Analysis of Dementia's Impact on Independent Living in Enfield Borough

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The impact of dementia on older people age 65 +
living independently in Enfield borough of
London

TABLE OF CONTENTS
1. Introduction..................................................................................................................................1
1.1 Introduction and Background context...................................................................................1
1.2 Research aim..........................................................................................................................2
1.3 Research objective.................................................................................................................2
2. Literature review..........................................................................................................................3
2.1 Causes and effect of dementia in Enfield borough of London..............................................3
2.2 Challenges faced by older people with living alone..............................................................3
2.3 Services available for older people that are living alone.......................................................4
2.4 Promoting independent living in Enfield...............................................................................4
2.5 Summary................................................................................................................................5
3. Methodology................................................................................................................................6
3.1 Introduction............................................................................................................................6
3.2 Research philosophy..............................................................................................................6
3.3 Research approach.................................................................................................................6
3.4 Data collection.......................................................................................................................7
3.5 Analysing and presenting data...............................................................................................7
3.6 Reliability and validity..........................................................................................................9
3.7 Ethical considerations............................................................................................................9
3.8 Limitations.............................................................................................................................9
References......................................................................................................................................10

1. Introduction
1.1 Introduction and Background context
With increasing trends in health and social care, dementia is one of the growing concerns in the
parts of London. Current study will focus on analysing the impact of Dementia on the old age
people that are living their life independently in Enfield borough of London. Dementia is a
progressive disorder that would affect how the brain will work and reduces the ability to
remember, think and reason. The risk of dementia increases with the age of the people and
people mostly above the age of 65 are majorly (Sampson et.al. 2012). People suffering from
dementia have increasing problem of the memory where they might become confused and would
only do those things they find it easy. It is thought that age, genetic background, medical history
and lifestyle can combine to lead the onset of dementia.
However, the study observed the situations of dementia that impact on the old age people of
above 65. However, it is necessary for the people and their families to get the diagnosed
treatment and they need to live the life fulfilling as possible. As per Enfield borough council,
(2019), sample of 139 community residents are mostly at the age of 65 and 21.6% had an
incident requiring emergency interventions. With this, people living alone have the high risk
factor as they are not able to take care of themselves. However, in London, cares homes need to
built special services and provide treatments for reducing the deaths that are being caused with
dementia.
The approach for curing dementia has been effectively conducted by many of the researchers.
The main treatments of the dementia are being based on achieving support both financially and
emotionally. Carers group to find emotional support from other careers. Managing money and
applying effectively for career allowance. It is necessary for the dementia sufferer to think about
the future and make appropriate plan for health that might extend the life of the people suffering.
In addition, it is effective for the councils and other local care homes to support in reducing the
amount of diseases causing from dementia (Strydom et.al. 2013).
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1.2 Research aim
The aim of the research is based on analyzing the impact of dementia on older people age 65 +
living independently in Enfield borough of London.
1.3 Research objective
In order to have better understanding of the research, objectives of the research can be divided
into two or three. This would develop better theoretical knowledge about the concerned research
topic. Concerned objectives of the research are explained as:
 To investigate the Challenges face by order resident living on their own.
 Identify the interventions services for older people living on their own in Enfield
 Role of health care practitioner in promoting independent living.
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2. Literature review
2.1 Causes and effect of dementia in Enfield borough of London
According to Enfield borough council, (2019), dementia isn’t a specific disease it mainly
describes the group of symptoms that affect the memory, thinking and socially disable even to
serve the daily functions. Strongly related condition like dementia is becoming more prevalent in
the parts of London and is needed to be treated with modifications in treatment. In overall UK, it
is being estimated that dementia in worldwide will rise from 24.3 million by 2020 and 81.4
million by 2040. This has the serious problem and consequences for both individuals and
families but also for demands on and costs of health and social care. No models have majorly
studied the entire spectrum of dementia.
As per (Livingston et.al. 2017), in 2016/ 17, 44028 people in Enfield has been recorded
hypertension that is one of the major cause of dementia. Also it has been estimated that out of
total population of 51744 people with live with disabilities in Enfield. 77% of the age group
belongs to 65+ and other are from below age. However, the number is being growing in the
Enfield and also the expected cases are higher cases than the number of cases diagnosed.
