Evidence-Based Holistic Care: Improving Outcomes for Dementia Patients

This essay addresses the critical issue of dementia care within healthcare settings, emphasizing the need for evidence-based practices to improve patient outcomes and reduce recurrent hospitalizations. It defines dementia as a cluster of symptoms affecting cognitive functioning and memory, particularly in older adults. The essay explores various strategies for holistic care, including multidisciplinary team approaches, family involvement, non-pharmacological interventions like psychosocial therapy, and pain management techniques. It also highlights the importance of person-centered care, social inclusion, assistive technology, and environmental modifications to enhance the quality of life for dementia patients. The conclusion reinforces the significance of symptom management, culturally sensitive care, and prioritizing patient needs to deliver effective and compassionate care.

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Introduction:
According to the statistical report published by the World Health Organization, it has
been estimated that approximately 50 million individuals are living with Dementia globally
(Dementia Statistics Hub, 2019). It has further been predicted that the estimated statistical figure
could potentially reach up to 82 million by the end of the year 2030 (Dementia Statistics Hub,
2019). In addition to this, studies have indicated that the every year approximately 9.9 million
new cases of Dementia are reported globally (Prince et al., 2013). Also, the prevalence of
Dementia has increased by 30% in comparison to the annual data that was published by the
Alzheimer’s Disease International and World Health Organization in the year 2010 (Prince et al.,
2013). The statistical facts and figures clearly indicate that Dementia among the elderly has
emerged out to be a matter of global concern.
Dementia can broadly be defined as a mental health condition that is characterized by
poor cognitive functioning and memory loss (Livingston et al., 2017). It should be noted in this
context, that Dementia is not a disorder or a disease but the term refers to a cluster of symptoms
that represent poor cognitive and memory skills which subsequently interferes with an
individual’s ability to normally carry out the activities of daily living (Alzheimer’s Disease and
Dementia, 2019). The risk of Dementia increases with an advancing age and senior adults aged
65 and above are most commonly affected with Dementia. In this regard it should be noted that
the percentage of older population is rising and it expected to exponentially rise up to the year
2050 (Asha.org, 2019). Also, studies reveal that Dementia patients occupy 25% of the hospital
beds and that the rate of recurrent hospitalization has also reported to be highest in case of
Dementia patients (Dementia Statistics Hub, 2019). Therefore, it is extremely important to
devise appropriate holistic care for the patients in order to reduce the recurrent hospitalization

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rate and also promote positive patient outcome. This assignment would therefore evaluate the
evidence base in order to determine the best practice to impart holistic care to Dementia
patients within a healthcare setting.
Discussion:
As has already been discussed the general symptoms of Dementia include gradual loss of
memory and poor cognitive functioning. The intensity of the signs and symptoms typically
increase with the advancing age and even lead to disorientation and communication impairment.
According to the ASHA, the common symptoms in Dementia patients include, distraction and
decreased ability to process information under the category of attention (Asha.org, 2019). In
addition to this, patients also exhibit deficits in recollecting episodic memory, recalling important
dates, names or appointments under the category of learning and memory. Further, patients
experience difficulty in making decisions or regulating self control (Konno et al., 2014). In
addition to this, patient fail to recognize familiar people and environment and the speech
becomes empty and repetitive (Konno et al., 2014). Also, patients become extremely agitated
and experience difficulty in sleeping pattern (Asha.org, 2019). Also, patients experience
fluctuations in mood, develop suspicions and experience of social isolation (Asha.org, 2019).
According to Callahan et al. (2014), adapting a multidisciplinary team based approach for the
care of Dementia patients can help in yielding positive outcome. The researchers in the paper
have also discussed that involvement of a family member in the care process can help in the
provision of effective care (Callahan et al., 2014). However, the researchers in their study
typically identified the problem of increased medical cost in cases of long term hospitalization.
The researchers had thus formulated two economically feasible models of care that include the
organizational model and the implementation approach where in care professionals work in close

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collaboration with the physicians and disseminate hands on care and show empathy to the patient
and involve the family members of the patient for appropriate decision making in the best
interest of the patient. The proposed model avoids the use of costly medical services and aims to
provide holistic care to the patients with the help of effective and financially feasible
interventions. Another study conducted by Cabrera et al. (2015), intended to evaluate the best
non pharmacological intervention for the effective treatment of the Dementia patients within a
healthcare setting. The researchers conducted a review and evaluated the impact of five groups
of intervention therapies which included, psychosocial therapy in combination with health
literacy, administration of physical activity, administration of sensorial therapy, administration of
staff-focused intervention and administration of complex interventions (Cabrera et al., 2015).
The findings clearly revealed that administration of psychological intervention could
significantly improve the quality of care and quality of life among Dementia patients within
healthcare setting. However, researchers recommended that prior to the implementation step the
activities included in the therapy must be adjusted according to the extrinsic factors and the
comfort level of the residents so as to acquire positive outcome (Carbrera et al., 2015). Another
research study conducted by Galvin et al. (2014) also suggested that the quality of life of the
Dementia patients within the healthcare setting could be significantly improved with the adaption
of collaborative care models that involve a multidisciplinary team based approach and make use
of multi- component treatment interventions. Another research study conducted by Achterberg et
al. (2013), investigated four important perspectives of pain management among the Dementia
patients. It has been estimated that 50% of the Dementia patients within a healthcare setting
complain of regular and persisting pain (Livingston et al.2017). In addition to pain, patients also
complain about discomfort and distress caused due to pain that leads to abnormal behavioral

