Capstone Experience: Dementia Prevalence and Management in Australia

This capstone project delves into the critical issue of dementia within the Australian healthcare context. The project begins by establishing the significance of the topic, highlighting the rising prevalence of dementia and its profound health, social, and economic impacts on individuals, families, and the healthcare system. The student then undertakes a self-assessment, employing journaling and guideline itemization to evaluate their own skills and knowledge in relation to dementia care. The core of the project lies in a critical reflection and analysis of the student's experiences in applying evidence-based nursing practices to manage dementia in aged care settings. This includes a detailed exploration of communication, spiritual and emotional well-being, social interaction, personal care, and environmental considerations. The project also includes a professional portfolio outlining the student's qualifications, experience, and goals. Finally, the project concludes with a synthesis of findings, including a proposed evidence-based approach to nursing care for dementia patients, emphasizing the importance of communication, spiritual and emotional wellbeing, social interaction, personal care, and physiological health. The project aims to contribute to improved care and management of dementia patients within residential aged care facilities.

Running head: CAPSTONE EXPERIENCE IN HEALTHCARE 1
Capstone Experience in Healthcare
Student’s Name
Institution

CAPSTONE EXPERIENCE IN HEALTHCARE 2
Capstone Experience in Healthcare
Introduction
Like in most graduate school programs that require the fulfillment of a thesis, a capstone
project is a similar program used in the competition of undergraduate and graduate course
degrees. This projects are however quite different from theses when the goals and aims of the
program are considered. Hence, a capstone project allows a student the opportunity to use
learned materials and apply them in a specific area of practice. The capstone experience will in
such a case entail identification of a particular issue or problem in the real world and then
utilizing or applying the learned skills to develop the solution that will directly resolve the
problem at hand. Thus main goals of a capstone experience will entail define a problem or
opportunity, decide on the techniques to be used, make a positive influence on the community
and base the findings on specific area of interest.
Alternatively, capstone projects aim to enable a student take advantage of the learned
knowledge and theory and utilize such information in a real world setting. Nursing students are
for instance given the opportunity to be involved in public health practice projects and further
synthesize, integrate and apply the skills and competencies acquired during their course work.
By focusing on a specific issue, students are expected to describe the problem using an evidence
or fact-based approach taking into account various contributions by other scholars. Hence, the
completion of a capstone project experience requires the student to base their findings on their
field experiences.
In my case, the capstone experience project revolved around the prevalence of dementia
and ways through which medical practitioners can manage or treat the condition. Notably,

CAPSTONE EXPERIENCE IN HEALTHCARE 3
dementia is not a specific disease but rather, it is a degenerative and irreversible condition that
mostly affects the elderly populations (Cations, Radisic, Crotty & Laver, 2018). The current and
widely used management practices involve provision of support to patients with dementia and
their caregivers. In Australia, care is mostly provided in residential aged cares with hygienic
routines, timely sleep and waking time, and engagement in physical activities being the primary
management practices in these care facilities (Dementia Australia, 2019). Caregivers in this case
follow a strict formula of impact, progress and treatment for every patient.
The aims of the capstone experience project is to determine the prevalence of dementia in
Australia and unfold the methods and techniques through which care and treatment are provided
for patients diagnosed with dementia and are living in age care homes (WHO, 2019). Ideally, it
can be noted that based on the capstone experience project operational and managed care plan
for dementia patients in aged care units lies on seven key areas including; communication,
spiritual and emotional wellbeing, social interaction and lifestyle management, personal care,
cultural and behavioral needs, and the environment.
Another aim of the capstone experience project is to identify the prevalence, causes and
challenges in managing dementia. Notably, this information will aid in the justification of
dementia as a concerning health issue in Australia. The data will similarly aid in identifying the
patient populations that are most affected and pinpointing the pitfalls associated with currently
used treatment and management practices (Gaskin, Georgiou, Barton & Westbrook,
2012)Finally, this capstone experience project aims to reflect and analyze the applicability of the
identified treatment and management plan.
Outline and the content of the body of the essay

