Exploring Dementia Abuse: Best Practices for UK Service Users

This report delves into the critical issue of dementia abuse within the UK healthcare system. It explores the prevalence of abuse, its causes, and the impact on service users. The report examines various theoretical frameworks, including Bowlby's and Erikson's theories, alongside the social and medical models of disability to understand the complexities of dementia care. It analyzes the trends of abuse, identifying key risk factors and proposing practical strategies to minimize the chances of abuse, such as improved caregiver training, implementation of robust policies, and enhanced patient-centered care. The methodology includes literature review, data analysis, and ethical considerations, culminating in recommendations for improved practices within care homes and the wider community. The report aims to understand the trends of abuse towards dementia patients, and identify ways of minimizing the chances of abuse.

Exploring best practice in the UK, different approaches for
keeping service users with Dementia safe from abuse or
minimising the chance for it.

Table of Contents
Introduction ...............................................................................................................................4
Background ...........................................................................................................................4
Reason for studying...............................................................................................................5
Problem statement......................................................................................................................5
Aim-.......................................................................................................................................5
Objectives..............................................................................................................................5
Questions -.............................................................................................................................5
Literature review .......................................................................................................................6
Concept of dementia..............................................................................................................6
Bowlby’s theory....................................................................................................................7
Erikson's Theory....................................................................................................................7
Social model of disability......................................................................................................8
Medical model of disability...................................................................................................9
Caregiver stress theory..........................................................................................................9
Causes of abuse in patients suffering from dementia..........................................................10
Understand trends of abuse towards dementia patients and to understand ways of
minimizing the chances of abuse.........................................................................................11
Methodology ...........................................................................................................................12
Types of investigation.........................................................................................................12
Research Approach..............................................................................................................13
Rationale for the selected approach.....................................................................................13
Data collection ....................................................................................................................14
Trend analysis of dementia .................................................................................................15
Data analysis .......................................................................................................................16
Ethical implications ............................................................................................................16
Resource..............................................................................................................................17
Time Table...........................................................................................................................17
Data Analysis ..........................................................................................................................20
Theme 1: The concept of dementia.....................................................................................20
Theme 2: The causes of abuse in patients suffering from dementia...................................21

Theme 3: Trends of abuse towards dementia patients.........................................................22
Theme 4: Different ways through which chances of abuse can be minimised....................23
Theme 5: Impact of dementia on patients...........................................................................24
Conclusion................................................................................................................................24
Recommendations....................................................................................................................25
Reflective statement.................................................................................................................25
Bath Spa University Research Ethics Approval Form.............................................................31

Introduction
The focus area of this current research proposal would be to explore the best
implementation in UK and minimizing chances of abuse with Dementia patients. It has been
evident that dementia patients in UK are subjected to elder abuse (Cherry and Jacob, 2016).
The general public is not able to understand that how to behave with people having problem
of dementia in order to improve their comfort level. People suffering from dementia get
abused by society and care providers in hospitals which impacts negatively on medical
condition of these individuals. This research will delve into finding best practices that will
successively aid in alleviating such practices. The research will study recent trends, theories,
and models that will successively lead to the formulation of best practices.
Background
Dementia can be described as general term for a decline in mental ability severe
enough to interfere with daily life including memory loss. It is observed that people forget
about their daily routine activities in critical dementia. Dementia patients are at very high risk
of abuse and their struggle to explore their feelings adds fuel to the fire. In UK, one common
reaction regarding abuse is communication withdrawal (Collier, Knifton and Surr, 2015). In
UK, 70% of dementia adults have evidently has been reported to be scared from moving in
care homes. 64% of adults suffering from dementia agree that care homes are unable to look
after them (HEALTHTALK, 2018). In UK, there is a big gap in training for care providers
that must lead to the creation of the aforementioned thought. Staffs are unable to
communicate properly and henceforth are unable to take Mental Capacity Act 2005 into
account. There is also a need for robust enforcement for better care provision for such
patients. The investigation about given topic related to dementia provide support to analyse
the actual cause behind the problem of abuse which facilitate to gain knowledge about
solving it properly.
The investigation regarding abuse with patients with dementia is significant to be
carrying out in order to determine actual causes of this issue in respect to sort out them in
proper manner. It is necessary to identify types of abuse which has been faced by people
having dementia including psychological, financial, emotional, sexual and physical abuse
along with inappropriate prescription of antipsychotics. It has been analysed that in mots of
the causes of repeated abuse, the abuser is well known to the old patient.

Reason for studying
Reason behind this study is to explore best practice from UK so that dementia patients
are free from abuses. The purpose of study is to analyse the problem of dementia in people
and cause of abuse take place with them in society as well as care providers. However, it is
necessary to determine this problem in order to gain an idea of establishing appropriate
practices and techniques in order to reduce the abuse of dementia patients because it impacts
negatively their medical condition (Stevenson, McDowell and Taylor, 2018). Moreover, it is
important to find out reasons of problem in respect of using different approaches for to make
such patients secure from abuse along with reducing risk of occurring the same.
Problem statement
The problem statement is “exploring best practice in the UK, different approaches for
keeping service users with Dementia safe from abuse or minimising the chance for it”. It
involves to analyse about problem of abuse with patient suffering from dementia in order to
make more effective as well as efficient practices for reducing the problem properly.
However, abuse of dementia patients impacts ion their condition negatively and results into
complicated situations accordingly.
Aim-
“To understand trends of abuse towards dementia patients and to understand ways of
minimizing the chances of abuse”
Objectives
There are 3 objectives that are as follows:
 To analyse the concept of dementia.
 To determine the causes of abuse in patients suffering from dementia.
 To understand trends of abuse towards dementia patients and to understand ways of
minimizing the chances of abuse.
Questions -
 What is the concept of dementia?
 How to determine the causes of abuse in patients suffering from dementia?

