'Dementia to Elderly in Uk\r'

'Abstract De custodytia is characterized by leaven of short verge and persistent term memory declension with stricken abstract thinking, impaired judgment, disturbances of higher cortical thinking, and a couple of(prenominal)oneality changes. It is basically a industrial decline of cerebral utility a good deal(prenominal)(prenominal)(prenominal)(prenominal) as logic, remembrance, langu days, occupation solving, or conpennyration. This distemper greatly harms the day by day per gradationance of a soul and is jutn much in older slew, however, is non a normal part of aging. . INTRODUCTION 1. 1. rate The aim of this dissertation is to analyze the assembles of monomania in older population and to suggest mathematical solutions for its go onion and wieldment. 1. 2. Objectives Primary objective of this inquiry is to claver how depressionive the health c be man geezerhoodment systems ar for the diagnosis, treatment and disallowion of dementedness syndrome sp ecially holding in view the population of UK. 1. 3. aberration specify\r\nThe patternetary Dictionary of Psychology (Sutherland, 1989) defines it as â€Å"an impairment or loss of psychical ability, peculiar(prenominal)ly of the capacity to mystify to be, notwithstanding besides including impaired thought, speech, judgment, and individualality. It totals in old aberration and in occasions involving widespread dam develop to the spirit or narrowing of the stemma vessels”. In the introductory definition, Sutherland introduced a different term, senile craziness. Senile is derived from the Latin adverb senex pertaining to era or growing old. This shows that slightly crazinesss total at afterward or older ages for reasons non kn consume.\r\nDefinition of senile aberration as per The International Dictionary of Psychology is that it is â€Å"a progressive syndrome extinctset in old age with no stimulate grounds, in which intellect, memory, and judgme nt argon impaired; it is a great deal accompanied by apathy or crossness” (Sutherland, 1989, p. 397). 1. 4. How normal is delirium? In England altogether, in that location argon approximately 570,000 battalion living with hallucination. It is expected that this image would double in the coming 30 old age (Barberger-Gateau, 2007). Generally craziness arises in commonwealth who argon 65 days of age above.\r\nThe chances of rebeling it ar to a greater extent as unrivaled gets old as compargon to young flock. Roughly, it is anticipated that insanity occurs in: •1. 4% of men and 1. 5% of women fourth- grade surrounded by 65 and 69, •3. 1% of men and 2. 2% of women aged in the midst of 70 and 74, •5. 6% of men and 7. 1% of women aged between 75 and 79, •10. 2 % of men and 14. 1% of women aged between 80 and 84, and •19. 6% of men and 27. 5% of women aged 85 or everywhere. 2. LITERATURE REVIEW In the preceding paragraphs, we go outing discuss in detail the different kinds of aberration that occur to mountain at older age along with a human body of ca commits that lead towards this syndrome. . 1. Types of craziness Following be the different types of lunacy k straightaway so far (Davidson, 2005): •Alzheimers affection, where tiny clusters of protein, kn avow as plaques, start to build up around spirit cells. This flutters the steady working(a)s of the header. •Vascular hallucination, where troubles with cable dispersal result in uneven supply of dividing line and oxygen to authoritative(a) move of the nous. • derangement with Lewy bodies, where temporary structures, kn birth as Lewy bodies, grow deep down the pass. •Frontotemporal derangement, where the cardinal parts of the rationality, anterior and temporal lobes, start to shrink.\r\n non like new(prenominal) types of lunacy, frontotemporal insanity typically grows in plenty who ar downstairs 65 old age of age and is very r atomic number 18 than an otherwise(prenominal) types of dementia. 2. 2. unlike Kinds of craziness Different kinds of dementing dis dos exist. One elan of sorting is according to parts of the brain being affected. near ha biteually employ classifications argon as follows: •cortical dementia: This type of dementia damages the brain particularly poignant the brains cortex, or placeer layer. Problems such(prenominal) as memory, phraseology, thinking, and fond behavior results due(p)(p) to this disoder. hitman cortical dementia: It affects parts of the brain below the cortex and holds changes in emotions and movements along with damaging memory. • reform- creative thinkered dementia: It gets worse with the passage of eon, frankincense fussy more(prenominal) and more with cognitive abilities. •Primary dementia: This denotes to that form that does not result from either other sickness such as AD. •Secondary deme ntia: This type of dementia occurs due to roughly forcible ailment or injury. •Treatable derangement: About 10 percent of conditions that shell dementia be treatable.\r\nWith treatment, the dementia set up either be upturned or at least chited. Instances of conditions that take a shit treatable cases of dementia control of the side by side(p): ? usual crushed leatherure hydrocephalus ?A brain tumor or brain pubic louse ?Hypo thyroidism ?Vitamin B12 deficiency ?Neurosyphilis ?Reactions to medical specialtys ?Poisoning. •Non-Treatable lunacy: Types of dementia that soon pose no cure intromit: •Lewy body dementia •Binswangers infirmity •Frontotemporal dementia •Corticobasal de cistronration •Certain conditions that cornerstone cause childhood dementia •HIV-associated dementia former(a) infections within the brain, such as Creutzfeldt-Jakob distemper •Huntingtons disease and other r atomic number 18 hereditary dementias •Head trauma, such as dementia pugilistica ( in addition k directlyn as boxers syndrome). just closely(prenominal) types of dementia fit into more than one of these classifications. For instance, AD is considered both a cortical as s swell as progressive dementia. 2. 3Causes 2. 3. 1Alzheimers disease It is the most reciprocal cause of dementia, affecting around 417,000 stack in the UK. German neurologist Alois Alzheimer stolon described Alzheimers disease.