CAPSTONE EXPERIENCE IN HEALTHCARE 4
The capstone experience project contains a specific outline which can be described as
follows. The project experience will first justify the choice of the capstone experience project by
highlighting the prevalence of dementia in Australia. Justification will also be based on the
health, psychological and cost impacts that dementia has on the patients and other key
stakeholders such as the national government and patients’ relatives and friends. Ideally, this
justification process will help in bringing to light why dementia is one of the main healthcare
concerns and further illustrate how nurses have a critical role to play in management of this
condition (ABS, 2016).
The essay will then focus on self-assessment and evaluation. In this section, details
concerning the student’s assessment will be discussed in the process detailing journalizing and
itemization of guidelines as the main tools used in the assessment process. Such information will
further be aided by a rationale why self-assessment is important in nursing profession (Lima,
Newall, Kinney, Jordan & Hamilton, 2014). Also, the section will entail the main goals that
were set by the student in an attempt to fulfill the requirements of the capstone experience
project. Ideally, the main goals will encompass the identification of an evidence-based nursing
care for treatment and management of dementia cases among the elderly in residential care
homes (Arendts, Dickson, Howard & Quine, 2010).
The following section will comprise a critical reflection and analysis of the capstone
experience project. In this part, the essay will cover the experiences of the student in applying the
evidence-based nursing approach in the management of dementia in residential aged care. A
critical reflection framework will specifically be used to provide a vivid narration of the

CAPSTONE EXPERIENCE IN HEALTHCARE 5
experiences that the student had in their area of practice. As such, this critical reflection section
will be focused on the total experience of the nursing issue. The discussed stages will include;
description, feelings, evaluation, analysis, conclusion and an action plan.
The fourth section of this essay will be based on the professional portfolio of the student.
The content of the professional portfolio will include; personal details, educational
qualifications, professional membership, personal goal, work experience, key personal strengths,
and a description of the students current position.
Finally, this project will conclude by detailing a summary of all the findings in this
capstone experience project. Ideally, this information will include; aims of the project,
identification and justification of the issue, the devised action plan and a description of the same,
and a reflection and outcomes of the capstone experience project.
Justification for choice of capstone experience project
More than 50 million people are currently diagnosed with dementia. In Australia, the
prevalence of this condition has been alarming and since the condition lacks any desirable
treatments or cure, dementia has resulted in thousands of deaths over the past few years. The
latest evidence reveals that dementia related cases have been on the rise with data revealing that
more than 400,000 Australians are diagnosed with dementia as of 2018 (Dementia Australia,
2019). Most of the affected individuals are the elderly who are aged 65 years and above. 40% of
these cases are attributed to people who are aged above 85 years. This population group is also
the most vulnerable to other health conditions such as increased risk of falls and other disabilities
(ABS, 2016). It is further expected that without timely and effective management of this
condition, it is highly likely that dementia prevalence will continue to increase in the near future.

CAPSTONE EXPERIENCE IN HEALTHCARE 6
Dementia poises advance health, social and cost implications to affected individuals and
their families. At the onset of this condition, dementia is associated with other health conditions
such as diabetes, cardiovascular diseases, stroke and ultimately death. The best that medical
practitioners can do to manage the condition comprises delay in its progression. Dementia
patients and their caregivers have also been dealt with hefty costs of medications coupled with
adverse psychological effects as dementia progresses towards its latter stages (Hunter & Doyle,
2014). The costs have also been borne by the federal government with latest evidence indicating
that the government of Australia spent more than $15 billion in managing this condition by the
end of 2018. Such costs have been disseminated through programs such as Dementia Initiative
but changes in government policy and priorities have either terminated such initiatives or
provided lesser funds to finance the entire management process inclusive of education and
training of caregivers and treatment options (AIHW, 2016).
Families and carers also suffer a great deal of emotional burden when providing care to
patients of dementia. It can be emotionally overwhelming to experience the health of a loved one
deteriorates especially when this condition reaches its latter stages. Financial pressure further
contributes to stress thereby warranting the need for support (Fazio, Pace, Maslow, Zimmerman
& Kallmyer, 2018). Thus, in light of the aforementioned challenges not only to the families and
carers, but also towards the state of a nation, dementia becomes a great public health concern that
must be tackled. Even so, evidence indicates that delaying dementia by at least two years can
have significant psychological and financial effects (Wells & Smith, 2017). In this light,
residential care for the aged populations has been touted as the most and one of the primary
settings to offer care and service to the aged people diagnosed with dementia (Parker & Clifton,
2014).