2.2 Challenges faced by older people with living alone
As per Stokes, (2017), living alone in the community makes the people feel isolated and the
person generally goes through the period of depression. Social isolation and loneliness are one of
the key determinants of the current health conditions of the people. This also enables the
situation of older populations that are being living alone and are facing among the population.
Loneliness and social isolation among the older people causes negative impact on the people
health status and demonstrate the strong association with the depression.
Wimo et.al. (2017) state that people that stay alone are more depressed and remain isolated as
they are living away from their close ones. When older people live alone they forget to take
care of themselves and they are not able to handle their basic needs. Those people who live alone
become anxious and depressed and all this lead to cause disease among the person. Nearly about
3.5 million people age 65+ live alone, over 2 million or nearly half of the people aged 75 are
over and live alone (Conditions of Older people in Enfield, 2019). Some of the people facing
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dementia are not able to get the best treatment as they are living alone. 17% of the older people
in Enfield have less than weekly contact with the family, friend and neighbour.
Elderly people are at the higher risk on malnutrition that can result in weak health and is the
main cause of dementia, depression, anxiety, etc. Elderly people living alone have to do work on
their own and in such case 65+ do not have energy to manage all the household work. For this,
they perform things that extend their health capability. This increases concerns over the poor
well being and poor conditions of health.
2.3 Services available for older people that are living alone
Housing care facilities are also available in Enfield borough that provide health care services,
help in home and care home, community support of activities, day centres and information and
other kind of advisory services. In addition, there are people that provide free meals and also
meals are being provided at home to old age people. Also government is taking initiatives to run
campaign that aims at reducing the loneliness and for this government is trying to engage and
communicate with the people that are lonely and isolated (Age UK, 2019). For this, it is
necessary for old age people to stay in community and enjoy the social sharing for overcoming
the cases of harmful diseases.
In addition, there are mainly health care centres and care homes that provide emotional and
mental support to elder people. Also dementia is one of the common diseases that are being
observed in the parts of Enfield. It is necessary to take necessary actions that can be divided into
both long and short term support. Short term actions with dementia among old age people
include living with friends and family, creating the best possible environment, carers group,
sorting out legal affairs, getting suggestions about future care, etc. In addition, UK is being
providing long term support and changes that provide carers allowance, getting help from social
services, day centres, providing better treatment, etc.
2.4 Promoting independent living in Enfield
As per Giebel et.al. (2015), Practitioners are the independent body that help in increasing the
quality and access to health care services. Basic role they offer is to improve the access and
promote health by taking actions to prevent the diseases and deliver health care services to the
individuals. Potentials for improving physical functions and maintain the independent living
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have the alternative towards health behaviours, improving general health behaviours and
promoting the independence among the older people. There are local age UK and other care
homes that need to educate people to live their life independently and provide the details to reach
in emergency situations. (Conditions of loneliness in Enfield, 2019) argues that independence is
better idea but at the age of 65 every older people need help of its family and relatives to enjoy
its basic living and also to be happy.
Practitioner is responsible to raise awareness about the need to cure disease and overcome the
cases of deaths as people have one life for living. In primary care, the healthcare practitioner is
the person that provides an opportunity to improve and develop the skill mix in healthcare team.
Such practitioner outlines the standard and motivates people to have the healthy diet and deliver
the best care and services.
2.5 Summary
Overall review of literature is based on the study of the impact of dementia and the conditions of
the older people that are living alone. Dementia is one of the growing concerns in Enfield
borough but government is taking actions to overcome such disease above the age of 65+.
Review has identified that people face severe conditions with living alone. These are needed to
be provided special care and support in form of both emotional and financial. This would
improve conditions to reduce the fear of diseases and have the better living. In addition, role of
government, council, care homes and healthcare practitioner can play effective role to overcome
the cases of dementia and promote the independence of old age people.