 How to understand trends of abuse towards dementia patients and to understand ways
of minimizing the chances of abuse?
Literature review
Literature review refers to published information certain subject area and at times,
information in particular area of subject within certain time period. Literature review can be
simple summary of sources, it usually has organizational pattern which combines synthesis
and summary. Literature review is a type of evaluation and search of available literature for
the given subject. It gives readers an easy access to the research on specific topic by choosing
high quality articles that are meaningful, valid, important and relevant and also summarising
them in a single report. This also provides excellent starting point for the researchers to start
the research in new area by pressuring them to evaluate, compare and summarize research in
the particular area.
Concept of dementia
Dementia can be described as a kind of mental health problem which consist a group
of symptoms associated with decline in memory and other thinking skills severe enough to
reduce person's ability. As per views of Martin L, Albert and Bracha Mildworf (2019), it
consist several symptoms of dementia such as memory loss, communication & language
difficulty, reduce ability to focus & pay attention, reasoning & judgement and visual
perception respectively. However, Alzheimer's disease can be known as most common cause
of progressive dementia in older adults. The abuse is with patients suffering from dementia is
observed which impacts negatively on condition of them facilitating complications in future.
It involves that abuse of such people is mostly attempt by citizens living in society and care
providers. The effective practices and approaches are required to be implemented for every
person in order to reduce risk of abuse with dementia patients. It consist to make strict legal
rules and policies in care institutions for make such patients secure along with reducing
chance of occurring the same.
In context of selected topic like to understand trends of abuse towards dementia
patients and to understand ways of minimizing the chances of abuse, several investigations
has been carried out. According to the opinion of Mahendra (2018), it is analysed that
researchers already conducted investigation regarding this topic in order to analyse types of
abuse to old people suffering from dementia. It has been evaluated that previous researches
has a gap that they only find out issues related to abuse and people who are responsible for

abusive activities but they did not focus on methods or practices to prevent abuse. However,
it is not much enough to just determine causes of particular problem but is mandatory to
identify actual methods or techniques in order to sort out the issue properly. The present
investigation is going to determine appropriate strategies in respect of solving problem of
abuse with old patients having health issue of dementia.
Bowlby’s theory
According with this theory, Bowlby’s theory describes that there is always a strong
physical and mental attachment towards a caregiver. This attachment is very much important
for a patient, especially dementia patients. These patients suffer from memory loss and have
social and thought related symptoms. This leads these patients to dwell into baseless thoughts
and at this very moment, caregivers are required. Care providers for dementia patients require
them to bond with these patients and win trust. This theory also suggests that care providers
must understand patients’ temperament (Curtis and Burns, 2015).
If they are feeling low or are under abuse related issue, it will the care provider’s job
to understand them. Then there is a need to provide them with requisite ideas for fighting
with those issues. UK has legislation, based on such patients’ betterment, have formulated
multiple laws that will help care providers. Such laws include The Equality Act of 2010 and
Mental Capacity Act of 2005. Both acts provide better suggestions for care services to take
necessary actions against anyone who is abusing their patients.
According to Pasmore (2015), care providers must take this theory in their practices
so that they are able to deal in a much better way. Those patients that are already abused must
also be approached by care providers so that any tendency of death does not occur. If a
patient is not at a service centre, the family members must take this theory into account.
Bonding with dementia patients will shed a better light on their inner thoughts of anger and
despair (Ellis, Winslow and Noble, 2016).
Erikson's Theory
In dementia patients, it is evident that families are the ones that provide most of the
care. Due to acceptance of this strategy, it is evident that such patients become more and
more vulnerable to external abuses (ALZHEIMERS, 2015). This also must lead to the
discussion that dementia patients tend to stay away from commercially available care homes.
Since dementia is not curable, families are required to look for earlier signs. This will lead to

having much better-benefiting chance from treatment. Furthermore, it will aid in learning
about unknown anxieties.
Abuses related to dementia patients have increased so much that caregivers or
families must incorporate this theory so that they are able to understand what is going inside
the patients’ mind (Glasby, 2017). It is evident that with integrity and despair, there is always
a positive outcome and if negative, it is death. It is also seen that if the patient has achieved
life fulfilment related sense, they are less likely to fear death and external abuses.
As suggested by Howieson and Hodges (2014), this is the part where caregivers and
families come into play. Anyone who is in provision of care for the patients must provide
them with a better sense of life. So, even if any external factor tries to abuse them, they will
never take the path of death. This theory also demands the presence of a very close and
trustworthy partner who will train patients in direction.
Social model of disability
This model or framework provides a better way to assess dementia patients' rights.
This framework also underpins legislation based on a nation or global regarding disability.
This framework dwells mostly into The Care Act of 2014 and The Equality Act 2010. Hence,
there is an immense need to understand this model for the ultimate betterment of dementia
patients and alleviating their abuse (Tible et al. 2017).
This model attains its roots from the 1970s movement of disability rights of US.
People gathered at a single place to discuss relevant issues of dementia abuse. They also
shared their own experiences as most of them were suffering from dementia. Their
experiences opened up a new idea that such patients generally stayed out from mainstream
life. Much to its dismay, general population also misbehaved with these people and this led to
creation of a great spark among the dementia community in UK.
In the 1980s, disabled patients and professional care providers came out on the roads,
asking from a framework that will look out for the betterment of such patients. Equality act
came as the answer to the movement that provided a great sigh of relief to patients and
professional caregivers. Now they had Harvarda framework that looks for any abuse
occurring with them. Furthermore, these acts called in for strong punishments for those who
will commit abusive atrocities against dementia patients. According to the concepts of Day
(2013), it is because of the leaders of those times that helped to bring change in this sector.

