Provide support to people living with dementia

1. Mavis suffers from severe dementia (this question has to be refer with the
text content)

Your client Mavis suffers from severe dementia. Prior to her diagnosis, she
participated in many social activities including the country women’s group, line
dancing, and regularly attending church. But after the diagnosis, her condition
worsened to the point that she could no longer live in her own home and she
now lives in an assisted living facility. She regularly forgets what day it is and
gets frustrated over her unfamiliarity with time.

a. In what ways could you assist to make the transition from home to the
assisted living facility easier for Mavis.

Answer: a. I would assist Mavis to make a transition from home to assisted living
by employing a person cantered approach in all my interactions with her by

Getting to know her as a person and build trusting relationship with her.
Sharing of power and responsibility, respecting preferences and treating her as
partners in setting goals, planning care and making decisions about care, treatment
or outcomes.
Meeting her choices through providing timely, complete and accurate information
which she can emphasise freedom of choice.
physical and emotional comfort
Involving the person’s family and friends, as appropriate
 Putting up her picture and his family in her room
 Involved her with line dance
 Involved her with the church
 Encourage her to join women group
 Keep calendar in her room and help her to mark them or put the
digital clock display date

b.  How can you find out more information about Mavis?

Answer : ways to find out more information about Mavis will include by asking
family members, spouse and other careers.

 From the friend’s church

  Observing her
 Check on her previous medical history

c.  Give two examples of how you would ensure person-centred practice in this
scenario.

Answer : by ensuring she is involved in choosing activities and the care which she
wants by respecting her choices and preferences.

1. Involved mavis in activities in dance activities she like.

2.
d. When communicating with Mavis, what are some communication strategies
you can use in order to gain her trust.

Answer ; communicating strategies I can use in order I can gain her trust include
verbal and non-verbal communication strategies like being a good listener and the
use of intuition.

 Listening to her feelings and observing nonverbal cues

 Address her by name or prefer name (Mr/miss)
 Use calm and gentle voice
 Never argue
 Talk slowly and use simple English words.

e. Describe what activities you could arrange for Mavis in order to enhance her
self-esteem as well as allow her to maintain as much independence as
possible.

Answer: Activities I could arrange for Mavis in order to enhance her self-esteem
as well to maintain as much independence is activities which include her existing
skilled like dancing and her familiar routine like attending church.

Dance, church, women group or crafts

f. In what ways could you address any possible stigma in relation to this
scenario?

Answer : ways to address any possible stigma in relation to this scenario include
education of family and general public on dementia encourages family and the
general public to ask question to clarify concerns on dementia.
 2. Beth goes for a check up

Beth is your 67-year-old client who you are taking to the GP for a medical
check-up. You arrive at the house to find her in the backyard arguing and hitting
her husband with her hand and then with a newspaper. She is accusing him of
having a lady friend staying in the house. She appears confused and aimlessly
wandering in the garden, incessantly moving pot plants around and accusing the
next door neighbour of stealing them.

a. List the behaviours of concern exhibited by Beth.

Answer : * wondering, aimlessly wandering

 Repetitive behaviour, incessantly moving pots around

 Sun downing (wrong can’t used it), suspicious, accusing neighbours
and husband of something that is no real.
 Hitting the husband with hand and then newspaper


b. Which behaviours if exhibited by Beth would you consider a risk to yours

and other’s personal safety?

Answer : Behaviour that I would consider a risk to my and others personal safety
will be aggressive behaviour.

 Hitting
 Moving the pot
 Accusing
 Aggressive behaviour
c. Using your workplace procedures as a guide, discuss the management
strategies you have used to manage behaviour of concern with a client with
dementia. Include in your answer:
 Its effectiveness
 Any assistance provided before during or after
 Evaluation of the management strategy
 Future plans
 Refer to the needs driven behaviour model

Answer: Management strategies to manage behaviour of concern Psychosocial

strategies. Doll therapy is a diversional intervention that provides people with
dementia an opportunity to interact with a “life-like” baby doll on a manner that is
therapeutic to them. Music therapy is the use to improve well-being. It can include
listening to music, singing, humming, play instruments and tapping to the beat.
Exercise and physical therapy is the use to movement to improve physical health
and wellbeing Validation therapy is a communication approach that “validate” or
accept the values, beliefs and reality of the person with dementia, even if it has
no perceived basis. Dementia friendly environments those that have been modified
of purposefully designed through the application of design principles that consider
the needs of with dementia. This strategy has been found to be effective the
management of behaviour concern.