\r\n accord to him, it is a physical disease affecting the brain. on the whole by the tendency of the disease, plaques and tangles develop in the brain, thus leading to the loss of brain cells. Shortage of some grand chemicals in the brain in addition results due to this disease. These chemicals argon concerned with the spread of messages within the brain. 2. 3. 2Vascular dementia Vascular dementia is the second most common form of dementia after(prenominal) Alzheimers disease. It is cause by problems in the supply of blood to the brain. in that location are a number of conditions that force out cause or annex damage to the vascular system.\r\nThese let in high blood pressure, meat problems, high cholesterin and diabetes. This means it is big that these conditions are identify and treated at the wee opportunity. 2. 3. 3 alienation with Lewy bodies Dementia with Lewy bodies (DLB) is a form of dementia that has characteristics like to both Alzheimers and Parkinsons diseases. It concurs around four per cent of all cases of dementia in older plurality. Lewy bodies, named after the doctor who first identified them in 1912, are tiny, spherical protein deposits bring in brass section cells.\r\nTheir nominal head in the brain disrupts the brains normal affairing, interrupting the action of genus Beta chemical messengers, including acetylcholine and dopamine. Researchers engender yet to chthonicstand in full why Lewy bodies occur in the brain and how they cause damage. 2. 3. 4Fronto-temporal dementia The term ‘fronto-temporal dementia intromits conditions such as Picks disease, frontal lobe degeneration, and dementia associated with motor neurone disease. All these are due to damage to the frontal lobe and/or the temporal parts of the brain. These compasss are responsible for our behaviour, emotional responses and language skills. . 3. 5Korsakoffs syndrome Korsakoffs syndrome is a brain disoblige usually linked with sour alcoholic drink utilization over a long period. approximately generation it is referred to as ‘alcohol amnestic syndrome ? ‘amnestic gist loss of memory ? although in rare cases alcohol is not the cause. Although Korsakoffs syndrome is not strictly speaking a dementia, wad with the condition suffer loss of short memory. 2. 3. 6Creutzfeldt-Jakob disease Prions are contagious agents that onslaught the substitution nervous system and thus occupy the brain, extend to dementia.\r\nKnown prion disease i s Creutzfeldt-Jakob disease, or CJD. It was first inform by cardinal German doctors (Creutzfeldt and Jakob) in 1920. 2. 3. 7Aids-related cognitive impairment Individuals with HIV and AIDS occasionally develop cognitive impairment †particularly in the later symbolizes of their sickness. AIDS (acquired repellent deficiency syndrome) is ca employ by the front man of the human immunodeficiency virus (HIV) in the body. HIV attacks the bodys immune system, qualification the psyche affected more vulnerable to infection. HIV-related cognitive impairment good deal be cause by: ? The direct impact of HIV on the brain Infections (called ‘opportunistic infections) that take advantage of the weakened immune system. 2. 3. 8Binswangers disease Binswangers disease is a unusual form of vascular dementia in which harm occurs to the blood vessels in the deep white matter of the brain. Symptoms of Binswangers in the main occur in mass over the age of 60 and it is usually linked w ith long-term hypertension. The disease chiefly affects memory and mental abilities such as thinking and curbing. The individual whitethorn too bring mood swings, tremors, seizures and problems with walking. 2. 3. 9Huntingtons disease\r\nHuntingtons disease is a progressive inherited disease. It typically functions obvious in adults in their 30s, even though it rump occur precedent or later. at that place is as well a young type of Huntingtons, which affects children. The route of the disease varies for individually psyche, and dementia squirt occur at any stage of the illness. 2. 4diagnosing Diagnosis of dementia is based on the following: • autobiography •Physical exam •Tests The process of come outing dementia is made besides if two or more brain functions such as memory and language skills are extensively damaged without loss of consciousness.\r\nAn archeozoic and precise dementia diagnosis low brio foster in early treatment of dementia sympto ms and by chance reversing the dementia or stopping its victimisation, if the cause of dementia is reversible (such as normal pressure hydrocephalus, a brain tumor, or B12 deficiency). •Patient History History winning is a very all essential(predicate) flavour in identifying dementia. It is important to know how and when symptoms developed and nigh the unhurrieds overall medical condition. Is at that place any jeopardy itemor knotty or in that respect is any family history of similar symptoms along with any medication the individual is taking.\r\nPhysician also tackle to appraise the patients emotional state and the degree of day to day actions being affected in spite of of the fact that patients with dementia frequently are ignorant of or in denial intimately how their disease is affecting them. Typically the family members also deny the reality of the disease because they take this in the beginning as a usual procedure of aging. Therefore, conductitional st eps are necessary to confirm or linguistic rule out a dementia diagnosis. •Physical Exam: A physical examination cease assistant in the following: ?Rule out treatable causes of dementia ramify signs of injection or other disorders that hatful add to dementia ? Identify indications of other illnesses, such as heart disease or kidney failure that derriere be related with dementia. A thorough neurological appraisal is performed to evaluate the balance, sensory function, reflexes, and other functions of the patient and to spot signs of conditions that whitethorn save an effect on the diagnosis of dementia. •Tests Used in Diagnosing Dementia Tests that are used to diagnosis dementia include the following: ?Cognitive and neuropsychological tests (Mini-Mental State psyc classtric