Medical model of disability
This model goes in conjunction with model and it takes conditions of patients as
central point of view. Decisions regarding this model are specifically made by healthcare
professionals and patients that are already suffering from disability. This model also
maintains aspects of oppression, exclusion from society and passive form of dependence. If a
person with dementia is found to be suffering from any form of abuse like sexual assault and
fighting will have serious implications to follow. Medical professionals interpret provided
information regarding dementia by patients so that a certain diagnosis is determined (Cabrera
et al. 2015). This also is followed by help from the patient’s care provider and family.
Medical professionals try their best to define normality and successive abnormality.
This is ascertained from the perspectives of biology. This model continues linking diagnosis
with physical conditions of dementia patients. Furthermore, this model also aids in assessing
recent life quality and then formulates requisite plans of actions that will enhance current
situations by biological aid. Medical interventions are thought to be better than usage of
regular theories as it regulates a patient’s internal circumstances. It will lead to chalking out
of plans like exercises, medications, lifestyle change and inclusion of a partner.
According to the words of Tible et al. (2017), patients that have suffered from any
kind of abuse must have clear indications on their body. If no physical harm is present, there
will be marked changes in behaviour and here comes the role of partner. They are to check
correctly that what marked differences have risen and then convey the same message to
healthcare professionals so that they are able to provide necessary steps of actions. It is to be
noted that, unlike social mode, this model will only provide medical aid to alleviate their
stress against any harm or abuse.
Caregiver stress theory
This theory is considered as natural theory for psychological and physiological abuse
in elders that are suffering from dementia. This theory assesses that multiple acts of neglect
and abuse occur due to a much high rate of dementia-related symptoms of behaviour and
stress from caregivers. This theory sheds light on the further inclusion of family provided
care. According to Zabalegui et al. (2014), family provided care is the best form of care since
family members are much more accustomed with change in behaviour of dementia patients.
Caregivers lack necessary amount of patience and training to handle such patients. This leads
to the occurrence of abuse in their lives which is unacceptable by family members. Abuse

from caregivers has led to patients with enraged behaviour and freedom loss. Therefore,
professional care providers must dwell into this theory so that such atrocities are not repeated.
In health care institutions, some of the activities are significantly enough to interfere
individual's working, living, mentally and physically condition in negative manner. Now a
days, most of the patients who are suffering from critical disease faced numerous issues in the
health acre institutions. It can be happen while services provider or any other person uses a
position of authority to engage in unwelcome conducts. These kind of practices can impacts
negatively upon humans in terms of mental disorder, physical disability and so other. In those
unpleasant activities patient's suffers and it will be hard for them to upbringing themselves
from such situations. For this, it is required for health care auditors to analyse situations
behind such unwelcome activities and requires to promote a clear, comprehensive policies
that convey safety, respect, inclusion and equality for each and every individual. These kind
of policy and practices assist in promoting standard of guidelines, institutional response,
abusive practices and so on.
Causes of abuse in patients suffering from dementia
Patients with dementia may have high risk of abuse. Psychological abuse is most
common for the patients who are suffering from dementia. Many individuals experiences
multiple forms of the abuse and also mortality risk from abuse. The patients who are with
dementia can be perpetrators and victims for abuse. Abuse includes physical emotional,
sexual harm and physical which can impact on the dementia patients. Dementia patients are
particularly vulnerable to disturbing trend. Unsurprisingly taking care for patients who have
dementia needs patience and time as well as advanced practice and medical care. Dealing
with intellectual impairments of dementia can be challenging for the unprepared caregiver
and for family members and which frustrate and lead to abuse. As mentioned by Donald
Weaver (2019), dementia patients have violent mood swings, this behaviour can also lead to
violence sometimes and then abuse. In this condition there will be development of anger and
aggression, behaving aggressively with caregivers make them to abuse. In early stages it is
very hard to understand, patient are acutely aware with changes happening to thoughts and
memories & regularly feel overwhelmed. As disease progress, patients help with the every
little work such as bating, dressing and with other activities. It can be devastating for the
individual sense of self or pride, these emotions can also manifest usual hostile and
aggressive behaviour. Dementia can activate outbursts and violent mood swings, these can be
extreme patient can seem perfect at one moment and screaming to the other moment.

Changes in neurochemistry of brain can destabilize moods that can cause more violent
emotions. There are possibility to get trauma and head injury in such cases. As the patient
behave in strange way that can impact on other people who are around that individual and it
can cause to abuse for dementia patients.
Anxiety, social contacts, depressive symptoms, emotional status and perceived burden
of caregiver can make them violent and which also cause abuse for dementia patients. As per
views given by Lesley Carcary (2012), individual with dementia has different mood swings
those can not be predict and such behaviour can be dangerous sometimes for people who are
providing care and treatment and according to action people react to situations which can
abuse patients. Dementia with the progression can create major problems for the patient.
Dementia have numerous economic and social impose and impacts physiological, financial,
institutionally and physical stress on individual who have dementia and also on their
caregivers. Abuse can seen by people but they do not react and take stand in favour of these
patients.
Understand trends of abuse towards dementia patients and to understand ways of minimizing
the chances of abuse
Abuse for dementia patients has different trends which lead to various abuses. It can
also create mental and health problem in patients who are with dementia. It consist different
types of abuses including psychological, physical, financial, neglect and sexual abuse which
are described here. Initially, psychological abuse include threats of abuse, intimidation,
harassment and verbal assaults. Physiological abuse creates mental anguish by humiliation,
manipulation, other cruel conduct, fear and threats. Threatening an individual who is with
dementia is particularly a type of abuse. Secondly, physical abuse can be described as a type
of abuse can cause physical pain and injury in dementia patients. Sometimes due to
consequences of irrelevant behaviour caregiver can hurt them physically. Thirdly, financial
abuse consist to withholding or misuse of individual's financial resources such as property
and money can be disadvantage or advantage for someone else. In addition to this, Neglect
includes that due to the lack of cognitive and insights changes, individual with dementia may
be not able to adequately and safely provide for every day needs and also can be at risk of
falls, malnutrition, wandering and harm. Moreover, sexual abuse involves abuse such as
fondling, any kind of sexual activity and touching when individual is unable to detect,
unwilling to consent, physically forced or threatened.