Pharmacological strategies, use of medication to control these behaviours of

concern. This strategy has been found effective.

Needs driven behaviour model is a theory that a person may exhibit behaviours
when their needs are not met example : hunger, thirst. Toilet pain, fatigue,
temperature, over/under stimulations, social engagement. Maslow’s hierarchy of
needs is one way of conceptualising the priority of needs, with the needs
fundamental to survival being the foundation for higher order needs. Strategy is the
attempt to understand which individual unmet needs are contributing to behaviours
of concern and manage these needs prior to behaviours occurring.

 Distracting with fav food/ picture

 Calm her down and talking slow
 Identify her need and try to attend to it
 Music therapy

d. What could the potential triggers for these behaviours of concern have
been?

Answer : Potential triggers to behaviour of concern include:

Fatigue

 Disruption of sleep patterns causing sleep deprivation

 Physical discomforts such as pain, fever, illness or constipation
 Loss of control over behaviours due to the physical changes in the
brain
 Adverse side effects of medication
 Impaired vision or hearing causing the person to misinterpret sight
and sounds.

e. In what ways could the other members of your team be of value when
caring for clients with dementia?
Answer : by contributing to team discussion on support planning and review of
care plan

 Sharing of strategy/ technique



f.  In what ways could you provide support to Beth’s husband in this
instance?

Answer ; ways to provides Beth’s husband include :

 Introducing him to dementia support group, suggesting ways to

manage stress, encourage him to ask question to clarify and issues
he has and to ask for help when he needs help.

g. Following your workplace procedures, what reports or documentation would

need to be completed following care of Beth on this day?

Answer : documentation to be complete this day following care of Beth will be

progress report.

 Incident report
 Change in behaviour
 Progress note or daily journal

h.  Detail how you would complete the documentation in line with your
organisation’s procedures relating the collection storage and dissemination of
information.

Answer : I will complete the documentation in the clients home maintaining privacy
by ensuring I do not leave the files unattended but secures at all the times and
ensuring the following requirements:

 They must be legible with correct spelling and grammar. If your

handwriting is unclear or difficult to read, then it is advised to print
your report.
 They must be written in plan English
 The year, date, and time must appear on each entry
 The record must clearly identify on each page the client’s

i. What possible impacts could Beth’s illness have on Syd or other family
members?
Answer ; Possible impact of Beth;s illness on the family include stress, guilt, grief,
loss and anger

3. Peter moves in with family

After experiencing a number of health problems, Peter (85 years old) has recently
moved in with his son Joe and daughter-in-law Alyssa in an up-and-coming
subdivision just outside of the city. In recent months, Peter has experienced a
number of health concerns, including some falls and frequent problems remembering
things. Doctors think Peter might be showing signs of dementia.

Lately, Peter has noticed that he has not been receiving his mail as he did when
he lived by himself. Peter asked Joe if he has noticed anything about the missing
mail. Joe assures him that when the mail is delivered to the mailbox at the end
of their road, he makes sure to collect and open all of Peter’s mail to ensure it
is handled promptly. This makes Peter uneasy. He feels he is completely capable
of dealing with his own mail and does not feel that Joe needs to do it for him.
However, since he has recently moved in with Joe and is relying on Joe to help
him with some of his day-to-day tasks, Peter is fearful of confronting his son and
hurting his new living arrangement.

a. Do you see any signs of possible abuse? If so, what types of abuse?

Answer : Yes I see signs of possible abuse. The type of abuse is emotional
abuse/ psychological abuse as his son’s behaviour takes away his dignity.

b. How should you provide support services to an older person when suspected
or confirmed abuse is occurring?

Example :* Report suspected cases of abuse immediately to their supervisor.