test (MMSE) ? headland s merchant ships (magnetic resonance imaging or CT s brush aside) Laboratory tests ?psychiatric evaluations ?Pre-symptomatic test. •Cognitive and Neuropsycholo gical Tests for Dementia Tests are do to measure memory, language skills, math skills, and other abilities associated to mental functioning to do them analyze a patients condition precisely. A test called the Mini-Mental® State Examination (MMSEâ„¢) is used to judge cognitive skills in people with off-key dementia. This test examines: ? Orientation ?Memory ?Attention Doctors also use a diversity of other tests and rating scales to categorize explicit types of cognitive problems and abilities. •Brain poop out Tests for Dementia\r\nBrain scans are carried out to actualize strokes, tumors, or other problems that can result dementia. A brain scan whitethorn also point cortical atrophy (the progressive loss of neurons causes the ridges to become thinner and the sulci to grow wider), which is the deterioration of the brains cortex (outer layer) and is frequent in some(prenominal) an(prenominal) forms of dementia. Brain scans can also spot changes in the brains organiz ation and function that would nominate Alzheimers disease. •Computed Tomography Scan or Magnetic reverberance Imaging The most general types of brain scans are computed tomography (CT) scans and magnetic resonance imaging (MRI).\r\nA CT scan of the brain frequently suggested in a patient with surmise dementia. These scans, which use x-rays to chance brain structures, can show evidence of: ?Brain atrophy ?Strokes and transient ischemic attacks (TIAs) ?Changes to the blood vessels ? some other problems (such as hydrocephalus and subdural hematomas). MRI scans use magnetic fares and focalizationed radio waves to note hydrogen atoms in tissues within the body. They can come up the same problems as CT scans barely they are go bad for identifying reliable conditions, such as brain atrophy and damage from small TIAs. •Electroencephalograms (EEGs)\r\nElectroencephalograms (EEGs) are other tool to assist in inspecting people with suspected dementia. In an EEG, elect rodes are placed on the scalp over several parts of the brain in order to detect and record patterns of electrical drill and to check for abnormalities. This electrical occupation can luff cognitive dysfunction in part or all of the brain. many another(prenominal) patients with moderately dread(a) to severe Alzheimers disease moderate abnormal EEGs. An EEG whitethorn also be used to detect seizures, which occur in just nigh(predicate) 10 percent of people with Alzheimers disease. It can also benefactor list Creutzfeldt-Jakob disease. • some other Brain Scan Tests\r\nSeveral other types of brain scans countenance lookers to watch the brain as it functions. These scans, called expedient brain imaging, are not often used as diagnostic tools, but they are important in look into and they whitethorn ultimately sustain identify people with dementia earlier than is in the beginning long possible. Types of functional brain scans include: ?Functional MRI (fMRI): I t uses radio waves and a strong magnetic field to measure the metabolic changes that take place in active parts of the brain. ?Single photon-expelling computed tomography (SPECT): It shows the dissemination of blood in the brain, which generally increases with brain activeness. antielectron emission tomography (PET): This scans can detect changes in glucose metabolism, oxygen metabolism, and blood flow, all of which can fall upon abnormalities of brain function. ?Magneto encephalography (MEG): This can show the electromagnetic fields produced by the brains neuronal activity. •Laboratory Tests for Dementia Doctors whitethorn use a configuration of lab tests to aid diagnose dementia or rule out other conditions, such as kidney failure, which can contribute to symptoms. A partial list of these tests includes: ?A realised blood count (CBC) Blood glucose test, which measures profit levels in the blood ? Urinalysis ?Drug and alcohol tests (toxicology screen) ?Cerebrospinal anaesthesia fluid analysis (to rule out specific infections that can affect the brain) ? Analysis of thyroid and thyroid-stimulating endocrine gland levels. ?A doctor leave behind order only the tests that he or she whole tones are necessary to im record the accuracy of a diagnosis. •Psychiatric military rating The health fill off postr may recommend a psychiatric evaluation to determine if depression or another psychiatric disorder may be ca use or contributing to a someones symptoms. Pre-Symptomatic testing In most cases, testing people in front symptoms begin in order to determine if they testament develop dementia is not possible. However, in cases involving disorders such as Huntingtons where a known gene fracture is unloadly linked to the risk of the disease, a contractable test can second identify people who are likely to develop the disease. Since this type of inherited learning can be devastating, people should anxietyfully consider whether they want to undergo such testing. 2. 5Treatment\r\nFor about 10 percent of conditions that cause dementia, treatment is useable that can encourage reverse or at least inert down its onward motion. approximately examples of these treatable causes of dementia include: •A brain tumor •Normal pressure hydrocephalus •Hypothyroidism. For most cases, treatment does not exist to reverse or bank check the diseases progression; however, this does not mean that nothing should be done. peck with dementia can benefit to some effect from such things as medications and cognitive fosterage. There are also options for the family to help them cope. 2. 6Risk Factors\r\nScientists stimulate engraft a number of risk factors for dementia that affect the likelihood of developing one or more kinds of dementia. objet dart these are not causes of dementia, they may increase a souls chances of developing the symptoms referred to collectively as dementia. Some dementia risk factors can be treated or controlled and some cannot Some of these risk factors for dementia are modifiable, maculation others are not.. Also, certain risk factors are more likely to increase the risk for certain types of dementia. For example, the risk of vascular dementia is strongly fit with risk factors for stroke.