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3. Methodology
3.1 Introduction
In the general terms, research is the suitable process of collecting data and also reliable
information to give justified conclusions on the particular topic. It also means carrying out the
genuine information to develop the understanding of the following topic. Current research is
being based on application of methods and interpretation of the collected data for achieving the
verified results. Current study is being based on the study of analysing the impact of dementia on
older people that are living independently. The researcher used the clear defined methodology of
the research.
3.2 Research philosophy
This is being concerned as belief about the way in which the data is being interpreted, analysed
and used. There are mainly different types of research philosophy that is being used as per the
nature of the study. This research philosophy includes pragmatism, positivism, realism and
interpretivism. It is being applied to develop knowledge with the completion of the research.
This also includes following the accurate research process that is based on the assumptions and
nature of the knowledge (Hughes and Sharrock, 2016). Current research is based on using the
realism research philosophy relies on the idea of independence of reality into the human mind.
The current philosophy is based on assumption of scientific approach with the effective
development of the knowledge.
3.3 Research approach
Research approach is concerned as the plan and procedure with concerned as the broad
assumptions to have the accurate data collection, analysis and interpretation. There are different
methods of research approaches that include in deductive approach and inductive research
approach. Current research has applied deductive approach to get the fair conclusions and it will
help researcher to generalise from the general and specific. However, the research will evaluate
the hypothesis that is being related to the existing theory (Maxwell, 2012).
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3.4 Data collection
There are mainly two types of data collection but it depends upon the researcher to choose based
on the nature of the research. This includes primary and secondary data collection. This means
primary data is being collected with the help of fresh sources and the data is being gathered for
the first time. In addition, secondary data is being collected with the help of second hand sources
such as books, journals, articles and other online websites. Current research is needed to be
developing more kind of theoretical knowledge and for this secondary research is effective to be
used (Daas and Arends-Tóth, 2012). In current research, data is collected with the help of
secondary sources. In addition, thematic analysis would be effectively performed to have
analysis and presentation of the findings of the research.
3.5 Analysing and presenting data
Theme 1: Conditions of dementia in Enfield borough of London
Dementia is one of the major concerns that is significantly increasing in the parts of Enfield
borough of London but with support of different care homes and charitable organisations that
percentage has been controlled. The percentage is still not in control and it is needed to be
effective to present some of the actions to control the conditions of dementia. As per (Conditions
of Older people in Enfield, 2019), 39.9% of people living with the dementia are being formally
diagnosed. There are almost 70,000 people across London that is affected by the dementia and
even with these friends and family are affected by the condition. These people are not living well
and are isolated with the vital care and the support they need and deserve.
Some 34% of the people with dementia need excessive care and supervision. Improved services
in health and care industry can reduce the need for long term dementia care as well as improving
the quality of the life. A large increase in the cases of dementia is being forecasted but the effects
are increased among the population that is needed to be treated with bringing effective change in
the treatments. In 2014/15, the rate has been improved but still projections is being estimating
that cases might increase till 2020 and majorly the disease is being causing above the age group
of 65+. However, this percentage can be reduced with the efforts of the government and also the
support of charitable firms (Conditions of loneliness in Enfield, 2019). 65+ people must be
provided special care towards reducing the cause of dementia and conditions of the borough can
be improved.
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Theme 2: key challenges of older people with alone living
Elderly people that live alone are more likely to be poor and do not pay attention towards their
diseases because they are not able to pay their regular bills. In Enfield, people at old age are not
able to walk properly and they are not capable of receiving the best treatments. Also living alone
increases the risk of accidental overdose because at this age, old age people might take pills
twice or forget to take the pill that increases the risk on health.
As per Dening et.al. (2012), there are many challenges older people are facing and this is
resulting an increase in the cause of diseases such as tension and dementia. From the above
theme, the number of dementia can be worse till it reaches 2020. Alone living are the people that
are majorly of age 65+ and they are even not able to take care of their basic necessity. Such
people feel more depressed and frustrated as they are alone and are helpless of doing any other
activities. Moreover, challenges of the people are increasing and are needed to be controlled with
the support of care services of friends and families must be responsible for taking care of old
people. In case, older people are living alone, day centres can be helpful to improve their living.
