IMPROVING DEMENTIA SERVICES

Is Your Loved One Ready for Assisted Living Care Because of Memory Loss?

Dementia, covers a range of progressive, terminal brain conditions which affect an estimated 600,000 people in England and this number is rising rapidly. People with dementia require a complex mix of health and social care with patients regularly moving across organisational boundaries. The effectiveness of care depends on co-ordination and co-operation between the NHS; social services; care homes; and the voluntary sector. This is where Carefirst 24 Ltd who has got a group of professionals dedicated to improve the care and quality of life for service users who suffers from such condition. We envision Carefirst 24 to be globally recognized as the resource of expertise on dementia.

Stigma and negative attitudes towards mental illness and old age further exacerbate the problem. Dementia costs £8.2 billion a year in direct health and social care costs but much of this spend is in response to crisis, in the later stages of the disease.

The Department of Health recognizes that dementia would become a national priority and that it would be developing a National Dementia Strategy.

In February 2009 the Department launched an ambitious and comprehensive five-year National Dementia Strategy aimed at helping people to live well with dementia.

What is dementia?

The term 'dementia' is used to describe the symptoms that occur when the brain is affected by specific diseases and conditions. These include Alzheimer's disease and sometimes as a result of a stroke.

Dementia is progressive, which means the symptoms will gradually get worse. How fast dementia progresses will depend on the individual. Each person is unique and will experience dementia in their own way.

Who gets dementia?

• There are approximately 1 million people in the UK with dementia.
• Dementia mainly affects older people. However, it can affect younger people: there are over 16,000 people in the UK under the age of 65 who have dementia.
• Dementia can affect men and women.

Unusual behaviour

If you are caring for a service user with dementia, you may sometimes find as dementia develops, it can cause behaviours changes that can be confusing, irritating or difficult for others to deal with, leaving carers, partners and family members feeling stressed, irritable or helpless. By learning to understand the meaning behind the actions, it can be easier to stay calm and deal effectively with the challenges that arise.

Each service user is an individual, with their own preferences and character traits. However, certain forms of behaviours are particularly common in service users with dementia. If the service user  you are caring for has difficulty expressing him or herself in words, the unusual behaviours may become more extreme. By working out what each behaviours means, and finding ways to overcome the problem, the situation can become more manageable.

Common types of unusual behaviours

Repetitive behaviours

Service users with dementia often carry out the same activity, make the same gesture, or ask the same question repeatedly. Medical professionals sometimes call this 'perseveration'. This repetition may be because the service user  doesn't remember having done it previously, but it can also be for other reasons, such as boredom.

It is not unusual for a service user with dementia to go through the motions of the activity they may previously have carried out at work. Specific types of repetitive behaviours may include:

• Asking the same question over and over again ? As well as memory loss, this can be due to the service users feelings of insecurity or .......
• Repetitive phrases or movements ? this can be due to ......
• Repetitive actions ? Actions such as repeatedly packing and unpacking a bag, or .....
• Repeatedly asking to go home ? this may take place in residential care, or when the service user is already at home.  
• Multiple phone calls ? Some service users with dementia phone their loved ones over and over again ? particularly in the middle of the night. This can be very frustrating and distressing. The service user with dementia may forget that they have already called, or may be insecure or anxious. If you are receiving repeated calls, it may help to ........

Restlessness

Some service users with dementia suffer from general restlessness. This can be a sign of .......

• Pacing up and down ? Pacing may indicate that ....
• Fidgeting ? Someone with dementia may fidget constantly. As with pacing, try to .......

Shouting and screaming

The service user may continually call out for someone, shout the same word, or scream or wail over and over again.

• They could be in .......
• A person with dementia may feel ......
• If the person shouts out at night, try this ......
• If they are calling for someone from their past, try .......

Lack of inhibition

The service user may behave in a way that other people find embarrassing because of their failing memory and general confusion. In a few cases, this may be due to specific damage to the brain. Try to react calmly.

• Some service user with dementia may undress in public, having forgetten when and where it is appropriate to remove their clothes. If this happens, take the .......
• Stroking or exposing genitals in public, or apparently inappropriate sexual behaviour, may be a result of the physical damage to the part of the brain that allows us to recognise acceptable social behaviours. If this happens ......
• If the service user behaves rudely ? for example, by insulting people or swearing or spitting ? don't attempt to ......

Night-time waking

Many service users with dementia are restless at night and find it difficult to sleep. Older people often need less sleep than younger people in any case. Dementia can affect people's body clocks so that they may get up in the night, get dressed or even go outside. This can be very worrying ? and exhausting ? for carers.

• Make sure the service user has .......
• Try a .......
• If the service user wakes up, gently .......
• During the light summer months it can feel like daytime even late at night or very early in the morning, so ......

Trailing and checking

Living with dementia makes many service users feel extremely insecure and anxious. This can result in the service user constantly following their carers or loved ones around, or calling out to check where they are. A few moments may seem like hours to a service user with dementia, and they may only feel safe if other people are nearby.

• This behaviour can be very difficult to cope with, but try not to .....
• If you are busy, give the service user .......
• You as a carer make sure you .........

Hiding and losing things

Service users with dementia sometimes hide things and then forget where they are ? or forget that they have hidden them at all. The wish to hide things may be due to feelings of insecurity and a desire to hold on to what little the service user  still has.

• However impatient you feel, try to be ........
• Don't leave ......
• Try and find out the service user`s .....
• If the service user hides ......

Suspicion

Some service users with dementia can become suspicious. If they have mislaid an object they may accuse someone of stealing it, or they may imagine that a friendly neighbour is plotting against them. These ideas may be due to failing memory, an inability to recognise people, and the need to make sense of what is happening around them.

• If this happens, state .....
• Try to remember that although the service user`s .....
• Explain to others that they should .......
• Don't automatically dismiss the service user`s suspicions if there is any possibility that they may be true.

Tips: Coping with unusual behaviour

• Try to remember that the service user  you are caring for is not being deliberately difficult. 
• Ask yourself whether .......
• Try to put yourself in the service user`s  situation. Imagine how they might be ......
• Offer as much ....
• Remember that all behaviour is a means of communication. If you can .....
• Distract the service user  with .......
• Try to make sure that you have .....
• Some people find unusual behaviours, particularly a repetitive behaviour, very irritating. If you feel you can't contain your irritation, make ......
• If you find the service user`s behaviour really difficult to deal with, ask for ......

This is our expertise, please do feel free to give us a call on 0208 241 6900 for any further assistance