Self-Management of Dementia: Pathophysiology, Causes, Impact, Treatment, Health Promotion, Cultural Safety and Empowerment

This article discusses the self-management of dementia, including pathophysiology, causes, impact, treatment, health promotion, cultural safety, and empowerment. It also highlights the importance of culturally safe care and empowerment in dementia care.

Running head: COMMUNITY NURSING
COMMUNITY NURSING
Name of the student:
Name of the University:
Author note:

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Introduction:
Chronic diseases are considered as a form of ailment which sustains for over a period.
Most of the chronic diseases cannot be cured but could be managed with effective nursing
interventions (Mostafalou & Abdollahi, 2013). It has been found that more than half of the
global population suffer from one or more chronic illnesses (Murray & Lopez, 2013). The
purpose of the assignment is to discuss about the self management of a chronic illness. The
chosen chronic disease selected for the assignment is dementia. Dementia is defined as a
form of brain disease that leads to the reduction in the ability of thinking and remember
things for long period of time. Due to the effect of dementia a person could suffer from
memory issue, complication with language, emotional issues and distress as well. Such
condition affects the ability of a person to perform daily activities (Baumgart et al., 2015).
Such impact on the mental health of the patient has significant effect on the family and care
givers as well (Ornstein et al., 2013). Reports revealed by World Health Organization state
that more than 47.47 million people is suffering from dementia across the world and the
number is expected to reach over 75.63 million by the year 2030 (who.int, 2018). Thus, it has
become one of the major concerns of the world health system. Thus, it is important to
conduct in-depth research on dementia in order to understand the factors influence the
chronic disease to introduce adequate nursing interventions to address the factors in an
effective manner. Due to such reasons, dementia has been chosen as a subject of discussion
for the following assignment. The following paper will provide brief discussion on dementia
including Pathophysiology, causes, impact, treatment, health promotion, self-management,
cultural safety and empowerment.
Pathophysiology:

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According to Baumgart et al., (2015) dementia is not defined as the specific disease
but is explained as the combinations of group of symptoms that affect the thinking, memory,
social abilities to perform daily activities and emotional distress. However, several people
suffer from memory loss, however such a health issue tends to cause due to various reasons.
Thus memory loss alone cannot be considered as dementia (Ornstein et al., 2013). There can
be identified different causes of dementia and according to the causes the symptoms of
dementia also varies and can be reversed. Symptoms of dementia comprise both
psychological and cognitive changes whereby the most common psychological symptoms
include depression, changes in personality, anxiety, inappropriate behaviour and agitation as
well. In some cases people suffering from dementia has been found to suffer from visual and
auditory hallucinations (Baumgart et al., 2015). Paranoia is another symptom associated with
dementia that leads to the persistent and irrational feelings within a person (Freud, 2014).
Beside such psychological sufferings there are some significant cognitive changes as well. In
case of dementia, memory loss is one of the most common cognitive changes within the
patient (Baumgart et al., 2015). In addition, communicating problem, difficulty in reasoning,
confusion, disorientation, lack of concentration, problem in coordinating motor functions,
difficulties in recognizing language and understanding words have been found as the
common signs of dementia (Ornstein et al., 2013). There are some treatable medical
conditions that could help to live life meaningfully while managing dementia, thus it is
important to identify the underlying causes and consult with health professionals in case the
symptoms are identified (Chen et al., 2014).
Causes:
The main cause of dementia includes the damage of nerve cells present in the brain
and the effect of dementia varies according to the area of brain that has been affected.
Alzheimer’s disease has been considered as the most common cause of dementia (Rajan et

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al., 2015). Vascular dementia is occurred due to the damage of the blood vessels connected to
brain. Such damage in the blood vessels can be caused due to severe blood vessel conditions
or stroke as well (Barker et al., 2014). In certain cases it has been identified that some
abnormal clamps of protein leads to the consequence of lewy body dementia, one of the most
common progressive dementia (Donaghy & McKeith, 2014). Breakdown or damage of nerve
cells in the temporal or frontal lobes in the brain could lead to the consequence of dementia
(Chen et al., 2014). There are some severe disorders that could cause dementia such as,
traumatic brain injury, Parkinson’s disease, disorder due to genetic mutation and some brain
disorders (Homma et al., 2015). In addition, it has been found that symptoms of dementia can
be caused due to infections or side effects of immune disorder, medication issues, nutritional
problems, anoxia and brain tumour as well (Rullier et al., 2013). Furthermore, age such as 65
years or more, family history such as parents or other family members having dementia,
down syndrome, cognitive impairment, excessive use of alcohol, depression, smoking,
diabetes, cardiovascular risk and sleeping disorder have been found as the risk factors of
dementia (Baumgart et al., 2015).
Impact on life of individual and family:
Beside physical and psychological problems, dementia poses severe impacts on the
lives of the patient, family and the care givers as well. Both the personal and professional life
gets affected by the symptoms of dementia. Due to suffering from dementia it becomes
difficult for the patient to recognize the language and words thus they face problems in
communicating with others (Ornstein et al., 2013). Due to depression and anxiety they
become stubborn and sometimes become detached from the family and the society as well.
Due to the lack of ability to remember things and reasoning they face difficulties in
performing daily activities thus they have to depend on other family members or the care
givers for their daily activities (Kasper et al., 2015). Such realization of disability leads to