With the help of certain ways abuse in dementia patients can be reduced. Many
strategies and approaches have been implemented so that abuse can be prevent in dementia
patients. And certain actions against it that mitigates abuse consequences. Innervations which
have been implemented to prevent the abuse include public & professional awareness
campaigns, school based intergenerational programmes, caregiver training for dementia,
residential care policies to determine and improve the standards of care, caregiver support
interventions and screening of potential abusers & victims. Isolation in such patient can cause
sadness, loneliness and depression which will increase rate of abuse so it should be avoided
isolating patients. Asking about their problem and try to understand their condition can
decrease their aggression and anger which will prevent abuse.
Social welfare sectors with the help of legal provision, housing and financial support
contribute to reduce abuse. In education sector like awareness campaigns & public education
as well as health sector through treatment and detection of victims by the primary health care
workers will help to reduce it. Caregiver support after the abuse has been occurred decrease
likelihood of abuse school based intergeneration and re-occurrence programmes, shown
certain promise as caregiver support to control dementia patients abuse before it takes place
and also professional awareness about problem. With the help of these strategies and
programs abuse for dementia patient can be minimized.
Methodology
In order to conduct a well structured investigation on a particular topic, this section
specifically plays a crucial role. It is being found that, if a researcher picks right approaches,
design, structure of the investigation, it directly helps pulling out favourable outcomes for a
particular topic which has been chosen by investigator. Along with this, a research method is
a systematic plan for conducting research (Stevenson and Taylor, 2017). Sociologists draw on
a variety of both qualitative and quantitative research methods, participant observation,
survey research, including experiments and secondary data. Quantitative methods aim to
classify features, count them, and create statistical models to test hypotheses and explain
observations. Qualitative methods aim for a complete, detailed description of observations,
including the context of events and circumstances.
Types of investigation
The investigation types can be categorised into qualitative and quantitative research in
which more suitable action should be selected by research properly. Initially, quantitative

research focus on collection of numerical data. It deals in logic, numbers and stance of
objective. This data is highly structured and result is based on exact data and larger sample
space. It highly reliable method for gathering data (Ellis, Winslow and Noble, 2016). In this
research all the aspects are analysed before any kind of interpretations are made. Qualitative
research refers to symbols, characteristics, metaphors, description and definitions. It
emphasise on quality of processes and entities which are not experimentally measured with
respect to intensity, amount, frequency or quantity. They comprises of research methods and
concepts which are gathered from academic fields (Campbell, 2017). In present investigation,
researcher has chosen qualitative approach in order to conduct the investigation in a rightful
manner. With the help of this, right amount of modifications could easily be made in
specified time frame. The topic which has been chosen by the investigator, i.e. keeping
service users with Dementia safe from abuse or minimising the chance for it. This is why
researcher has chosen qualitative approach as it is directly connected with the mental abilities
and disabilities at the same time.
Research Approach
This is very commonly used element of research methodology. It involves in various
plans and procedure for the research and explain the collection of data, analysis of data and
interpretation of the graph. These approaches are based on the two types of investigation that
is inductive and deductive researches approach. In the deductive approach new and
innovative theories are created with the help of hypothesis. Wherein, inductive approach data
has been formulated through the implementation of an effective observation of existing
figures and facts in regards with the research project. In the present research project,
inductive research approach has been applied through the investigator because this research
report is based on the qualitative approach. This approach also helps in generating reliable
and valuable data for carry out research activities in the right direction (Fileborn, 2017).
Rationale for the selected approach
Specifically, the significance behind selecting this method is that, it helps in analysing
the topic in depth. It can be said that qualitative approach focuses on feelings, perceptions
and many more. Through this, maximum benefits could easily be gained right on time from
the research. On the other hand, it can also be said that a much more influential approach
would aid in improvising the knowledge related to the topic and i.e. keeping service users
with Dementia safe from abuse or minimising the chances of it.

Along with this, it is the most important part of research project, which helps the
researcher in carry out the work in right direction with effective manner. Research philosophy
is divided into two categories such as interpretivism and positivism. In the present scenario of
work, researcher focuses on applying interpretivism research approach as it helps in offering
qualitative report through which the researcher is able to identify the data at various levels
(Podnieks and Thomas, 2017).
Data collection
Importance and relevance of data collection methods is often the quality quantity
adequacy and appropriateness of the data which determines the quality of research. As a
methodology I will use online sources for case studies and CQC reports, because case study
is one of the important data collection methods in social research.
This is a process by which investigator can collect information or data about their
research problems and make effective research report. With the help of this, person or an
organisation both will solve their problem, measure outcomes and analysing about emerging
future trends. Along with this, effective research report says about the efficiency and
importance of data collection method by which it will be determine about the quality of
researcher (Beach, 2017). There are two methods of data collection such as primary data and
secondary data which are described as below:-
 Primary Data:- This method says that all the information or data can be collected by
an researcher only for preparing an appropriate research report. In addition to this,
primary method can be collected by many ways such as interviews, surveys, focus
group, direct observation and so on. With the help of this sources, researcher can
solve its research problem and provide right information to people. Also, this primary
data method helps other to enhance their knowledge and prepare their project in an
effective way. This method is also known as first time collection of data method.
 Secondary Data:- In this method data whole information or data can be gathered by
some one else. Along with this, it will collected by many sources such as journals,
books, case studies, magazines, government agencies, trade association and many
more. Secondary data aids researcher to make effective research report and prepare it
on specified time period. The motive of this method is to help other while preparing a
research report and solve their own problem in an appropriate manner.