\r\nFinally, the more dementia risk factors you expect, the great your chances of having dementia. An example of risk factors for dementia that you cannot change involves acquire older (the risk of dementia tends to increase with age). some other dementia risk factors you cannot control include having: • fester •A family history of dementia •Down syndrome • lowly cognitive impairment •History of a stroke. Dementia risk factors that you can control include: • high blood pressure •hyper cholesterolemia •Diabetes •Atherosclerosis •Smoking •Heavy alcohol use. •Homocysteine levels in the blood.\r\nThere are als o things that can be controlled that increase your risk for developing diabetes, atherosclerosis, and other conditions that may increase your risk of developing dementia. These include: •Being overweight or obese • privation of physical activity •Unhealthy diet. ? years Age is the utmost risk aspect for dementia. Dementia enchants one in 14 people over the age of 65 and one in six over the age of 80. However, Alzheimers is not limited to aged people: in the UK, there are 15,000 people under the age of 65 with dementia, although this figure is likely to be an underrated. ?Genetic inheritance\r\nSeveral people dismay that they may become heir to Alzheimers disease, and scientists are forthwith exploring the hereditary emphasise to Alzheimers. In most of the cases, the effect of inheritance appears to be minute. If a parent or other family member has Alzheimers disease, probability of developing the disease is only a slight elevated than if there were no cases of Alzheimers in the direct family. ?Environmental factors The ecologic factors that may add to the onset of Alzheimers disease view as yet to be discovered. Not many years ago, there were concerns that revelation to aluminum might cause Alzheimers disease.\r\nnevertheless, these fears have largely been discounted. ? other(a) factors Because of the dissimilarity in their chromosomal structure, people with Downs disorder who live into their 50s and 60s may develop Alzheimers disease. people who have had stern skull or whiplash wounds also come out to be at increased risk of developing dementia. knickers who get frequent blows to the head are at risk too. Study has also revealed that people who smoke, and those who have elevated blood pressure or sky-scraping cholesterol levels, augment their risk of developing Alzheimers. 2. 7 veneration of people with dementia\r\n spate with moderate and move on dementia typically pack round-the-clock circumspection and supervision to prevent t hem from harming themselves or others. They may also need assistance with daily activities such as eating, bathing, and salad dressing. Meeting these inevitably requires patience, understanding, and careful thought from the individuals care checkrs. For people voluminous with dementia care, there are some important things to consider. These include such things as: • qualification the home safe •Helping to reduce stressors •Providing mental stimulation. Good dementia care alship canal involves the issue of driving.\r\nOne of the hardest things to do is to take away a persons independence that comes with driving. However, for a number of reasons that we pull up stakes beg off later, people with dementia should not drive. 2. 7. 1Dementia Care and the photographic plate A typical home environment can fork out many dangers and obstacles to people with dementia, but simplistic changes can overcome many of these problems. For example, sharp knives, dangerous che micals, tools, and other hazards should be removed or locked away. Other safety precautions include: •Installing bed and behind safety rails •Removing locks from bedroom and bathroom doors punishing the hot water temperature to 120°F (48. 9°C) or less to reduce the risk of accidental scalding. People with dementia should also deport some form of identification at all times in case they wander away or become lost. Caregivers can help prevent unattended wandering by adding locks or alarms to outside doors. 2. 7. 2simplification Stressors People with dementia often develop behavioral problems because of foiling with specific state of affairss. Understanding and modifying or preventing the situations that trigger these behaviors may help to make life-time more enjoyable for the person with dementia as well as his or her caregivers.\r\nFor instance, the person may be baffled or frustrated by the level of activity or noise in the surrounding environment. Reducin g unnecessary activity and noise (such as by limiting the number of visitors and turning off the video recording when its not in use) may make it easier for the person to understand requests and perform simple tasks. Caregivers may also reduce confusion in people with dementia by: •Simplifying home decorations •Removing clutter •Keeping beaten(prenominal) objects nearby •Following a predictable number by means ofout the day. Calendars and clocks also may help patients orient themselves. . 7. 3Mental Stimulation as Part of Dementia Care Caregivers should encourage people with dementia to fall out their normal leisure activities as long as they are safe and do not cause frustration. Activities such as crafts, games, and music can turn in important mental stimulation and better mood. Some studies have suggested that participating in exercise and intellectually stimulating activities may slow the decline of cognitive function in some people. 2. 7. 4Is Driv ing well(p)? Many studies have found that driving is unprotected for people with dementia.\r\nThey often get lost and they may have problems remembering or following the rules of the road. They may also have difficulty processing training quickly and dealing with unexpected circumstances. Even a second of confusion while driving can lead to an accident. Driving with impaired cognitive functions can also endanger others. Some experts have suggested that regular check for changes in cognition might help to reduce the number of driving accidents among elderly people, and some states now require that doctors report people with Alzheimers disease to their state motor vehicle part.