Reflection on Dementia Care: Challenges, Strategies, and Outcomes

This reflective assignment discusses the increasing societal burden of dementia and the psychological and social issues faced by patients. The author reflects on their experience caring for dementia patients, highlighting the importance of palliative care in improving patient symptoms, reducing caregiver burden, and ensuring informed treatment decisions. The reflection covers various aspects of patient care in nursing homes, including the use of advanced prognostic tools, increased patient satisfaction, and the challenges of decision-making, especially when ethical frameworks are not strictly followed. The author emphasizes the need for advanced care planning, advocacy for high-quality counseling, and a decision-making procedure that balances benefits and burdens. The reflection concludes with a call for regular access to healthcare services, regardless of social background, and the utilization of structured conversation guides and written materials for patients with advanced dementia. The assignment references several research studies to support the observations and arguments made.

Surname 1
Name
Professor
Institution
Course
Date
The societal burden of dementia is an increasing problem. Those people who have
dementia face psychological and social issues. Palliative care is a therapeutic specialty that gives
much attention to the prevention and relief of suffering. Patient care is also important in offering
the best quality support for patients. Effective palliative care is crucial to the patients and the
families who face serious illnesses. Palliative care can improve the symptoms of the patient,
lessen the burden from the caregivers and assist in ensuring treatment decisions are made after a
thorough consultation.

Surname 2
During this episode, I was taking care of people who were suffering from dementia.
There was a lot of research on the quality of care given in nursing homes and the costs of care.
The result showed that nursing home was the most common site of death for the people who
have dementia (Livingston, Sommerlad, Orgeta, Costafreda, Huntley, & Ames, 2017, p. 56).
There were specific considerations put in place to improve the quality of care given to these
patients. There was an increase in the quality of care given to patients with advanced dementia
during the episode. The patients received aggressive and costly interventions. The patients also
received culturally sensitive and high-quality counseling. The patients who had eating problems
were so many. Some patients also developed pneumonia, and this could quickly increase the
mortality rate if not well tackled. Care was intensified during this episode, and many lives were
saved (Maayan, Soares‐Weiser, & Lee, 2014, p. 67).
There were rigorous efforts put in healthcare during the entire episode. There was the
utilization of minimum data set in the creation of the advanced prognostic tool. The latter is an
additive score that comprises the patient's info about his or her age, gender and the level of
functional dependence and the nutritional status, among others (Mitchell & Agnelli, 2015, p. 77).
During the episode, the number of patients who sought for regular medical attention increased
and the level of patient satisfaction also went high. There was also increased use of hospice
among the patients who had advanced dementia. The hospice were however not a prerequisite
for palliative care approach which is appropriate for all patients (Dewing & Dijk, 2016, p. 79).
Decision making was challenging, especially in advanced dementia. The decisions were
emotional, and in most cases, they were reliant on substitute decision making if there were no
definite plans laid by the patient before the cognitive decline. There were challenges in that
decision making was not always following an ethical framework as it should and hence did not

Surname 3
reflect a balance of gains and burdens and respect for the autonomy. There was increased
profound for the patients who had advanced dementia. The latter made me as a caregiver to make
healthcare proxies for the patients. The proxies I made were a reflection of the wishes of the
patients. The treatment and care that I gave to the patients who have dementia were in alignment
with their desired aspirations and primary goals in healthcare. Some of the patients wished to
receive medication and care that would help them live long while others needed medicine that
would relieve them from the pain they were experiencing. As a result of various needs presented
by the patients, I offered both palliative care services together with curative and disease-
modifying treatments. During the episode, there was the enforcement of advanced care planning
in the management of patients with advanced dementia. The latter was meant to avoid
unnecessary treatments (Maayan, Soares‐Weiser, & Lee, 2014, p. 121). I had the mandate of
preparing the patients with early disease and their families of what to expect in the later stages in
the development of dementia.
I noted that there was vigorous care given in some parts of the country while others
received minimal levels of healthcare. Given a chance, I would advocate for regular admission of
healthcare services to all communities in the United Kingdom. I would advocate for high-quality
counseling to all patients regardless of the social background and the status they held in society. I
would also advocate for a decision making a procedure that follows a framework reflecting a
balance of benefits and burdens. The latter would involve creating a substituted judgment and
weighing the interests of the patient. I would call for soliciting treatment preferences before
complications arise. I would also consider using a structured conversation guide and written
materials which would be directed to the patient with advanced dementia (Livingston,
Sommerlad, Orgeta, Costafreda, Huntley, & Ames, 2017, p. 143).

Surname 4
References
Dewing, J., & Dijk, S. (2016). What is the current state of care for older people with dementia in
general hospitals? A literature review. Dementia, 15(1), 106-124.
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., & Ames, D. (2017).
Dementia prevention, intervention, and care. London: Lancet.
Maayan, N., Soares‐Weiser, K., & Lee, H. (2014). Respite care for people with dementia and
their carers. Cochrane Database of Systematic Reviews, 9(2), 1-4.
Mitchell, G., & Agnelli, J. (2015). Person-centred care for people with dementia: Kitwood
reconsidered. Nursing Standard (2014+), 30(7), 46-47.