. If a person develops
dementia, family members are usually faced with grief due to the loss of the person they used to
know which would mean the loss of a relationship and the loss of the future they had planned to
have together. The family members may also feel angry and frustrated for having to be
caregivers to the family member suffering from dementia. The anger can also result as a result of

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other family members who seem not to be helping out, or due to the behaviors of the patient and
also angry with the support services .
Self-management approaches offer strategies on how the family members and caregivers
can manage and overcome these emotions such as perseverance, counseling and seeking support
from other institutions like the community. This helps the family members and caregivers to see
caring for their loved one as a rewarding experience that strengthens bonds and ties by ensuring
close and intimate relationships. The self-management approaches also ensure that the family
members and caregivers are informed on the progress of the patient by the healthcare providers
who also advises them on the actions to take hence ensuring the formation of partnerships.
Formation Of Partnerships Within The Health Sector
Self-management of dementia advocates for the formation of partnerships with all the
stakeholders who include: the patient, family, caregivers, and health personnel. The involvement
of stakeholders leads to better outcomes since there are proper decision making and proper
management of dementia. Through partnership formation, the patient is able to manage the
physical as well as the cognitive aspects of dementia through strategies that are provided by the
healthcare providers to the patients and family members for compensation of memory loss and
the stimulation of cognitive capabilities as well as physical activity procedures and requirements.
Through partnerships, dementia patients are able to receive emotional management which
includes a positive attitude and an approach that aims at day-by-day management of dementia.
There is role management which includes social support and system support such as the
Alzheimer Society.
Empowerment Of People Living With Dementia

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Siriaraya and Ang (2014) argue that empowering dementia people to manage their own
signs and symptoms as well as bringing them together helps them feel confident about
controlling and managing daily life with the condition. Empowerment of dementia patient
involves group-based interventions that are aimed at helping patients manage their own
conditions. Patients are encouraged to attend self-management group sessions which encourages
discussion, socialization, problem solution and setting goals that foster independence and
promotion of social support. The trained facilitators aim at providing persons with a better
understanding and comprehension of their dementia and offering ways to manage it. Research
shows that empowering patients with dementia to take control and manage their own conditions
is beneficial as the patients feel more involved in matters concerning their health. The
empowerment involves supporting and educating patients to manage their own symptoms,
treatment, and suggestions on lifestyle changes with reliable information as well as expert help.
The patients attending the support groups and group counseling sessions are encouraged to share
various ideas and approaches for dealing with their conditions. They are also encouraged to
record notes and writing reminders in a handbook to help them remember.
Health Promotion
Health promotion towards the persons suffering from dementia is aimed at risk reduction
and keeping healthy. Individuals living with dementia need information, education, resources,
and support to be able to successfully undertake self-management strategies. As stated earlier,
dementia is not a normal part of human aging. Therefore, persons especially those at high risks
of developing the conditions are educated and informed on ways to reduce risks. The people with
dementia are also given information on how to carry out self-management approaches to manage
and control the condition. The patients through health promotion are encouraged to keep the

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body, mind, and spirit active so as to reduce complications related to dementia and also reduce
the symptoms. To ensure healthy aging, dementia patients are advised to eat a balanced diet, stay
connected spiritually and socially (Haber, 2013).
Through health promotion, dementia patients should be informed on the disease and its
progression, strategies for self-management such as physical activity and balanced diet, and
given emotional and social support since self-management advocates for the formation of a
partnership among the involved parties: the patients, family members, caregivers, and healthcare
providers. Health promotion also advocates for personal planning that involves both health and
community services for help and support. The dementia patient should be advised to keep his or
her brain active since dementia reduces cognitive abilities and also impairs the functioning of the
brain which leads negative changes that affect many aspects of the individual and the society.
The patient should keep the brain engaged and be socially active. The patient should also be
encouraged to keep fit and healthy through healthy eating by consuming balanced diets, and
participating in a regular standardized physical activity for a healthy body and brain so as to
reduce dementia symptoms.
Cultural Safety
In healthcare, cultural safety refers to an environment that is safe for patients: free of
assault, challenges or even the denial of their identity. Therefore, cultural safety in the self-
management of dementia involves respect, shared knowledge, preservation of dignity truly
listening to the concerns of the patients which include the cultural values, identity, and practices.
Cultural safety is considered to be well beyond cultural sensitivity and cultural awareness as it is
the experience of the dementia patient receiving care (Jones, Moyle & Stockwell‐Smith, 2013).
Cultural safety gives a dementia patient the power to comment on care in terms of their preferred

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values and cultural practices which leads to the reinforcement of positive experiences and
consequently improves self-management of the illness. It also helps in making the changes in all
the services that are found to be negative. For instance, the Australian Dementia Society
advocates for cultural safety in the management of dementia patients. This has helped in the
creation of an environment where the Torres Strait Islanders and the Aboriginal are treated well
and in a culturally respectful way hence empowering them to actively participate in the self-
management of dementia since they believe that they are valued, taken seriously and understood.
Conclusion
From the discussion above, it can be concluded that the burden of chronic illnesses is
greatest among individuals living with dementia, a group of patients that is on the rise as the
population is aging and lifestyle changes. These changes have adverse effects on the patient,
family members and caregivers hence calls for their intervention. To ensure optimal management
of this chronic illness, there needs to be an effective patient self-management plan. Self-
management is an intervention strategy that offers approaches that help the people living with
dementia to play an active role in the management of their condition. Consequently, dementia
patients are empowered through health promotion mechanisms to have the ability to manage
dementia symptoms through treatment, lifestyle changes, physical and psychological
engagement. The self-management approach advocates for the group based psychological
interventions for dementia patients. Management of dementia is a collaborative activity that
requires formation of a partnership among the patient, family members, caregivers, and
clinicians. Therefore, the self-management strategy expects that the health care providers work
with the patients, and family members to assess the current capabilities of the patients, identify
any barriers to successful self-management and try to adjust the information given according to

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the skills of the patient (Martin, Turner, Wallace, Choudhry & Bradbury, 2013). Self-
management also ensures cultural safety as patients are given the opportunity to incorporate
culturally significant practices in their treatment hence preserving their identity and dignity.

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