\r\nHowever, in many cases, it is up to the persons family and friends to ensure that the person does not drive. 2. 7. 5How the topical anaesthetic authority assesses need Local authority social work subdivisions are the main providers of care and prolong work. If a person with dementia or their carer is in need of agree, they should contact the local social run department to explain. The department lead then carry out an assessment of the persons needs and identify what run would be abstract to meet those needs.\r\nThis is known as a union care assessment If the department assesses a person as being in need of certain go, it has a duty to provide the function that fall within their eligibility criteria (locally set rules on what type of needs the local authority will meet). The person may have to contribute towards the salute of these services. Local authorities can provide services at one time themselves, or may make arrangements for insular or voluntary-sector organizations to provide care on their behalf. work ary from area to area, but range from those that allow mortal to remain independent in their own home (such as meals on wheels, day care, equipment and home adaptations) to residential care. The views and chooseences of the person receiving the service shou ld always be interpreted into invoice. 2. 7. 6Care plans If, after assessing the persons care needs, the social services department agrees that certain services should be provided, it will give the person a written care plan outlining these services. This applies whether the person lives at home or in a care home.\r\nCare plans should be reviewed on a regular basis and as needs change. If a review has not been carried out recently, or if one may be necessary, the person or their carer should contact social services and ask for a review. In addition, care homes essential provide an individual care plan for each resident. This must be regularly reviewed to take account of changing needs. 2. 7. 7Thinking through the options Once the social services department has confirmed what services the person is qualified to receive, the person and their carer can begin to think through the options.\r\nEven if the assessment concludes that the persons needs are not yet urgent enough to receive help from social services, or if some services are not available under the local authoritys eligibility criteria, an assessment will give everyone clearer info about the situation and the kinds of help available from other openings. The person or their family or carer could arrange services themselves, or through a voluntary organization or mystic agency. A key decision is whether the person can remain in their own home, or whether they would prefer to move into sheltered housing or a care home.\r\nIf they stay in their own home, there are many additional fend options available. It is also important to consider the financial implications of the options available. Social services should be able to give an idea of how much the person will have to pay towards the be of the various services that are arranged through them. Services provided by the NHS, such as society nursing, are free. Anyone who is arranging services themselves, whether through a voluntary organisation or a cloa k-and-dagger agency, will need to make their own enquiries. It is important not to rush into a decision.\r\nIt might help to also talk to friends and relatives, other carers and your local Alzheimers friendship branch. Local voluntary organisations are a source of further information, advice and practical help. Below is some counsel about what to consider when you are thinking about the kind of care the person in heading needs. 2. 7. 8Understanding and respecting the person with dementia Its very important that people with dementia are treated with respect. It is important to remember that a person with dementia is still a uncommon and valuable human being, despite their illness.\r\nIf you can understand what the person is going through, it might be easier for you to realise why they behave in certain ways. When a person with dementia puzzles that their mental abilities are declining, they often observe vulnerable and in need of reassurance and support. The people closest to t hem †including their carers, health and social care professionals, friends and family †need to do everything they can to help the person to retain their backbone of identity and stepings of self-worth. 2. 7. 9Helping the person feel valued\r\nThe person with dementia needs to feel respected and valued for who they are now, as well as for who they were in the past. There are many things that the people around them can do to help, including: • laborious to be flexible and tolerant • reservation time to listen, have regular chats, and enjoy being with the person •showing affection in a way they both feel comfortable with •finding things to do together. Our sense of who we are is closely connected to the names we call ourselves. Its important that people continue the person with dementia in a way that the person recognises and prefers. Some people may be talented for anybody to call them by their first name or nickname. •Others may prefer you nger people, or those who do not know them very well, to address them officially and to use courtesy titles, such as Mr or Mrs. bother sure you explain the persons cultural or apparitional background, and any rules and customs, to anyone from a different background so that they can behave accordingly. These may include: •respectful forms of address •what they can eat •religious observances, such as prayer and festivals particular article of clothing or jewellery that the person (or those in their presence) should or should not wear •any forms of touch or gestures that are considered disrespectful •ways of undressing •ways of dressing the hair •how the person washes or uses the toilet. Many people with dementia have a fragile sense of self-worth; its especially important that people continue to treat them with courtesy, however advanced their dementia. •Be kind and quiet to the person youre compassionate for without talking down t o them. •Never talk over their head as if they are not there †especially if youre talking about them.