Theme 3: Treatments to older people that live independently
With observing the growing conditions of dementia and also for the people that are nearly living
alone, government and other charitable organisations are being taking steps. This includes
providing them help of providing special home care services those who are living alone. Also
Age UK is one of the leading charitable organisations that look after the health conditions of the
older people. It provide different services to old age people where they educate people about
dementia and also provide them advice to take care to overcome such disease. Along with this,
they guide them to get the best treatment and also provide emotional support to build the strength
of the elder people.
Stokes, (2017) argues that people that live independently face many of the challenges that is
being argued in the above section. But with advancement in the technology there are different
modifications in the health care can lead to improve their conditions. Councils have taken growth
and science has been observed modifications in the treatments to variety of diseases. In addition,
older people are necessary to be provided special treatments to overcome the cases of dementia.
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Theme 4: Promotion to independent living and the support of medical practitioner?
In Enfield borough, Age UK is one of the famous charitable organisations that are taking care of
elder people health. General practitioner plays effective role to change the health behaviours,
improve conditions of health conditions and also increasing the independency of the elder
people. Older people must be educated about their regular body check-up and care homes can
provide free pick and drop facility to the people that are living alone. There are both negative and
positive causes that can lead to promote independent living (Prince et.al. 2014). At the age of 65,
usually older people are not physically fit and they need support of someone. With this, either
they can be sent to care homes or family can be supportive in such conditions.
3.6 Reliability and validity
Secondary resources that are being used are authenticated and used from the verified sources.
The data is effectively reliable and valid and with this the basis of objectives is being considered
for carrying out the effective findings of the research. In addition, the research conducted can be
effectively stored and can be used in the near future to conduct more detailed research.
3.7 Ethical considerations
While conducting the research, the data is being conducted from reliable sources and with this
the researcher has maintained some of the ethics. In addition, researcher has also considered the
time and resources while carrying out the research effectively. Valid and justified sources of the
authors have been taken from genuine sources that make the research valid and realisable.
Researcher has also maintained the confidentiality in the data by storing at the appropriate
location (Hughes and Sharrock, 2016).
3.8 Limitations
Researcher has faced some of the limitations as the data is being collected with the help of
secondary resources. In secondary research, the data present on the sources might be wrong and
lead to confusing results. For this, it is necessary for the researcher to make necessary
modifications and filtering in the data for the convenient purpose and resulting to valid
conclusions. With this, the researcher needs to make modifications in the study and also
limitations are needed to be overcome to have expected findings and results.
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References
Books and Journals
 Daas, P. and Arends-Tóth, J., 2012. Secondary data collection. The Hague/Heerlen:
Statistics Netherlands.
 Dening, K.H., Greenish, W., Jones, L., Mandal, U. and Sampson, E.L., 2012. Barriers to
providing end-of-life care for people with dementia: a whole-system qualitative
study. BMJ supportive & palliative care, 2(2), pp.103-107.
 Giebel, C.M., Sutcliffe, C. and Challis, D., 2015. Activities of daily living and quality of
life across different stages of dementia: a UK study. Aging & Mental Health, 19(1),
pp.63-71.
 Hughes, J.A. and Sharrock, W.W., 2016. The philosophy of social research. Routledge.
 Innes, A. and Manthorpe, J., 2013. Developing theoretical understandings of dementia
and their application to dementia care policy in the UK. Dementia, 12(6), pp.682-696.
 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.
 Maxwell, J.A., 2012. Qualitative research design: An interactive approach (Vol. 41).
Sage publications.
 Prince, M., Knapp, M., Guerchet, M., McCrone, P., Prina, M., Comas-Herrera, A.,
Wittenberg, R., Adelaja, B., Hu, B., King, D. and Rehill, A., 2014. Dementia UK: -
overview.
 Sampson, E., Mandal, U., Holman, A., Greenish, W., Dening, K.H. and Jones, L., 2012.
Improving end of life care for people with dementia: a rapid participatory appraisal. BMJ
supportive & palliative care, 2(2), pp.108-114.
 Saunders, M.N., Lewis, P., Thornhill, A. and Bristow, A., 2015. Understanding research
philosophy and approaches to theory development.
 Stokes, G., 2017. Challenging behaviour in dementia: a person-centred approach.
Routledge.
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