With the predicted rise in the population of older people, will come a rise in number of people with dementia and, therefore, an increase in some of the problems and barriers they face. As people live longer with the condition, our role is to ensure we can help people with dementia to live as full a life as possible. We offer an insight into the issues people with dementia often face so that your employees are aware of these when caring for them.
Dementia is a catch-all term for a group of conditions affecting the brain. Some of the symptoms are specific to the type of dementia and some are more general. The table to the right outlines the different types of dementia and their associated signs and symptoms.
Understand the Reason Why Dementia is on the Increase
Although you might think that the number of people with dementia is quite small (currently there are approximately 850,000 people with the condition, which accounts for less than 1% of the population), this figure is rising. The older population is to get increasingly larger over the next 10–15 years, with predictions that it will rise by over 30% during this time. However, the biggest increase will be in people aged 90 and over which will rise by 72% (as projected by the Projecting Older People Population Information System). This is significant as the incidence of people developing dementia increases with age. Therefore, a rise in the older population will mean a rise in the number of people more likely to have dementia.
Dementia is an Expensive Business
Each year, dementia costs the UK £26 billion. However, not all of it is paid by the NHS, which only contributes £4.3 billion, with local authorities picking up £4.5 billion. The highest amount paid is by service users and their family and friends who pay out a whopping £17.4 billion, either to pay for private social care (£5.8 billion) or in unpaid care (£11.6 billion). As this is the case, service users, family and friends are an extremely influential part of the care provision, and you should include them in any discussions about dementia care.
As this is such a costly condition, with no cure as yet, the Government is putting large amounts of money into research to either find a cure, to halt the condition or to prevent dementia from occurring in the first place. In the meantime, it is striving to help people to live well for longer with their dementia, thereby deflecting some of the cost associated with the condition.
As part of the Prime Minister’s Challenge on Dementia 2020 Implementation Plan published in 2016, a Well Pathway for Dementia has been developed, to assist organisations when developing their own dementia strategies to help people stay well.
How to Use the Well Pathway for Dementia
The Well Pathway for Dementia has 5 main pillars as follows:
1. Preventing Well – this will require you to give people information about the ways in which they can prevent the onset of dementia.
2. Diagnosing Well – this means if you recognise that a person may have dementia, you take steps to get this confirmed.
3. Supporting Well – this means you provide care and support to people with dementia.
4. Living Well – this will require you to help people to live as normal a life as possible.
5. Dying Well – this will require you to help people die with dignity.
In addition to these, there are 5 more areas that need consideration to complete the Well Pathway for Dementia. These are:
1. Researching Well.
2. Integrating Well.
3. Commissioning Well.
4. Training Well.
5. Monitoring Well.
You can download the Well Pathway for Dementia from https://tinyurl.com/y7qc3uct
Help People to Prevent the Onset of Dementia
This will require you to raise awareness amongst your staff of the risk factors associated with developing dementia so that they help reduce these. The Alzheimer’s Society suggests the following ways to reduce the risk:
• Encouraging people to eat a healthy diet i.e. one that is higher in fruit, vegetables and fibre and lower in saturated fat, sugar and salt.
• Maintaining a healthy body weight i.e. one with a BMI between 20 and 25.
• Getting a bit of exercise. The recommended amount is 150 minutes of aerobic exercise a week, which amounts to 20 minutes a day. Walking is a good exercise.
• Stop smoking and reduce alcohol consumption i.e. stay within the 14 units recommended each week.
• Reduce loneliness and social isolation, as a means of reducing depression.
Ensuring People Receive a Dementia Diagnosis
Without a dementia diagnosis, the person is unable to receive the services they need. This will include medication to help prevent or delay the early onset of symptoms. However, the number of people who receive a dementia diagnosis is not particularly high, in England it is 71%. Although this figure is an increase on the 45% of just a few years ago, it is still not good enough and the Government want to do more to increase this.
Your staff can assist with this by understanding the signs and symptoms, and reporting these on to their manager, if this is not you. You can then refer the person to the GP so that he or she can confirm a dementia diagnosis.
Once this diagnosis is in place, your service user can access many services to assist them along the Well Pathway such as:
• Attendance at their local dementia café.
• Attendance at memory clinics.
• Access to suitable activities.
Providing Effective Support to People with Dementia
There are a number of problems people with dementia can experience and your staff need to be aware of these so that they can provide the appropriate support for the person. Problems can include:
• Memory loss – people with dementia often have problems remembering the names of those around them, forgetting where they have put things e.g. glasses, getting lost on simple journeys, such as, to the toilet.
• Aggression – this can include being verbally aggressive, such as swearing, shouting and making threats, to physical aggression such at hitting, pinching or biting.
• Agitation or restless behaviour such as fidgeting or walking about – there is usually an underlying reason for this such as pain, hunger, needing the toilet, boredom, etc.
• Communication problems – unable to get their needs and wishes over to others, jumbled words, or repeating the same words and phrases repeatedly.
• Isolation from friends and family – receiving a dementia diagnosis may isolate the person from family and friends who do not know how to react or behave in front of the person.
To support a person with dementia to live well, your staff will need to know how to manage these problems.
|Types of Dementia and their Signs and Symptoms|
|Type||Signs and Symptoms|
This is the most common form of dementia with 62% of people having this type of dementia.
It is caused by a build-up of proteins in the brain which leads to the loss of connections between nerve cells that eventually die.
|Signs and symptoms become progressively worse as time goes on and include:
This form of dementia is the second most common type accounting for 17% of people with a dementia diagnosis.
Symptoms occur when the brain becomes damaged due to problems with the supply of blood to the brain.
|Dementia with Lewy bodies
This condition accounts for 10–15% of people with dementia.
It is sometimes mistaken for Alzheimer’s as it is also to do with protein deposits that infiltrate brain cells, causing disruption to the normal funtioning of the brain.
|In addition to the normal signs and symptoms of Alzheimer’s disease above, they may also exhibit the following:
|Other (Rare) Types of Dementia|
(sometimes called Pick’s disease).
|Creutzfeldt-Jakob Disease (CJD)