In this research report, investigator used secondary data method for preparing an
effective research report as it helps investigator to collect all data or information from
published data. With the help of this secondary data helps researcher to save their time and
complete it accordingly. In this, secondary data collection method is used which is used for
collecting and gathering by someone else. There are various sources and methods through
which researcher can gather data such as books, journals, magazines, case studies and so
more. This is the method which has been gathered and can be accessed by an investigator.
The data is used to increasing sample size of research and it is selecting the efficiency and
speed that comes with using already existing resources (Struble, Blazek and Kales, 2016). In
this research project, secondary data collection method is used to gather and collect accurate
information while completing this report. In context to this, researcher analyse the market and
identifying those people who are suffering from disease. After that researcher select those
individuals who are facing dementia disease by which people people can lose their memories.
In addition to this, especially old age people face such kind of difficulty and also they have to
bear many issues because of it like, people can take their advantage and get right on their
properties. By the help of this, researcher get whole information regarding dementia disease
and make effective research report. Also, investigator can enhance their knowledge and
generate awareness in market by which people can aware about it.
Trend analysis of dementia
According to statement implemented from Elo et al. (2014), a study will be
implemented in terms of executing trend analysis in case of Trajectory related to Dementia
patients. The study will illustrates using statistical methods in course of analysing dementia
related progression when a patient suffering from dementia must face abuse from family
members through following medical and clinic test. The researcher will make usages of
multiple-choice questionnaires which will assists in terms of analysing attitude and trends of
various patients suffering from dementia.
From another point of view, both statistical along with data analysis-based methods is
expected to be incorporated or applied in terms of identification of interdependence among
correlation and quantitative based data. The above specifies two different methods will be
implemented as it is one of the most reliable methods that will be analysed in terms of using
Assisted Living Facility (ALF) along with clinic-based setting.

Data analysis
This secondary analysis will assess acquired information from different sources such
as regular UK trends and case studies from governmental based websites. This study will also
incorporate analysis from different CQC report that will be analysed from different
competitive based business venture, various UK related legislation along with case study
related to both health and social care. As suggested by Lewis (2015), the initial case study
will be estimated to deal with carers of people that are suffering from dementia as in financial
year 2009 in month of February; the Department related to Health will inaugurate its motto in
terms of improving life of patients suffering from Dementia. In another point of view, the
researcher will incorporate making usages of effective quality-based information that will in
turn assists in achieving long term progress of dementia patients.
In context of analysing another case study, it will be analysed that video-based
training resources that is expected to be based on dementia was estimated to commissioned
by NHS. Education South Central (NESC) in terms of providing training to all nursing
related staff and to anyone that are expected to be working in primary care centres. In
addition to this conception this case study will further aim at incorporating interviews with
different carers of patients that are being affected with dementia and are usually expected to
be questioned in relation to group discussion. As commented by Howieson and Hodges
(2014), from another point of view, the researcher will incorporate usages of semi structured
interview process by making usages of qualitative data analysis as well as analysing
Grounded theory as one of the most effective used frameworks in context of using analysis.
While executing data analysis, the framework will take into consideration four different
stages that include: Execution of data collection process, Coding of different forms of data,
comparison among different form of data along with analysing theoretical saturation
(Healthtalk, 2018).
Ethical implications
Ethical implication regarding this research will be based on incorporating information
from different governmental sites rather than executing information from different
nongovernmental sites. The governmental based sites will be used by researcher in case of
analysing the impact of abuse among patients that are suffering from dementia. Dementia is a
disease that is expected to develop among elderly person and among those patient suffering
from high level of cholesterol and diabetes. In this various problems and issues have
automatically created in nature. For analysing of any work issues and conflicts which is faced

by the researcher. So that it is important for an investigator to make some alternate plan to
resolve them issues in a appropriate manner. The researcher play most crucial role in every
research by collecting reliable and appropriate information related to data with the help of
several sources. Researcher is responsible to keep information confidential in a effective
manner At the other hand, the given investigation follow the ethical norms at the time of
conducting overall study including respect to person, beneficence, justice, informed
consonant and maintain privacy of participants. However, personal data has been used by
taking approval of desired authority for conducting research (Teaster and Harley, 2016).
In addition to this, it is essential for investigator to focus on completing research
without being bias to anyone. For this, it is mandatory for investigator to use confidential
information of dementia patient for investigation purpose only. This initiation for maintaining
confidentiality of investigation will help researcher in conducting effective research along
ethical. It can be said that if in any case investigator requires or needs information of patients
then it is mandatory for them to ask patients first about the information and after taking their
permission investigator can easily use this information in their investigation (West, 2019).
Apart from this, another ethical consideration that is required to be considered by researcher
is to complete the present research in the provided time frame only. For this, it is important
for them to complete each and every activity according to the planned research schedule. This
will help investigator in completing whole research effectively within the pre determined
time frame.
Resource
In terms of analysing this study, the researcher will make usages of different
secondary sources that will incorporate usages of various governmental websites along with
using trend analysis. The researcher will implement trend analysis by incorporating
information from various online journal articles as well as from Newspaper that will in turn
assists in analysing information about dementia patient in a profound manner (O’Brolcháin,
2017).
Time Table
Another section which plays a crucial role within an investigation that aid in assigning
a specific time to a particular task. Here, it can be said that a range of tools which could be
used in order to set time for every single task. In present context, there are a range of tools
which could be utilised and these are Gantt chart and many more. Basically. A Gantt chart is