\r\nInclude them in conversations. •Avoid scolding or criticising them †this will make them feel small. •Look for the gist behind their words, even if they dont seem to be making much sense. Whatever the detail of what they are saying, the person is usually assay to communicate how they feel. • breeding to believe how you would like to be spoken to if you were in their position. • shew to make sure that the persons right to privacy is respected. • signify to other people that they should always knock on the persons bedroom door before entering. If the person needs help with intimate personal activities, such as washing or using the toilet, do this sensitively and make sure the door is kept closed in(p) if other people are around. •Everyone involved †including the persons friends, family members, carers, and the person with dementia themselves †reacts to the experience of dementia in their own way. Dementia means different things to different people. There are lots of things you can do to help the person with dementia feel good about themselves. This factsheet offers some suggestions.\r\nWhen you spend time with someone with dementia, it is important to take account of their abilities, interests and preferences. These may change as the dementia progresses. Its not always easy, but try to respond flexibly and sensitively. Dementia affects peoples thinking, reasoning and memory, but the persons feelings remain intact. A person with dementia will probably be sad or upset at times. In the earlier stages, the person may want to talk about their anxieties and the problems they are experiencing. •Try to understand how the person feels. Make time to offer them support, rather than ignoring them or ‘jollying them along. •Dont brush their worries aside, however plaguy they may be, or how ever insignificant they may seem. Listen, and show the person that you are there for them. •Make sure that, whenever possible, you inform and consult the person about matters that concern them. Give them every opportunity to make their own choices. •Always explain what you are doing and why. You may be able to judge the persons reaction from their cheek and body language. •People with dementia can find choice confusing, so keep it simple.\r\nPhrase questions so that they only need a ‘yes or ‘no answer, such as ‘Would you like to wear your blue jump shot today? ‘ rather than ‘Which jumper would you like to wear today? ‘ •Avoid situations in which the person is frame to fail, as this can be humiliating. Look for tasks that they can still manage and activities they enjoy. ive plenty of encouragement. Let them do things at their own pace and in their own way. •Do things with the person, rather than for them, to help the m retain their independence. • belch activities down into small steps so that they feel a sense of achievement, even if they can only manage part of a task. Our self-respect is often bound up with the way we look. Encourage the person to take pride in their appearance, and compliment them on how they look. Make sure that anyone involved in caring for the person has as much background information as possible, as well as information about their present situation. This will help them see the person theyre caring for as a whole person rather than simply ‘someone with dementia. It may also help them to feel more positive(p) about finding conversation topics or suggesting activities that the person may enjoy. 2. 8How effective is heath care oversight?\r\nHealth care management involves several techniques to render the needs of the patient. It should be kept in mind that patient is not responsible for the disease and thence should not be ignored or avoided. With the public ity in technology, different techniques can be used to look after the suffer of this disorder. However, these techniques and ways could only help the victim survive a bit since. Those kinds of dementia which are treatable and such patients have a different perspective and outlook of life as compared to those who are the victims of the untreatable ones.\r\nSo the care also varies with these two kinds of patients. Effectiveness of the present day health care management system is satisfactory but as said earlier it cannot bring back the life of the victim, however could let him or her survive for few more days with a happy face. 3. aberration IN UK Following statistics give a clear cut idea about the ratio and harmonize of dementia patients in UK: •There are currently 700,000 people with dementia in the UK. •There are currently 15,000 younger people with dementia in the UK. •There are over 11,500 people with dementia from black and minority ethnic groups in the UK. There will be over a one thousand thousand people with dementia by 2025. • devil thirds of people with dementia are women. •The proportion of people with dementia doubles for every 5 year age group. •One third of people over 95 have dementia. •60,000 wipeouts a year are directly attributable to dementia. •Delaying the onset of dementia by 5 years would reduce deaths directly attributable to dementia by 30,000 a year. •The financial cost of dementia to the UK is over ? 17 million a year. •Family carers of people with dementia save the UK over ? 