 Offer the older person the opportunity to speak to the supervisor

directly.
 Record any direct observation, information or discussions with ( or
concerning) the older person that might indicate the abuse is
occurring.
 Follow the organisation policy and protocols when responding to an
older person experiencing abuse.
 Follow the actions recorded in the care plan
 Report back to supervisor of any changes or concern about the
directives of action steps recorded in the care plan which care staff
are requires to follow.
 c. How should you provide services to the client when the alleged perpetrator
is integral to the older person’s life?

Example : I would provide services to client when the alleged perpetrator I integral
to the older person’s life by

 Listening to the older person, enabling them to tell their story,

remaining calm, not jump to conclusions or passing judgement.
 Affirming that I have heard them, acknowledge their and wishes and
reaffirming that they have rights.
 Confirm with the older person that abuse of any kind is not alright
and they have a right to safety, dignity and to have their concerns
addressed.
 Explaining and addressing confidentiality issues that may arise and
assure the older person no action will happen without their explicit
permission unless it is a reportable assault as defined under the ACT

d.  Detail the strategies you have in place to monitor how stressful situations
have a personal impact on you as a worker.

Answer : strategy to monitor stressful situations impacts on me as a worker is by

recognized warning signs of excessive stress at work which include feeling anxious,
irritable. Or depressed, apathy. Loss of interest in work, problems sleeping, fatigue,
trouble concentrating, muscle tension or headaches, stomach problem, social
withdrawal.

e. In what ways can you ensure that you can de-stress following incidents like
those listed above?

Answer ; ways I can ensure that I destress after incidents like those listed above
include participating in workplace debriefing, taking care of myself by eating right,
doing some exercising and getting adequate sleep, prioritizing and organising all my
activities and maintain good habits.

4. Source recent research on dementia. Provide a short summary on:

    a. The common indicators and symptoms of dementia,

o The pathological features of dementia,

o Any other conditions that might correlate with the onset of dementia.

Answer : Dementia is not a disease, but a broad term to cover a group of

symptoms, the most common being memory loss. The common indicators of
dementia are memory lapses, such as difficulty in remembering dates or finding the
right words, impaired judgement resulting in financial or ill-consideration decisions,
behaviour and personality changes, such as becoming more assertive/ more
withdrawn, less flexible, showing a loss of interests in things that have mattered
previously, becoming absent- minded or repeating the same story or question.

 Symptoms

Symptoms of dementia are grouped into 4 different stages which serve as guides.

The first stage, changes in their memory or thinking people with dementia generally
use much the same language as most people do. They might forget a word, a
phrase or a memory and then create little story to fill the memory gap. Sometimes
they may also appear vague in the way they communicate.

The second stage, people with dementia are far more relaxed and inclined to give
in and let go. They may start to withdraw and appear to become preoccupied with
the past, thinking back to happy times, restoring old memories and sometimes
living in that and reality. Their way of communicating may change too. Sentence
construction may not be as clear.

The third stage, people with dementia start to withdraw even future into the past
and become so preoccupied with their memories that they “live” almost entirely in
that time and reality in that time and reality. They may also start to wander
language, at this stage, may consist mainly of one- syllable words. Such as “Yes
and No interspersed with only a keyword.

The fourth stage, people with dementia may completely shut out the outside world.
They might sit in a chair or lie in bed staring into thin air, or they might have
their eyes closed. They may not respond when someone walks into the room or
speak with them.

 Pathological feature of dementia

Gross pathological features, gross examination does not show any apparent
alternation that can be considered to be diagnostic. Microscopic pathological feaures
the 2-primary microscopic cardinal lesions associated with dementia are the
neurofibrillary tangle and the senile plaque. The neurofibrillary tangle consist of
abnormal accumulations of abnormally phosphorylated tau within the perikaryal
cytoplasm of certain neurons. The senile plaque consists of a central core of beta-
amyloid.
  Other condition that may correlate with the onset of dementia are

Dehydration can cause confusion and increased memory loss-both symptoms of

dementia.

Constipation

Infection. Eg pneumonia, urinary tract infection or even the smallest infection can
cause dementia symptoms.

Pain- can cause dementia symptoms:

Medication poisoning. This can occur easily in older people because their bodies
are less able to excrete surplus medication which can build up in the system and
create side effect.

Brain tumours

Depression can also cause symptoms similar to dementia, such as decreased

memory and concentration loss, often leading to misdiagnosis.