being developed or consist of a horizontal bar chart which is developed as a production
control tool in 1917 by Henry L. Gantt. This is being considered as one of the frequently used
tool when it comes to project management, a Gantt chart provides a graphical illustration of a
schedule that helps to plan, coordinate, and track specific tasks in a project. Since the
investigation is related to dementia, researcher would specifically find issues related to
managing the time for conducting every single activity in specified time frame (Barboza,
2016).

Data Analysis
Theme 1: The concept of dementia.
Dementia is mental health problem which is mainly associated with thinking and
memory that is reduced in patient who are suffering from this disorder. Overall term which
described group of the symptoms that are related with decline in memory and severe enough
to decrease ability of individual to perform everyday work. It has been analysed that
dementia symptoms can effect memory, ability to focus, visual perception, reasoning &
judgement and capability to pay attention and focus. Individuals have dementia may suffer
with short term memory problem (Youdin, 2019). Observation of dementia patients has been
shown that this affects their regular activities and also personal life. Mostly dementias are
progressive that means symptoms initiate slowly & gradually and then it gets worse.
Alzheimer disease is progressive dementia in case of older people. Symptoms and causes of
dementia can change in behaviour of patient, this changed behaviour can irritate their loved
ones and caregiver. This research is mainly focused on abuse which dementia patients suffer
because of this mental health issue. Approaches and practices are needed to implement for
individuals to decrease risk of abuse in dementia patients. Medical model of disability mainly
focuses on the problems of these individuals and also decisions according the model are
certainly made by the healthcare professionals for dementia patients. Based on research this
has been analysed that patients with dementia who are dealing with abuse such as sexual,
emotional and physical should be prevented and better care has to be provided to improve
their condition.
According to analysis it has been observed that dementia is severe problem for adults
as well as younger children. This concept involves all the detailed information about
dementia and related abuse and also how it can be minimize with the help of different
approaches and programmes which are made to reduce all type of abuse in people who are
with dementia (Gopalan, 2018). Sometimes most of mental issues are ignored in society,
these problems commonly does not discussed openly because of certain reasons like to be

judged and fear. Care professionals have to provide care and treatment that can help to
control dementia and it's consequences. Disease management can help to prevent this in
community by creating awareness in public and schools. Public health programs gives the
knowledge about disease and how it can be managed with the help of different strategies and
approaches. According to the analysis concept of dementia tells about the issue and its effects
on human body. In the present research it has been analysed that abuse is common in case of
dementia patients which has to be reduced so that it can improve their quality of life.
Caregivers and family can support the patient to decrease dementia, these patients should not
be isolated because this creates loneliness and sadness that can also impact on mental health
of person. Preventing abuse for dementia patients is very important and it also help them to
improve in their issues (Bilbao and Bonavitacola, 2016). School based programmes also help
children to know more about disease so that they can prevent it initially.
Theme 2: The causes of abuse in patients suffering from dementia.
According to analysis patients with dementia are more likely to face abuse that can
be physical and psychological. Such types of abuse can create pressure on mental health of
patients and it affects their daily life activities. Patients with dementia can also face abuse
related to emotional, physical and sexual harm that can effect in negative to dementia
patients. From the present research it can be analysed that there are several causes which a
patient with dementia faces in daily life. Their behaviour may be a reason to get abuse from
other people. These patients can not perform even a single work without any support, every
time they will be needing someone to help them so that they can bath, dress and also other
activities. Sometimes such activities can create frustration in those who are helping and
providing case to patients and it may lead to abuse. In this condition person will be
aggressive for no reason which can not be determined so it is hard to understand when and
how they will react aggressively (Goergen and Beaulieu, 2017). In public it can be more
dangerous as people will not be knowing the reason behind their behaviour and it can cause
abuse. Development of more anger can make caregiver them to abuse. When this condition
progresses needs support for every little thing which can be devastating for those who are
providing care. As explained in this research that dementia can trigger violent mood swings
which can be extreme at times like patient seems good at one moment but to other moment
they can be aggressive which is undetermined. This also changes brain neurochemistry that
destabilize moods and lead to violent thoughts.