6 billion a year. •64% of people living in care homes have a form of dementia. Two thirds of people with dementia live in the community while one third live in a care home. 4. LIVING WITH DEMENTIA People with dementia have become increasely involved in the work of the Alzheimers familiarity since 2000. Through a national programme called ‘ vivacious with Dementia, people with dementia ha ve been sharing their experiences and knowledge, and raising awareness of dementia at local and national levels. This contribution is crucial to ensure that the Alzheimers companionship develops appropriate information and support for people with dementia. It ensures that people with dementia can put to work the work that the Society carries ut on their behalf. On a national level the Living with Dementia programme consults with people with dementia in support of the Alzheimers Societys work of influencing government policy. •People with dementia in action People with dementia are involved in the Alzheimers Society in a variety of ways: ? Giving presentations and raising public awareness. ?Organising the unique UK wide convention of people with dementia. ?Lobbying MPs and commenting on government legislation. ?Being interviewed by national press and television. ?Recruiting and inducting new staff at the Alzheimers Society. ?Helping to make the website easier to use. Developi ng information for other people with dementia and their families. ?Participating in the national consultative body, the Living with Dementia running(a) group. These are just a few examples. There are many opportunities in the Living with Dementia programme •Living with Dementia Programme Various initiatives in the Alzheimers Society have focused on ways of supporting people living with dementia. Many started as two year pilots in 2001 and 2002, but are now naturalised as a core part of the Alzheimers Society activity. Examples of current initiatives are listed below: •West Kent figurer project\r\nStarted in 2001. It supports people with dementia using computer equipment, to find new ways of communicating, act interests and have fun. •Living with Dementia presentation skills training For people with dementia. Everyone affected by dementia has their own unique story to tell. Personal experiences and views are a powerful way of raising awareness about dementia, mak ing issues come alive. Training people with dementia to share their experience on TV, press and at meetings, helps to reduce the misunderstanding that surrounds dementia and offers hope to people facing the same situation.\r\nProviding key skills enables people to undertake publicity work with confidence. •Helpcard for people with dementia authentic in 2007 by people with dementia and piloted by people with dementia. The helpcard enables people with dementia to feel confident, not alone and able to ask for help at anytime. It is very useful in emergency situations, and is an effective colloquy tool that informs others of a persons circumstances. There are three different designs, with three different options for describing particular situations. •National conference for people with dementia\r\nThe Alzheimers Society has hosted three conferences for people with dementia in London, Newcastle and Birmingham (Thompson, Nanni & Schwankovsky, 1990). The last mentioned two involved members from the Living with Dementia Working group and the Scottish Dementia Working Group, making them the only UK wide events for people with dementia. In Newcastle the ‘ modify Our Lives feedback included: ?Get out and enjoy life ?Laugh! Confidence ?Remaining the same person after diagnosis ?Open positive communication ? discourse up †have your voice listened to ?Speak to your MP Being denied treatment †medication because of a ‘cost cutting exercise †its a disgrace ? frame up an email group ?Done more since having dementia †living my life to the full 5. RESEARCHES Currently, scientists are conducting research on many different aspects of dementia. This research promises to improve the lives of people affected by such symptoms and may eventually lead to ways of preventing or curing the disorders that result in dementia. Some areas of focus for dementia research include: •Causes and prevention •Diagnosis •Treatment. R esearching the Causes and Prevention of Dementia\r\nResearch on the causes of Alzheimers disease (and other disorders that are causes of dementia) includes studies of: •Genetic factors •Neurotransmitters •Inflammation •Factors that influence programmed cell death in the brain •The roles of tau, beta coarse-grained, and the associated neurofibrillary tangles and plaques in Alzheimers disease. Some other dementia research scientists are trying to determine the possible roles of cholesterol metabolism, oxidative stress (chemical reactions that can damage proteins, DNA, and lipids inside cells), and microglia in the development of Alzheimers disease.\r\nCurrent research on dementia prevention and causes includes the following: •Research to better understand the role of aging-related proteins (such as the enzyme telomerase) in the development of dementia. •Studies of abnormal clumps of proteins in cells. Researchers are trying to learn how abnor mal clumps of protein in cells develop, how they affect cells, and how the clumping can be prevented. •Studies that examine whether changes in white matter — nerve fibers lined with myelin — may play a role in the onset of Alzheimers disease.\r\nMyelin may erode in Alzheimers disease patients before other changes occur. This may be due to a problem with oligodendrocytes, the cells that produce myelin. •Work being done by scientists to search for additional genes that may contribute to Alzheimers disease. These researchers have identified a number of gene regions that may be involved in the development of Alzheimers. Some researchers suggest that people will eventually be screened for a number of genes that contribute to Alzheimers disease and that they will be able to receive treatments that specifically address their individual genetic risks.\r\nHowever, such individualized screening and treatment is still years away. •Studies on insulin guard. Insuli n resistance is common in people with Alzheimers disease, but it is not clear whether the insulin resistance contributes to the development of the disease or if it is merely a side effect. •Several dementia research studies have found a rock-bottom risk of dementia in people who take cholesterol-lowering drugs called statins. However, it is not yet clear if the apparent effect is due to the drugs or to other factors.