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lack of ability to maintain relationships. Due to such condition the person suffering from
dementia lacks the ability to provide service work place thus they might leave their job or
they forced to leave. Such condition leads to financial challenges and social isolation
(Ornstein et al., 2013). In addition such sufferings of the patient affect the family members as
well. It is difficult to see a loved one to suffering from dementia and challenging as well.
Sometimes living with a person having dementia affects the mental health of family members
and brings significant changes in relationships (Kasper et al., 2015). Furthermore, the
caregivers also face challenges while managing a person with dementia. It has been reported
that lack of mental well-beings and risk of physical illness are associated with dementia care.
This is due to poor sleep pattern and increased emotional attachment with the patient.
Sometimes the care givers also become depressed and irritated while managing such patients
(Ornstein et al., 2013).
Diagnosis and Treatment:
In order to provide adequate treatment care it is important to diagnose the illness at
early stage. de Vug & Verhey, (2013) has indicated that diagnosis of dementia require
impairment of minimum two central mental function that could affect the daily activities. The
diagnosis mainly focuses on the language skills, memory, and capability to concentrate on a
matter, reasoning ability and visual perception as well. However a single test cannot diagnose
the presence of dementia (Chen et al., 2014). Thus, in order to diagnose dementia various
tests need to be performed. For example, doctors evaluate the neurological condition; conduct
CT scan, MRI and PET scan. In addition, blood test is conducted in order to identify any
physical problem that has contributed to the development of dementia. Furthermore,
psychiatric evaluation is also done to identify depression, anxiety, stress and other
contributing factors (Hall et al., 2017).

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Research conducted by Blom et al., (2017) has indicated that in most cases dementia
cannot be cured however, with proper nursing interventions the illness can be managed in an
effective manner. There are various therapies that could help a person with dementia such as
occupational therapy, music therapy, doll therapy, massage therapy and art therapy (Singh et
al., 2014). Other effective methods include improvement in communication, using exercise,
encourage to keep calendar to remember dates and important incidents and proper diet (Chen
et al., 2014). Effective medications are also available for example, cholinesterase inhibitors,
memantine, omega 3 fatty acids and vitamin E (Blom et al., 2017). Beside such nursing care,
adequate support from the family, friends, care giver and society is most important to manage
dementia (Singh et al., 2014). Together such interventions could help a person with dementia
to cope up with the situation and living a meaningful life.
Health promotion:
Health promotion is another important factor that helps individual to increase the
control over their illness, improve health condition and maintain well-beings. Health
promotion in dementia focuses not only on the individual health behaviour but also on the
social interventions (Woo, 2017). Various programs are available that helps to access
important information about dementia and about preventive measures. ‘Your brain matter’ is
one of such programs that help to promote healthy behaviour associated with dementia in
Australia (yourbrainmatters.org.au, 2018). Such health promotion programs mainly focus on
the prevention. Effective prevention methods such as involving in mentally stimulating
activities, quit smoking and alcohol, proper diet, adequate physical activities, manage other
chronic disease and proper consultation with doctor if symptoms are identified to manage the
illness from early stage (Haber, 2013). Such information helps to promote health and create
awareness within people regarding dementia.

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Self-management:
Quinn et al., (2016) observe that educating the patient suffering from dementia
regarding self-management is one of the most effective methods to help the patients to
manage their illness. In this regards it is important to provide information regarding the
quality of life and important components of living well and maintain day to day activities.
Study has indicated that knowledge and support are two most important factors of self-
management. The patients need to be trained about coping skills, acceptance of the disease
and self-awareness in order to reduce the risk of self-harm (Livingston et al., 2017). The
patients could be educated about the importance of healthy habits and skipping smoking and
alcohol. Motivation is another important factor in self-management of dementia. The patients
need to be motivated to set their personal goals and achieve them while managing their
illness (Martin et al., 2013). Such contribution in the management of dementia helps to cope
up with the illness with less difficulties.
Cultural safety:
Cultural safety in treatment is defined as the care approach which is emotionally,
culturally and physically safe for the patients and does not contain any assault or denial of
identity (Harding, 2013). Beside adequate treatment, prevention measure and effective self-
management it is also important to provide care to the patient with dementia that is culturally
safe. The patients with dementia suffer from significant emotional distress, thus it is
important for the nurse and care giver to have the skill of cultural competency (Teodorczuk et
al., 2015). It could help the nurse or care giver to understand the culture, views, beliefs and
perception of the patient and introduce holistic care approaches that are easily acceptable for
the patients (Harding, 2013). It would help to induce shared respect and dignity and trust.
Such culturally safe care could help to manage the disease in an effective manner.

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Empowerment:
Empowerment is identified as another important aspect of dementia care and self-
management. Empowerment helps the patient to realize their importance and understand that
that they are the central focus of the treatment. It helps them to involve in the treatment
(Hutchinson et al., 2016). There are various ways to induce empowerment in the dementia
care, for example, identify the strengths and weaknesses of the patient and use them to
develop purposeful activities, try to agree with the sense and views of the patient, listen to
their story and pay attention, increase self-reliance and ability to take decision and increase
the contribution in wider community (Klug et al., 2014). It could help to empower individual
along with community. Such methods would help to encourage the patient so that they could
manage their illness effectively.
Conclusion:
From the above discussion it can be concluded that, dementia is a brain disease that
leads to the lack of ability of thinking and remember things for prolong period. Due to the
effect of dementia a person could suffer from memory issue, complication with language,
emotional issues and distress as well. Such condition affects the ability of a person to perform
daily activity. There are various causes that could leads to the consequence of dementia.
Dementia cannot be cured completely however, the symptoms can be managed with effective
nursing interventions. Beside effective treatments, therapies and medication, support from the
family, friends and society is also important. There are different programs that help to
promote health and prevention measures about dementia. In addition adequate self-
management is also important. Culturally safe care approaches are also important to involve
the patient in treatment. Furthermore, empowerment could help to encourage the patient to

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participate in the treatment in an effective manner. Such dementia management process could
help the patient to live life meaningfully while managing their illness.

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