CAPSTONE EXPERIENCE IN HEALTHCARE 7
It is worthy to note that such services provided under home care facilities should be
tailored in accordance with the available evidence-based practices. This comes after research
indicated that many of the dementia patients who are under this provision of care have been
denied their human rights in the latter stages of their lives (Westbury, Beld, Jackson &Peterson,
2010). Precisely, physical and chemical restraints were used extensively in care homes for the
elderly. Hence, the environment in which dementia patients are located needs to be suitable to
manage the behavioral and social expectations of these patient populations.
Another notable issue arises from stigmatization. Ideally, many individuals diagnosed
with dementia tend to be socially isolated given that overtime and with the progression of the
condition, such patients find it difficult to integrate into the society. Many of the society
members find it difficult to relate with these patients since they lack sufficient knowledge to
understand how dementia patients can be handled or managed (Parker & Clifton, 2014). In the
end, such situations and environments further exacerbates the condition thereby increasing the
likelihood of dementia progression and the inevitable deaths of these population groups. In
consideration of such findings and in accordance with the capstone experience project,
communication, spiritual and emotional well-being, and environment are the most notable
aspects that would help in addressing such challenges (Leydecker, 2017).
Many patient groups diagnosed with dementia and the society alike has been led to
believe that dementia is a normal part of aging. As evidenced with the behavioral tendencies of
many patients, dementia patients may become delusional and spend long periods in denial (Wells
& Smith, 2017). In such situations, these patients refuse to accept that have developed dementia
and subsequently disassociate themselves with treatment plans. Thus it becomes difficult to

CAPSTONE EXPERIENCE IN HEALTHCARE 8
provide care for such patient groups and personal care in conjunction with behavioral
environment would aid caregivers in managing this group of patients.
In light of the above detailed evidence, this capstone experience project proposes an
evidence-based approach to nursing care for patients with dementia. It will therefore, focus on
the importance of importance of communication in residential aged care, spiritual and emotional
wellbeing of patients, social interaction and lifestyle changes, personal care and healthcare, and
physiological health.
Self-Assessment Statement
Nurses’ clinical competence is critical in their field or profession primarily because they
are the first line of service to their patients. This implies that they should at all times ensure that
patients are provided with quality care and that patient safety is maintained (Haugen & Musser,
2012). Moreover, the healthcare industry is undergoing rapid changes with changes in patient
needs and increased demand for cost effective healthcare (Finnbakk, Wangensteen, Skovadhl
& Fagerstrom, 2015). With such events on the rise, nurses must strive to assess themselves in
order to ensure that they provide the best services in accordance with available evidence-based
practices. Also, in all care settings, nurses have been given an important role to improve patient
safety and realize high quality care (Lima et al, 2014).
Given the continuous shortages in nursing workforce, self-assessments for nurses
becomes pivotal in alleviating job satisfaction and increasing the willingness to stay within this
profession. When nurses are subjected to self-assessments, they are provided with the platform to
identify key areas of improvements and they are also able to understand the areas of practice in
which they are good at (Jane Brooke, 2013). Such opportunities enhances the nurses’ ability to

CAPSTONE EXPERIENCE IN HEALTHCARE 9
provide the most suitable mix of nursing competence tailored towards the satisfaction of both the
nurse and the patient as well.
Another relevance that can be drawn from nursing self-assessments is that such a tool can
facilitate clinical competence of nurses. In their area of practice, constant monitoring and
supervision have become the norm for nursing environments. Historically, such authority has
been used as a tool to enhance nursing competence. However, nurses need to take another step
by being cognizant of whether their competence levels coincides or meets with required set of
standards (O’Connell, Ostaszkiewicz & Hawkins, 2011). In this light, self-assessments will
enable nurses to track their individual competence levels and be able to gauge whether such
levels meets the stipulated standards of healthcare services.
The elderly or rather older populations have acute and complex needs which will require
advanced competence from nurses in regards to provision of nursing care and administration
medical treatments (Hunter & Doyle, 2014). Therefore, this tool of self-assessment will prove to
be crucial in enabling me to keep track of my competence levels and be able to meet the diverse
demands of the elderly who are primarily the patient populations that I am in service to.
My self-assessment tool comprised of a well-developed checklist that I went through on a
daily basis. Since I was the one who solely developed the checklist I had to rely on complete
honesty and integrity in developing and answering the questions. I developed five key self-
assessments items in the checklist and which would guide me in tracking my competence levels.
For one, I had to ensure that I accurately completely nursing assessments on a timely basis. I also
had to report any changes in the condition of the patient to physician whenever they came about.
Checking on patients on an hourly basis was also made a priority. I had to assess cases of pain or