This analysis shows that social contact, emotional status and anxiety in dementia
patients can make caregiver violent and they may do not provide proper care and treatment
due to their aggressive and angry behaviour. Abuse causes are major problems for patients
and also the people who are helping and supporting them with their this issue. In case of this
disease causes can be wide but certain are common and specific for the problem. Any person
who is providing a good care to patient if the patient become suddenly violent as dementia
patient can not regulate their emotions so they act in this way, caregiver can be frustrated and
they can be cause of abuse (Nicastro, 2017). Caregiver stress theory is natural theory for the
physiological and psychological abuse which happens more in case of dementia and older
people. This theory is specifically for the caregivers as they face major impact on their mental
health while treating dementia patients. When caregiver will be calm and well trained for the
dementia they can provide a effective care to patients which will implement their health
condition. This theory also tells that many acts abuse occur because of high rate of the
dementia related symptoms of stress and behaviour from caregivers. This as been analysed
that such type of theory helps to caregivers and patients as well as prevent cause of abuse.
Theme 3: Trends of abuse towards dementia patients.
Abuse trends are not limited they can be wide sometimes when it comes to dementia
patients. There are two types of patient who have dementia and the older people who are with
Alzheimer's diseases. In case of older people there are more chances to been neglected and
abused. Trends of dementia impact on mental health of patient and they can suffer their
whole life. From the above research it has been analysed that there are some trends of abuse
such as psychological, physical, financial, self neglect and sexual abuse. Psychological abuse
can include verbal assault and emotional abuse that can impact on person's mental health.
Dementia patient abuse imposes great economic and social burden on the society. Abuse of
dementia patients are under-reported because detection of abuse is complicated by different
pathological, cultural, ethnic and biological factors (Chang and Dong, 2017). Moreover,
cultural nuances may increase difficulty to understand abuse of patients with dementia. It has
been observed that physical abuse can cause any kind of physical injury and pain by any
caregiver or other people. Financial abuse is that which is done when person wants to misuse
the patient's properly and money for their own use. Sexual abuse includes any kind of threat
and physically force which can hurt patient. Most of people who are with dementia are
ignored which can make them malnutrition and can harm them.

From the above analysis trends of abuse can be prevented and control with the help of
programmes which are provide for dementia patients. Education and awareness regarding
dementia has to be provide at school level which will help people to understand the issue and
prevention. Bowlby's theory is explained about strong mental and physical attachment with
caregivers. Attachment between patient and caregiver helps to understand the patient and
their problems so that they can choose appropriate care for patients. Such type of conditions
require more care and love so it is very essential for caregiver to form a trust. If caregiver will
able to understand individual's behaviour properly they can provide a good quality of
treatment (Shamaskin-Garroway, Giordano and Blakley, 2017). Good practice of care can
lead caregiver to implement in person's condition. To reduce these trends an effective care
and related programmes which are required to decrease abuse and its effect on people. Above
research showed that dementia patients have different types of abuse which lead them to
suffer which can be reduced if they are understand properly so that it can be controlled which
will help to individual to progress.
Theme 4: Different ways through which chances of abuse can be minimised.
If it is talked about different ways of reducing the chances of abuse, it can be said that
there are a range of tools which could be utilised in order to minimise different range of
abuses that are being faced by people that are dealing with dementia. This could be anything
from talk to patients, and try to listen or to understand what they are trying to say, better
treatment from the existing one and so on. Basically, people in all over the world that are
facing issues related to dementia which somehow includes sexual exploitation as well in a
range of cases. For the same, there are a range of theories that can be used and these are
social model of disability, Erikson's Theory and many more. With the help of this, it can
easily be said that many problems could easily resolved right on time. Considering the social
model of disability, both patients or their families could easily resolve all the issues in
specified time frame (Bloom and Gullotta, 2018). Along with this, it can be said that Abusers
are mainly relying on secrecy. They mainly focuses trying to keep elders silence so that no
one can doubt on them. In order to handle this situation, abusers mainly focuses on building
up their relationship with elders. they also tries to listen all activities carefully in order
understand their concerns and fears. Along with this, they also tell them to not worry about
situations. Basically, an issue could be resolved in specified time frame. On the other hand, it
can also be said that, it is required for one family member or a care taker to keep an eye on

the patient who is going through dementia so that no individual would take an advantage of
the same.
Theme 5: Impact of dementia on patients.
The dementia is a kind of mental health problem which is responsible for affecting
overall aspects of life of an individual including relationships with family and friends. It
involves the fact that if people comes to know that a person is suffering from dementia then
their relation with that patients start changing over the time. It has been analysed that some of
cognitive changes are observed in patients having problem of dementia which impacts
negatively on their regular lives. People in society also tried to avoid such people who has
problem of dementia which is not favourable to them (Stripling and et. al., 2017). As per
social model of disability, it has been found that negative attitudes & behaviour impacts on
dementia patients in terms of making them disable or may leads to their worst situation.
However, it involves number of aspects such as memory loss, difficulty in finding words &
communicating, problem in visual & spacial abilities like getting lost at the time of driving,
difficulty in problem solving & reasoning and not able in handling complex tasks. Moreover,
it also consist the problem facing while preparing plan of action & organising, difficulty with
coordination & motor functions and confusion & disorientation respectively.
At the other hand, it has been found that some of psychological changes take place in
patients with dementia which re very crucial for their regular life. It involves several
psychological modifications including personality changes, depression, anxiety, inappropriate
behaviour, paranoia, agitation and hallucinations (Teaster and Brossoie, 2016). Meanwhile, it
has been found that a person diagnosed with dementia may experience a range of emotional
changes including anger, grief, loss, fear, disbelief, shock etc. Furthermore, it has been
evaluated that dementia may cause people feel insecure and they lose their confidence in
themselves as well as abilities.
Conclusion
With the help of above mentioned report, it is being concluded that dementia is not a
specific disease. It is an overall term that explains a group of symptoms that are related with a
decline in memory or thinking skills. This disease is severe enough to reduce an individual's
ability to perform daily activities. Dementia affects each individual differently. There are
some common symptoms of dementia like memory loss, confusion, disorientation. It is very
important that family, friends and health professionals help the person with dementia to feel