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symptoms such as anxiety and panic. The researchers typically investigated four dimensions of
pain that comprised of assessing the neurobiology of pain, assessment of pain, use of analgesics
to cure pain and the challenges experienced by care professionals to manage pain in patients on
account of lack of education and training. The study critically indicated that the use of analgesics
in patients could help in providing relief however a combination of behavioral intervention and
pharmacological treatment could help in better management of pain (Achterberg et al., 2013).
The common treatment intervention for Dementia involves adapting a person-centred care
approach to build on the strengths and effectively address the weaknesses in relation to speech
and communication impairment. In addition to this, the WHO framework recommends
supporting the patients by increasing social participation and imparting training so as to facilitate
the learning of new skills and strategies (Alzheimer’s Disease and Dementia, 2019). Also, care
professionals must ideally evaluate the contextual and environment factors so as to ensure a safe
environment for the patients. In addition to this the use of Assistive Technology such as memory
aids and navigation tools could be used to improve health outcome (Konno et al., 2014). Also,
use of Hearing Assistive Technology systems such as induction loops, FM systems could help
patients with hearing issues. Research studies have also mentioned that the use of Computer
based cognitive interventions could help patients in remembering chores such as an appointment
or the timings of medication (Livingston et al., 2017). Modification within the environment
could also help acquire positive outcome such as use of sequencing cards to guide activity and
proper placement of furniture, appropriate lighting and reducing visual clutter could help patients
spot items easily (Livingston et al., 2017). Also, the use of simulated presence therapy has been
found to reduce anxiety level in Dementia patients by making use of an emotional approach
(Alzheimer’s Disease and Dementia, 2019; Asha.org, 2019). The therapy makes use of the sound

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of close relatives in order to evoke a feeling of warmth and affection and that subsequently
directs the recovery process.
Conclusion:
Therefore to conclude, it can be mentioned that Dementia is not a disorder but a cluster of
symptoms that affects senior adults. The condition is characterized by poor memory and
impaired cognitive functioning among senior adults and also has been reported to be the major
reason that contributes to higher hospitalization rate. Studies have significantly indicated that
care for Dementia patients is largely dependent upon controlling the symptoms. The use of
person-centred care approach and the involvement of the family members in the decision making
process can improve care outcome. Also, administration of a combination of pharmacological
intervention associated with psychosocial therapies could greatly improve the quality of care.
Also, educating patients about the condition, social inclusion and the use of assistive technology
devices could help in acquiring positive outcome. Care professionals must reinforce a culturally
safe environment and prioritize the needs of the patient in order to deliver holistic care to the
patients.

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References:
Achterberg, W. P., Pieper, M. J., van Dalen-Kok, A. H., De Waal, M. W., Husebo, B. S.,
Lautenbacher, S., ... & Corbett, A. (2013). Pain management in patients with
dementia. Clinical interventions in aging, 8, 1471.
Alzheimer's Disease and Dementia (2019). What Is Dementia?. [online] Alzheimer's Disease and
Dementia. Available at: https://www.alz.org/alzheimers-dementia/what-is-dementia
[Accessed 24 Feb. 2019].
Asha.org (2019). Dementia: Treatment. [online] Asha.org. Available at:
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935289&section=Treatment
[Accessed 24 Feb. 2019].
Cabrera, E., Sutcliffe, C., Verbeek, H., Saks, K., Soto-Martin, M., Meyer, G., ... &
RightTimePlaceCare Consortium. (2015). Non-pharmacological interventions as a best
practice strategy in people with dementia living in nursing homes. A systematic
review. European Geriatric Medicine, 6(2), 134-150.
Callahan, C. M., Sachs, G. A., LaMantia, M. A., Unroe, K. T., Arling, G., & Boustani, M. A.
(2014). Redesigning systems of care for older adults with Alzheimer’s disease. Health
affairs, 33(4), 626-632.
Dementia Statistics Hub (2019). Hospitals | Dementia Statistics Hub. [online] Dementia
Statistics Hub. Available at: https://www.dementiastatistics.org/statistics/hospitals/
[Accessed 24 Feb. 2019].

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Galvin, J. E., Valois, L., & Zweig, Y. (2014). Collaborative transdisciplinary team approach for
dementia care. Neurodegenerative disease management, 4(6), 455-469.
Konno, R., Kang, H. S., & Makimoto, K. (2014). A best‐evidence review of intervention studies
for minimizing resistance‐to‐care behaviours for older adults with dementia in nursing
homes. Journal of advanced nursing, 70(10), 2167-2180.
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., ... &
Cooper, C. (2017). Dementia prevention, intervention, and care. The Lancet, 390(10113),
2673-2734.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global
prevalence of dementia: a systematic review and metaanalysis. Alzheimer's &
dementia, 9(1), 63-75.