Nursing Case Study Dementia Care

Three million people over the age of 65 are diagnosed with the irreversible condition known as dementia, a disorder of the brain that will cause memory loss and difficulty with communicating. Many people mistake dementia as an illness, but it really is a set of symptoms that cause impaired thinking and memory. How can we better understand dementia in order to give the best care towards dementia patients? Spreading awareness of this disease is important so that people can catch the symptoms early enough to protect the health of Canadian older adults so that they can maximize their quality of life. It is also an important issue in nursing practice because nurses need to be aware of the proper care needed to be given to dementia patients as it

is a very fragile time in both the patient and families life. Using the CINAHL database, I searched for articles using the terms “nurs*” and “dementia”, which gave me 100 results. Using these results, I chose the articles that allowed me to gain a better understanding of dementia in the elderly.
The cause of dementia is due to the damage of the cells in our brain. This damage affects the ability of these cells to communicate with each other. When brain cells cannot communicate to each other efficiently, they affect the way a person thinks, feels and behaves. Our brain is divided into different regions, with different functions for each. There are several types of dementia that a person may have, depending on which region of the brain is affected. The most common type of dementia is Alzheimer’s disease, due to a large amount of protein around the brain cells that make it difficult for the brain cells to stay healthy and have effective communication with each other. Symptoms of Alzheimer’s are memory loss, poor judgement, disorientation, confusion, changes in behaviour and difficulty speaking, walking and swallowing. In can be difficult trying to take care of a loved one with these symptoms, therefore quality care is required from health care professionals with efficient knowledge and experience to provide the quality of life that patients with dementia deserve.
The role of the nurse is of major importance in the health of dementia patients. The CNA (2015) Framework for the Practice of Registered Nurses in Canada states RNs are self-regulated health-care professionals who work autonomously and in collaboration with others to enable individuals, families, groups, and communities to achieve their optimal levels of health. Dementia care differs from standard care which makes it unique and requires the nurse to understand the patient better than anyone else. Meaningful activities are the foundation because they help residents maintain their functional abilities and enhance quality of life. The nurse must attend to the holistic needs of older adults, especially with dementia patients as they differ from an elderly patient without dementia. Nurses need to understand the patient and their biological background to allow the patient to feel comfortable about their personal hygiene, enjoyment of their meals, to partake in social activities, and meaningful activities. There are several challenges for the nurse to consider when implementing the interventions such as cognitive impairment, communication, and a decline in problem solving, thinking and perception. Communication is a major challenge in dementia care as the patient cannot find the right words or the name of objects. These challenges may be overcome by getting to know the patient effectively that will help the nurse depict when something is wrong to provide the highest quality of care.
Barnes (2012) conducted a study in regards to providing quality, professional care to residents with dementia predisposed to agitated and violent behaviors.

The study suggests that dementia patients change due to their progressive loss of capacity. Due to this loss of knowledge base, the unintentional outcome could be the abuse or neglect of the patient with dementia (Levin, et al., 2003), resulting in agitated and violent behavior as an unintended result. Dr. Tom Kit-wood observed that the manner in which people with dementia were cared for contributed greatly to their experience. This is why the role of the nurse in dementia care is so important. Person-centered care of dementia patients is a philosophy the recognizes that these individuals have equal right to dignity, respect and to participate fully in their environment. The study also found that when living in a long term care home, it is important that it has a homelike habitat to provide home-like experiences for residents. The study found that these environments have dramatically reduced the incidence of agitated and violent behaviors. Due to the loss of verbal communication, the nurse’s role is dependent primarily on non-verbal communication. The nurse must get to know the patient’s non-verbal’s such as gestures, body language and facial expressions. It is important for nurses to understand rather than manage the patient’s

behavior.
Peacock (2008) conducted a study about the moral challenges involved in palliative end-of-life dementia care. the study discussed the moral issues that arise for nurses when caring for those living in a LTC facility with end-stage dementia and the implications for nursing practice. Dementia patients lose the capacity to make decisions about their care in the early-to-middle stages of their disease which is unlike other terminal illnesses. Due to the slow progression of functional and cognitive decline, it makes it difficult to determine when a dementia patient enters the end-of-life stage. Due to this stage being hidden, it may lead to inappropriate care for a person with end-stage dementia. The symptoms a person with end-stage dementia experience are more pain, greater shortness of breath and more hospitalizations, as well as increasing functional needs. End-of-life care is an opportunity for nurses to become leaders for change in practice. By improving education and knowledge about end-of-life care, nurses will be able to face the moral issues with more confidence which will improve the quality of health care in dementia patients.
Thornton (2011) conducted a study about person-centered care as an ethical approach to care for people with dementia living in long-term care residential settings.

The stigma behind persons with dementia is that they are less than fully human. This study discusses the importance of individual personhood care in order to preserve autonomy of the individual and contributes to a personalized care environment in which the individual can thrive. Person-centered care can improve the quality of life for persons living with dementia. Preserving personhood is essential for the physical and mental well-being of persons with dementia (Buron, 2008). When nursing staff are educated and trained in person-centered care, they report greater job satisfaction and there is also decreased staff turnover. Life story work is a creative method for discovering the person behind the patient. It involves nurses working with a person and their family to find out about their life, recording the information, and then using the information with the person in their care (McKewown, et al., 2010). This intervention is relevant to understanding dementia in the elderly because nurses have the ability of enhancing a dementia patient’s quality of life, and person-centered care is a way to achieve

this.
In conclusion, dementia is increasing in those aged over 65 years of age and it is important that nurses have the knowledge and education needed to provide the best quality of life that those diagnosed with dementia deserve. Dementia causes pain and suffering to both the patient and their family in physical, psychological and social ways. By getting to know the patient and their family through the use of personhood care, learning about their life story and with an efficient educational background, nurses have the opportunity to improve their quality of life which is the overall goal in dementia care.