Types and causes of Dementia
Dementia is a general term for a collection of symptoms that occur due to impairment in the memory of an individual (Dyer et al., 2016). Interference with the thinking capacity of the patients interferes with the ability of an individual to perform daily chores. The primary types of dementia include Alzheimer’s disease and vascular dementia. Examples of causes of the complication include vitamin deficiencies and thyroid problems. The condition has physical, cognitive, and behavioral impacts on the patient. A majority of the clients are of advanced age above sixty-five years. This paper will discuss the findings based on an observation of a fifty-bed residential aged care facility located in a town of approximately thirty thousand people. The write-up will elaborate on how the patients of dementia have difficulties in accessing their physical environment. The discussion will relate to the physical and cognitive changes due to the disease. Finally, the essay will discuss the recommendation for an enabling environment for the patients.
The team of experts visited the aged care facility to explore the impacts of dementia on the patients. The investigators conducted both individual and group interviews with the selected patients. The researchers also checked on the medical records of the patients for more information. Data analysis was through SPSS and the findings recorded for future reference.
The physical and the cognitive impacts of dementia make the patients have difficulties in accessing the aged care facility (Eshkoor, Hamid, Mun, & Ng, 2015). The complication makes it difficult for the clients to recognize places and people. Therefore, when the patients go out of the facility, they find it hard to identify the location of the hospital and the other patients. The disease also makes individuals forget their way into the hospital and the specific bed where they always rest. Dementia makes patients have a poor memory; thus finding it hard to locate their bed space.
The information from the medical records of the patients also indicates that the patients get confused easily. Consequently, the clients can forget the bed space of fellow patients for their own. The patients also noted that they have deficient levels of attention and concentration. Therefore, it is easy to distract the patients due to the default in their memory (Wong et al., 2016). The disease also disrupts the thinking capability of the patients. The clients also find it hard to solve simple problems within the health facility. An example is when the patient recognizes a running water tap but fails to close the valve.
Impacts of Dementia on Physical Environment
Apart from the cognitive impacts, dementia also has physical effects on the patients. The disease impairs the ability of the patient to move from one place to the other. A majority of patients walk by drugging their feet and shuffling (Carr, & O’Neill, 2015). The client also finds difficulty in sitting up. The impairments make the patients spend a majority of their time in a sleeping position. Therefore, the family of the patients should take them to the aged care facility for adequate medical attention.
The complication decreases the sensitivity of the patients. The clients can lose the sense of sight, hearing, and smell after the development of dementia (Irish, & Piolino, 2016). Therefore, the patients who have lost sight find difficulties in walking during the night or in poorly-lit places. The disease also makes an individual restless and sleepy at most times. Individuals who are always sleepy cannot stand for long as they can fall. Dementia weakens the immune system of patients thereby increasing their vulnerability to infections. Therefore, factors like bright lights can interfere with the sights of the patients.
The disease interferes with the normal breathing and pulse cycles of patients (Nehen, & Hermann, 2015). An individual with an irregular pulse and breathing issues cannot walk for extended periods as they can collapse on the way to their destination. The condition also results in pain in most of the body parts of the clients. Pain experienced in the legs hamper the ability of an individual to access their physical environment. Therefore, irregular breathing and pain minimize the capability of a person to conduct daily chores.
Dementia makes it difficult for the patients to swallow drinks and food. An individual who cannot eat lacks the energy to move around and access the physical environment. The difficulty in eating lowers the interests of patients in taking meals. Recent research has shown that a majority of patients lose weight during the onset and progression of the disease. The disease also impairs the bowel and bladder functions of the clients (Petersen, 2016). Therefore, it is common to find the patients urinating and defecating on themselves. The cognitive and physical impacts of dementia impair the ability of patients to access their physical location.
An enabling environment is essential to enable the dementia patients to manage the cognitive and the physical impacts of the condition. The first recommendation is to establish effective signage that can help the patients to locate the aged care facility (Bond, Jorm, Kitchener, Kelly, & Chalmers, 2016). The patients have a hard time recognizing their beds and their fellow patients. The health facility should write the name of each patient on their couches for easy recognition. The typists should write the name in bold letters with a different color from that of the bed. The health facility should also label the doors to avoid confusion.
Impacts of Dementia on Cognitive Functioning
The old health facility should ensure that the door signs are well-lit and are on the same level as the position of the eyes. The patients cannot remember the door of their room at the hospital; thus require a well-lit indication to judge their memory. The healthcare stakeholders should strategize the signs at a decision point. Strategic placement of signs assists patients due to their poor memory (Bennett, 2015). The disease impairs the bowel and bladder function of the patients. Therefore, placing visible signs that indicate the location of the toilet to helps the patients to ease themselves.