safe and secure. The best living environment for an individual with dementia is one that will
help these people to be happy and independent as possible. The home environment will help
them to know where they are and where they want to go. Some individuals with dementia
become disoriented and get lost in unfamiliar or previously familiar surroundings and thus it
is important that they carry appropriate identification with them at all times including their
names, contact number of family member, etc. A safety checklist can be made for helping a
person suffering from dementia as this checklist will help in ensuring that the environment
inside and outside the home is as safe as possible. Considering all the above information
could help patients (facing issues with dementia) will directly reduce the risks that are
involved in it.
Recommendations
Considering above discussion, it has been recommended that family members should
support patients suffering from dementia by conducting several activities to make condition
easy for them. It involves the to put better lighting in homes which facilitate to boost up
visibility which is favourable to such patients to conduct their daily routine work
appropriately. However, it has been suggested that government and healthcare organization
should apply strict policies and regulations in order to reduce abuse of dementia patients by
care practitioners. In addition to this, it is necessary to place financial power of attorney
immediately by ageing by ensuring that a legal document is in place according to state law
that empowers a succession of individuals. Moreover, it has been recommended that training
& learning programs are required to be carried out in order to support carers to deal with
dementia patients because such people behave aggressively. It is suggested that external
agencies should put efforts to conduct inspections in care organisations to ensure that patients
suffering from dementia remain abuse free which impacts positively on their situation.
Reflective statement
My project was relating to finding best practice about how we can assure safety of
patients who are suffering from the problem of dementia. At the time of working, I learnt
about whole concept of dementia and what are the key causes behind it. It helped me getting
aware about latest development in this sector, it also assisted me in understanding the mental
status of people who are facing this problem. This knowledge will help me in forthcoming
time and it also enhanced my research skill. Beside this, I also faced some troubles like
difficulty in making aims and objectives. Problems are part of every tasks it support an

individual in acquiring more knowledge. If I will again get the opportunity to do work on
similar kind of project again then I will like to double check aims and objectives of my
project. Whole content of while is based on questions and objectives so next time I will be
more concentrated towards them.

Reference list (in progress)
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Bath Spa University Research Ethics
Approval Form
Student/Staff name Cristina Burjacovschi
Programme and/or module BA(Hons) Business and
Management (Health Care)
Dissertation
Title of the proposed
research project:
Exploring best practice in the
UK, different approaches for
keeping service users with
Dementia safe from abuse or
minimising the chance for it.
Number and type of
proposed participants
N/A
How is permission being
sought from the participants
and/or their parents/carers?
N/A
How is participants’
anonymity to be preserved?
N/A
Describe the research
methods proposed (e.g.
interviews, classroom
observations)
Secondary research, data
collection
List the ethical issues and
potential risks associated
with the research methods
outlined above (e.g.
confidentiality) and how you
propose to deal with each of
Confidentiality

these.
Describe how your findings
will be reported or
disseminated
through reports
I have read the
University’s Process and
Procedure for the
Approval of Research
Activity
(please sign and date)
Cristina Burjacovschi
15.12.2018
Ethical Review of Research Projects – Checklist
Supervising Tutor/
Director of Studies
Approval level
required
a) proposals using human participants for research YES 
NO
b) proposals for research that intends to use undergraduate students
as participants
YES 
NO
School Ethics Sub-
Committee approval
required
c) procedures involving any risk to a participant’s health (for example
intrusive physiological or psychological procedures
YES 
NO
d) research involving the donation of bodily material, organs and the
recently deceased
YES 
NO
e) proposals which involve financial payments or payments in kind to
participants above reimbursement of expenses;
YES 
NO
f) proposals wishing to use children under the age of 16 or those
over 16 who are unable to give informed consent (e.g. people with
learning disabilities; see Mental Capacity Act 2005) as participants
YES 
NO

g) research proposals to be carried out by persons unconnected with
the University, but wishing to use staff and/or students as
participants
YES 
NO
h) proposals which investigate existing working or professional
practices at the researcher’s own place of work (including staff
surveys)
YES 
NO
i) research where the safety of the researcher may be in question; YES 
NO
j) proposals which require participants to take part in the study
without their knowledge and consent at the time;
YES 
NO
k) research involving prisoners and young offenders. YES 
NO
University Ethics
Sub-Committee
approval required
l) research involving access to records of personal or sensitive
confidential information, including genetic or other biological
information, concerning identifiable individuals;
YES NO
m) surveys, questionnaires and any research, the nature of which
might be offensive, distressing or deeply personal for the particular
target group;
YES NO
Supervising Tutor/Director of Studies/Director of Research use only:
Comments on the ethical
issues raised by the
proposed research:
Either: I am satisfied that the ethical issues raised
by the proposed research project have been
addressed and give approval for the project

to go ahead
Or: The ethical issues raised by the proposed
research project require referral to the
School Ethics Sub-Committee.
Signature and
Date:
A copy of this form should be sent to the Director of Research in the School

School Ethics Sub-Committee Use Only:
Comments on the ethical
issues raised by the
proposed research and how
well they have been
addressed
Either: I am satisfied that the ethical issues raised by
the proposed research project have been
addressed and give approval for the project to
go ahead
Or: The ethical issues raised by the proposed
research project have not been adequately
addressed and require re-submission to the
committee.
Or: The ethical issues raised by the proposed
research project require referral to the
University Ethics Sub-Committee.
Signature and Date:
(Chair of School level
committee)
A copy of this form should be retained by the Director of Research in the School

University Ethics Sub-Committee Use Only:
Comments on the ethical
issues raised by the
proposed research and how
well they have been
addressed
Either: I am satisfied that the ethical issues raised by
the proposed research project have been
addressed and give approval for the project to
go ahead
Or: The ethical issues raised by the proposed
research project have not been adequately
addressed and require re-submission to the
committee.
Signature and Date:
(Chair of University
Ethics Sub-Committee)
A copy of this form should be retained by the Vice-Provost, Research & Enterprise