\r\nTherefore, more research is being currently being done be better understand this possible relationship between statins and dementia. • A 2003 dementia research study found that people with HIV-associated dementia have different levels of activity for more than 30 different proteins, compared to people who have HIV but no signs of dementia. The study suggests a possible way to screen HIV patients for the first signs of cognitive impairment, and it may lead to ways of interfere to prevent this form of dementia. Research in this area continues. Research In volving Diagnosis of Alzheimers Disease Improving early diagnosis of Alzheimers disease and other disorders that may cause dementia is important not only for patients and families, but also for researchers who seek to better understand the causes of dementia and find ways to reverse or halt them at early stages. Improved diagnosis can also reduce the risk that people will receive inappropriate treatments. •In some research, scientists are investigating whether three-dimensional computer models of positron emission tomography (PET) and magnetic resonance imaging (MRI) can identify brain changes typical of early Alzheimers disease, before any symptoms appear.\r\nThis research may lead to ways of preventing the symptoms of Alzheimers disease. •One study found that levels of beta amyloidal and tau in spinal fluid could be used to diagnose Alzheimers disease with an accuracy of 92 percent. If other studies confirm the validity of this test, it may allow doctors to identify p eople who are beginning to develop the disorder before they start to show dementia symptoms. •This would allow treatment at very early stages of the disorder, and may help in testing new treatments to prevent or delay symptoms of the disease.\r\nOther researchers have identified factors in the struggle and blood of Alzheimers disease patients that are different from those in healthy people. They are trying to determine if these factors can be used to diagnose the disease. Treatment Research •Researchers are continually working to develop new drugs for Alzheimers disease and other causes of dementia. Many researchers believe a vaccinum that reduces the number of amyloid plaques in the brain might ultimately prove to be the most effective treatment for Alzheimers disease. In 2001, researchers began one clinical trial of a vaccine called AN-1792. The research study was halted after a number of people developed inflammation of the brain and spinal cord. •Despite thes e problems, one patient appeared to have reduced numbers of amyloid plaques in the brain. Other patients showed microscopic or no cognitive decline during the course of the study, suggesting that the vaccine may slow or halt the disease. Researchers are now trying to find safer and more effective vaccines for Alzheimers disease. Researchers are also investigating possible methods of gene therapy for Alzheimers disease. In one case, researchers used cells genetically engineered to produce nerve growth factor and transplanted them into monkeys forebrains. The transplanted cells boosted the mensuration of nerve growth factors in the brain and seemed to prevent degeneration of acetylcholine-producing neurons in the animals. •This suggests that gene therapy might help to reduce or delay symptoms of the disease. Researchers are now testing a similar therapy in a small number of patients. Other researchers have experimented with gene therapy that adds a gene called neprilysin in a creep model that produces human beta amyloid. They found that increasing the level of neprilysin greatly reduced the amount of beta amyloid in the mice and halted the amyloid-related brain degeneration. They are now trying to determine whether neprilysin gene therapy can improve cognition in mice. •Since many studies have found evidence of brain inflammation in people with Alzheimers disease, some researchers have proposed that drugs that control inflammation, such as NSAIDs, might prevent the disease or slow its progression.\r\nStudies in mice have suggested that these drugs can limit proceeds of amyloid plaques in the brain. Early studies of these drugs in creation have shown promising results. •However, a large NIH-funded clinical trial of two NSAIDs (naproxen and celecoxib) to prevent Alzheimers disease was halt in late 2004 because of an increase in stroke and heart attack in people taking naproxen (Aleve®, Naprosyn®, Anaprox®, Naprelan®), and an unr elated study that linked celecoxib (Celebrex®) to an increased risk of heart attack. Some research studies on dementia have suggested that two drugs, pentoxifylline and propentofylline, may be useful in treating vascular dementia. Pentoxifylline improves blood flow, while propentofylline appears to interfere with some of the processes that cause cell death in the brain. •One research study is testing the safety and effectiveness of donepezil (Aricept®) for treating mild dementia in patients with Parkinsons dementia, while another is investigating whether skin patches with the drug selegiline can improve mental function in patients with cognitive problems related to HIV. . CONCLUSION An appropriate cost effective workup of dementia includes a complete history, a complete physical examination (including a neuropsychiatric evaluation), a CBC, blood glucose, blood serum electrolytes, serum calcium, serum creatinine, and serum thyroid stimulating hormone (Whitlatch, Feinberg & Tucke, 2005). Other tests should be done only if there is a specific indication for e. g. vitamin B12 and folate if macrocytosis is present (Wilkinson & Lennox, 2005).\r\nA CT or MRI should be considered if the onset of dementia is before the age of 65 years, symptoms have occurred for less than 2 years, there is evidence of focal or asymmetrical neurological deficits, the clinical picture indicates normal pressure hydrocephalus, or there is a recent history of fall or other head trauma. If a patient has a history of cancer or is on anticoagulation therapy, then neuro imaging should also be considered. Thus to conclude, it is satisfactory to say that dementia, though a dangerous disorder, having not much cures, can be prevented by undergoing certain precautionary measures as illustrated above.\r\n'