Dementia is a condition usually associated with people in their later years, but there are cases of much younger people developing the condition, in their thirties and forties usually linked to Pick’s disease or Huntington’s disorder.
Pick’s disease, a degenerative disease of the central nervous system, can be found in people in their forties and fifties. Huntington’s disorder can appear in people in their thirties.
Some forms of dementia are reversible, for example: malnutrition, when alcohol and medication toxicities, metabolic disorders, and depression.
Studies have been found that 10 to 20 per cent of dementia found in older people is reversible.
The risk of developing a dementia is much higher for people over eighty years of age, which is confirmed in the table below:
AGE UK figures ( Alzheimers’s Society ; Dementia Awareness , Tribal (2006).
|40-65||1 in 1000|
|65-70||1 in 50|
|70-80||1 in 20|
|80+||1 in 5|
An individual suffering from the beginnings of Alzheimer’s disease would show signs of difficulty to:
– make decisions.
As the condition worsens the individual can become increasingly confused and disorientated. People suffering from a dementia can be at risk from harming themselves, or being harmed by others simply by not being able to manage. A few examples I can think of in my own experience of people suffering from dementia, is leaving cookers on, unknowingly, fires starting, going out alone and getting lost, and leaving the front door wide open.
Evidently, people suffering from this level of dementia cannot cope living alone, and need extra support, either in receiving specific community care or residential nursing care.
This is where the G.P needs to get involved, hopefully with a referral from a family member, or a local social service or emergency service.
The General Practitioner (G.P) acts as a “Gate-Keeper”, able to refer the individual to relevant hospital specialists. Also, at this time accessing contact to a range of specialist healthcare professionals who are working within the community.
In today’s level of practise, all possible reasons for symptoms have to be ruled out. A “Mini Mental State Examination” (MMSE) must be carried out. Or, a diagnosis might be made over time, such as a fuller assessment, such as a brain scan. Plus further investigations by a specialist for a second opinion.
This type of assessment would not have been in place until the reform of hospital institution asylums, until then dementia sufferers were regarded as literally “demented”. This term is so derogatory, and disempowering. The patient is no longer considered as a person with rights or even a person within themselves. The term “demented” reflects a mind-set of people thinking sufferers of mental health are inferior, and ruined.
The word ‘demented’ so commonly used in the asylum hospital era represents fear of the condition and creates hysteria and fear to the general public. Keeping people locked up against their free will, segregated from every day society and removing their right to freedom is such an abusive way of handling very vulnerable people. It is so hostile to the patient.
Since The White Paper; Better Services for the Mentally Handicapped (1971) followed by The White Paper (1975); Better Services for the Mentally Ill, change has eradicated the emphasis of isolation of people with mental health illness, dementia and mental and physical disabilities. People with a wide range of conditions re-gained their rights and were at last given empowerment over their lives.
But even in today’s requirements of working to the codes of practise and polices according to legislation, abuse can still take place.
Disempowerment can occur at every level of care practise, a few examples are:
a) Hospital setting – leaving patients who can’t feed themselves, to eat their food un-assisted.
b) Local Authority care visitor – acting hostile and unfriendly towards a person receiving care in their own home.
c) Residential Nursing Home – providing residents with daily routine services without respect or acknowledgment. Talking over people, and not seeing them as a person to be considered.
Empowering individuals can only take place with the support and assistance of those that provide the care and support.
Today there are support services for those that provide the Care and Support. The City and Hackney Carers Centre provides emotional support groups for carers who care for a family member at home. They provide advice on how to deal with Social Services and other agencies, and they provide links into other support organisations.
Though, indirectly, this is a very empowering source of support. This area of integration links the carers in, so that they are able to keep themselves well and provide adequate support.
Practises that emphasise the rights of the individuals receiving the care and support, is reflected in care staff being up to date with relevant training in care and support.
Agencies providing care have the responsibility to update staff with regular training. Staff are required to deliver to certain levels of competence. Yearly inspections take place from outside auditors. All of these elements are indirect ways of empowering the individual so that the correct care approach is being provided.
Complaints procedures are in place to protect individuals from abuse, but abuse can still take place.
Although Criminal Records checks are a useful indicator to filter out any previous offences, it should in no way be seen as a licence to accept people without a criminal record as saints. Intuition should play a big role in social work, and bad things can happen.
A “Whistle-Blower” is a term used to describe blowing the whistle, breaking the silence, of bad practice. Investigations would take place. Witness reports, and interviews. Being a whistle blower is a very serious action to take, and is there for damage limitation, for the protection of the individual receiving care.
All of these are in place to empower the individual. A local organisation which has responsibility to provide support service to vulnerable homeless people is called Supporting People. They also provide voluntary sector agencies with funding and on an annual basis they carry out thorough investigations to the services being provided, that are seeking funding. They score the level of competence with a grade. It is a great way to keep a check on service delivery.
REFERENCE AND BIBLIOGRAPHY
Davison / Neale (1990), Abnormal Psychology; Organic Mental Disorders, Appendix Box A.1. Structure and Function of the Human Brain, p643, JohnWiley&Sons,New York.
(Cummings and Benson (1983); Gurland and Cross (1982); Small, Liston and Jarvik (1981); Spar (1982); Task Force Report (1980); Wells (1978).
ICS (2007), Who Cares – The Social Care Mosaic Study Guide 2, Section 7, Options and Choices in Old Age,p105, International Correspondence School,Glasgow.
Tribal (2006), Understanding Dementia; Dementia and Ageing, Section 1, p15, Tribal Education,York.
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