Apart from signage, proper lighting is a necessity in the aged care facility. The complication limits the ability of an individual to move from one place to the other. Therefore, properly lighting the entrance facilitates the movement of the patients around the facility (Turner, 2018). The lighting engineers should apply the natural light in the streets, corridors, and the wards; since artificial light has a reduced clarity. The disease decreases senses such as that of sight; therefore, an effective remedy should improve the ability of an individual to see correctly. The health facility should avoid bright lights as it can interfere with the sight of the patients.
Efficient flooring also helps the patients to cope with physical impacts of dementia like difficulty in mobility. The health facility should ensure that the floors are neither slippery nor reflective (Waller, & Masterson, 2015). A floor with has the two characteristics aids an accident-free accessing of the aged care facility. Dementia makes the patients drug their feet when walking and also develop a shuffling mode of movement. Therefore, the hospital administrator should ensure that the floor is leveled to accommodate the impaired walking style of the clients. The cleaners should also provide that the floor is dry before allowing the patients to move around.
The aged care facility should also improvise the seating facilities to improve the health of the patients. The complication makes the patients have irregular pulse and breathing; hence cannot stand upright for long hours. Therefore, the facility should place sitting facilities in areas such as dining halls where patients queue for food. The complication disables the capacity of patients to sit up. The hospital should replace hard benches with wooden ones to facilitate comfortable sitting (Chau et al., 2018). Additionally, the wooden chairs should contain cushions to solve the sitting problem that arises due to the progression of dementia.
Enabling Environment for Dementia Patients
Proper navigation assists the patients to move from one location to the next. Dementia patients easily get confused and cannot think clearly. Therefore, they can confuse a given building to be the aged care facility. The government should build the hospitals near attractive landmarks to help the patients in locating them (Meyer, Dow, Hill, Tinney, & Hill, 2016). Apart from finding the health facility, landmarks also assist the patients to locate essential rooms like the toilets and the bathroom. Consequently, the hospital administrator should ensure that the basic rooms are distinct to avoid confusion.
Conclusion
Dementia is a collection of symptoms that impair the memory of an individual. The complication has cognitive and physical impacts on the patients that minimize the ability of the clients to access their physical environment. The condition makes it difficult for the patient to recognize places or people. Therefore, the patients at the aged care facility fail to identify their wards and fellow clients. The complication also leads to poor memory during its onset and progression. Patients with dementia get confused easily and cannot think properly. Physical impacts include the inability to move from one place to the other and difficulty in sitting up among others. An improvement in the conditions in the health facility helps the patients to cope with the cognitive and physical effects of the disease. The enhancement includes proper signage, lighting, and flooring. Other improvement strategies include adequate seating and navigation.
References
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Bond, K. S., Jorm, A. F., Kitchener, B. A., Kelly, C. M., & Chalmers, K. J. (2016). Development of guidelines for family and non-professional helpers on assisting an older person who is developing cognitive impairment or has dementia: a Delphi expert consensus study. BMC Geriatrics, 16(1), 129.
Carr, D. B., & O’Neill, D. (2015). Mobility and safety issues in drivers with dementia. International Psychogeriatrics, 27(10), 1613-1622.
Chau, H. W., Newton, C., Mei Min Woo, C., Ma, N., Wang, J., & Aye, L. (2018). Design Lessons from Three Australian Dementia Support Facilities. Buildings, 8(5), 67.
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Nehen, H. G., & Hermann, D. M. (2015). Supporting dementia patients and their caregivers in daily life challenges: a review of physical, cognitive and psychosocial intervention studies. European journal of neurology, 22(2), 246-e20.
Petersen, S. W. (2016). Missed Diagnosis? A Patient With Cognitive Impairment. The Journal for Nurse Practitioners, 12(2), e53-e54.
Turner, T. (2018). Dementia care: an overview of available non-pharmacological therapies. Lung cancer, 15, 05.
Waller, S., & Masterson, A. (2015). Designing dementia-friendly hospital environments. Future Hospital Journal, 2(1), 63-68.
Wong, S., Bertoux, M., Savage, G., Hodges, J. R., Piguet, O., & Hornberger, M. (2016). Comparison of prefrontal atrophy and episodic memory performance in dysexecutive Alzheimer’s disease and behavioral-variant frontotemporal dementia. Journal of Alzheimer’s Disease, 51(3), 889-903.
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