Dementia is a collective term used to describe a group of symptoms related to cognitive decline severe enough to interfere with daily life. Impairments in thoughts, communication and memory are some of the symptoms of dementia. Dementia is caused by damage to brain cells. The brain damage inhibits the ability of the brain to carry out its function normally, which, in turn, affects feelings and behaviour. Though not a normal part of aging, it mainly affects older people. Many dementias are slowly; the symptoms start slowly and develop until they get worse. The symptoms of dementia may improve with treatments. However, most of the diseases that results in dementia are not curable.
History of Dementia
The history of dementia dates back to 2000 BC, when the concept was first documented by Egyptian psychiatrists. The word dementia is derived from the Latin word, which means “out of one’s mind.” Philippe Pine, a French psychiatrist, was the first person who coined the term. Ancient philosophers regarded mental decay as being related to ageing. With time, the study of dementia increased. At the beginning, the term was restricted to people with an intellectual deficit and loss of cognitive ability. During the 19 th century Doctor James Prichard introduced the term “senile dementia,” which means old, in his book, A Treatise on Insanity. Before 1906, syphilis was regarded as the major cause of dementia. It was not until 1906, when Alzheimer’s was identified as the major cause of dementia. “In 1906, Alzheimer, who looked at post-mortem brains of affected younger people, published the first case- a 50-year-old woman with dementia symptoms” (University of Queensland, N.d). After her death, Alzheimer was able to identify plaques and tangles through a microscope which are regarded as the hallmarks of the disease. The understanding of dementia was furthered after Oskar Fischer, a German psychiatrist, who observed plaques and tangles after studying the brains of older people. The understanding of dementia and its cause improved with the advance in medical technology.
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Importance of Taking Global Action on Dementia
There is a growing interest in dementia from policy makers due to the challenge it is posing in health and social care. Currently, dementia is seen as the main health and social challenge. Statistics indicate that cases of dementia are growing rapidly faster compared to other diseases. According to a report developed by WHO and Alzheimer’s Disease International (2012), the number of people calculated to be living with dementia in 2010 was estimated at 35.6 million worldwide. This number is projected to double by 2030 as well as a triple by 2050. Therefore, it is important for the world to prepare for this epidemic. Given that it is becoming a global problem, there needs to be a global response. The existing models and policies ought to be tested, improved, an expanded and new ones be developed in order to meet the needs and preferences of individuals living with dementia. Strategic plans and policies need to be implemented to address dementia in order to improve care as well as provide support and treatment.
Barriers to Progress Care Treatment Plan
There are numerous barriers in primary care that prevent diagnosis as well as a progressive treatment plan. Some of these barriers include identification and planning of services, inequality of access, and the quality of care experienced by people with dementia” (Bhadrdwa, 2015). People living with dementia require a formal diagnosis from physicians in order to continue to access further services. There are numerous factors that prevent individuals from living with dementia to seek a diagnosis. First, physicians and families view an individual living with dementia as dying given this protracted course and gradual loss of cognition and function.
Efforts to diagnose dementia at earlier stages and the development of new treatments which may possibly be used in advanced dementia, possibly will make it even difficult for many to view patients with dementia as dying. Additionally, families and clinicians may continue to view dementia as causing death even after acknowledging that dementias are a progressive and incurable disease. This also poses a barrier to progress care treatment. In a real sense, people living with dementia normally die cerebrovascular disease, cardiac disease, and pneumonia (Burns, Jacoby, Luthert, and Levy, 1990).
Secondly, many health profession does not have the ability to accurately identify and diagnose the disease, especially during the early stages. Due to their interactions with patients, practice nurses are regarded as the key to diagnosing cases of dementia. Gavin Terry, a policy manager at the Alzheimer’s society states “ People with dementia quite commonly have other long-term conditions such as diabetes or cardiac disease, managed by practice nurses. Because of this it is vitally important for nurses to have an understanding of dementia in order to identify it” (Bhadrdwa, 2015).
Treatment Options for Dementia and Goal-Oriented Cognitive Rehabilitation to achieve Standard Satisfaction
It can be challenging to diagnose dementia. Its diagnosis requires at least two core mental functions to be impaired enough in order to interfere with the patient’s daily life. According to Mayo Clinic (2019) these mental functions include memory, language skills, reasoning and problem solving, and visual perception. A physician will review the medical history and symptoms of the patient and perform numerous tests to diagnose dementia. However, there is no cure for dementia, but the symptoms can be managed. Some of the medications which are used to manage the symptoms of dementia include; cholinesterase, memantine, and other medications for treating a condition like depression or agitation. Cholinesterase is primarily used to treat Alzheimer’s but it can also be used to Lewy body dementia, treat vascular dementia, and Parkinson’s disease dementia. The mechanisms of this medication are to boost the levels of a chemical messenger involved in memory and judgment. Memantine regulates the activity of glutamate.
According to a study done by Hindle, Watermeyer, Roberts, Brand, Hoare, Martyr, and Clare (2018), cognitive rehabilitation helps dementia patients achieve goals. As a result, the patients get more satisfaction from attaining the goals. Goal-oriented cognitive rehabilitation reduces stress in dementia patients and also ensures that they live a better quality life. Goal-oriented cognitive rehabilitation is potentially an effective treatment dementias (Hindle, Watermeyer, Roberts, Brand, Hoare, Martyr, and Clare, 2018). In goal-oriented cognitive rehabilitation, individuals living with dementia work together with their family members and physicians to identify needs and goals, then try to achieve the goals.
Family Caregiver’s Subjective Experiences of Satisfaction in Care for Dementia
Disease and disability are sources of great psychosocial stress. Family caregivers experience both positive and negative reactions in caregiving situations. Providing the best care is regarded as a source of satisfaction and this is derived from; the interpersonal dynamic between the dementia patient and the caregiver, intrapsychic orientation of the caregiver, and from the desire of ensuring that there is a positive outcome for the individual receiving the care. A family ought to maintain the dignity and self-esteem of the dementia patient.
Conclusion
Dementia has become the main challenge worldwide. The disease is characterized by impairments in thoughts, communication and memory. The disease is mostly associated with old people. Dementia dates back to ancient times where is was documented by Egyptian psychiatrists. Advance in medical technology improved the understanding of dementia and its causes. Current statistics indicate that cases of dementia are growing rapidly. Thus, policies and models ought to be developed to meet the preferences and needs of dementia patients.
References
Bhardwa, S. (2015). Barriers to Dementia Care. [Online]. Available at: http://www.independentnurse.co.uk/news/barriers-to-dementia-care/72505 . Accessed 19 th April 2019.
Hindle, J., Watermeyer, T., Roberts, J., Brand, A., Hoare, Z., Martyr, A., and Clare, L. (2018). Goal-Oriented Cognitive Rehabilitation for Dementias Associated with Parkinson’s Disease- A Pilot Randomised Controlled Trial. [Online]. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.4845 . Accessed 19 th April 2019.
Mayo Clinic. (2019). Dementia. [Online]. Available at: https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019 . Accessed 19 th April 2019.
The University of Queensland. (N.d). History of Dementia Research. [Online]. Available at: https://qbi.uq.edu.au/brain/dementia/history-dementia-research . Accessed 19 th April.
World Health Organization. (2012). Dementia: A Public Health Priority. [Online]. Available at: https://www.who.int/mental_health/publications/dementia_report_2012/en/ . Accessed 19 th April 2019.