CAPSTONE EXPERIENCE IN HEALTHCARE 10
progression of pain especially after medications and report the same accordingly (Finnbakk et al,
2015). Finally, I strove to incorporate the best practice in service provision in accordance with
the available literature. This item would also entail making any relevant contribution to my field
of practice which in this case was provision of care to the dementia patients.
This self-evaluation proved to be a critical process in my area or practice. It required
demonstration of self-awareness and demonstration of high level of efficiency as a nurse. To
eliminate any chances of bias, I had to engage my supervisor every once in a while to go through
my checklist and further provide insights in areas where he felt some aspects were not
sufficiently addressed. I also perceived this step to be pivotal in giving my supervisor new
insights regarding my job satisfaction, areas of successes and the future goals that I had set for
myself (Vertino, 2014).
The final step that I took in completing this assessment was journalizing the findings
from the items on the checklist. I devised a weekly journal to denote whether the items
mentioned above were thoroughly addressed and met in accordance with provision of care for
patients diagnosed with dementia. It is worthy to note that the journal also comprised the initial
identified five objectives that govern provision of care for dementia patients under residential
care.
Additionally, it was worthwhile to incorporate some technical aspects of evaluation when
journalizing the findings from the five items. For one, it was of utmost importance to manage the
journal as a professional file. This meant that every detail that was denoted in this journal had to
be well-written. Grammar and spelling checks in addition to comprehensive proofreading were
done on a continual basis. The aim here was to catch missed mistakes and pay attention to detail.

CAPSTONE EXPERIENCE IN HEALTHCARE 11
These techniques would also ensure that the information in this journal were honest and could be
used by another professional evaluator (Lima et al., 2014).
Even though a journal is not a mandatory requirement in self-evaluation or assessment, I
have come to appreciate the calming effect that a journal has on me as a medical professional.
Nursing in particular can at times be stressful characterized by emotional highs and lows (ACU,
2017). For instance, when dealing with dementia patients who are irritable and aggressive, I
became subjected to high emotional levels and likewise, I was hit with an emotional low
especially when realizing the health deterioration of some of the patients. It was extremely
emotional to provide care to patients with the degenerative condition especially in cases where
most of them experienced complete loss of memory. In such cases, I often resorted to
journalizing my experiences in a bid to get these emotions out of my head. The medical journal,
therefore, became my coping strategy during emotional times. In one occasion, the journal
enabled me to deal with the heaviness of losing one of the patients who I had grown so fond of.
On the bright side, the journal also acted as a guide on my performance since I could be
able to document my progress and evaluate whether I met the standards that was required of me.
After journalizing weekly events, I could then reflect on my abilities and in this process identify
areas of weakness and areas of success (Reymond, Israel & Charles, 2011). For instance, I
realized that from my itemized practices, my supervisor had denoted that I failed to check up on
a patient at the required interval. This note was reminiscent of the time that the physician had
berated my ignorance to the situation. Sincerely, this was not one of my proudest moments but I
sure did manage to react on this situation and changed for the better.
A Critical Reflection and Analysis of the Capstone Experience

CAPSTONE EXPERIENCE IN HEALTHCARE 12
For purposes of conducting a critical reflection and analysis of the capstone experience,
background information regarding dementia is in order. Since dementia is not a specific disease,
it can be classified as collective set of symptoms for cognitive decline. Dementia affects the
brain functioning by impacting on an individual’s ability to reason, think, remember,
communicate and undertake regular physical activities (Cunningham, McGuiness, Herron &
Passmore, 2015). The common symptoms of dementia therefore, include; memory loss,
personality and mood changes, difficulty in performing familiar tasks, problems with language,
poor judgment and, disorientation of place and time.
Dementia progresses in several different stages. The first stage of dementia is mild
cognitive impairment. This stage is characterized by forgetfulness. This stage may occur in many
of the old aged people and in such cases, it tends to fade away as some people regain their ability
to remember. However, if general forgetfulness continues or prevails for a considerable amount
of time, then it can be taken to be the first stage of dementia. The stage is mild dementia. At this
stage, the affected individuals will experience cognitive impairments that affect their daily life.
Some of the symptoms that can be realized in this stage are memory loss, changes in personality,
confusion, and difficulty in carrying out tasks.
Moderate dementia is the third stage and the affected individual finds it very challenging
to carry on with their daily lives. In such a case, the dementia patient cannot carry out simple
activities like combing their hair and getting dressed. Their personality also changes significantly
and the dementia patient becomes suspicious or agitated with no definite reason. The final and
fourth stage is severe dementia. All the symptoms of dementia worsen considerably and the
diagnosed patient cannot be able to sustain themselves in the absence full-time care. The
situation is worsened since the patient of dementia is unable to control their body functions. In