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ADULT NURSING

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Introduction

According to the study, over 17% of people diagnosed with dementia are likely to have vascular dementia. It is one of the most common types of dementia in the aging population. For example, in the United States and many other countries, the majority of these affected are aged above 65. Therefore, it’s not a unique condition for the aged population. Vascular dementia is caused by an inadequate flow of nutrients and oxygen into the brain due to blood clots. Symptoms vary depending on the part of the brain that is damaged. However, they may be similar to these of Alzheimer’s dementia. The symptoms include confusion, memory loss, depression, and unsteady gait, among others. According to studies, there is no specific test for this condition, so diagnosis depends on the assessment of symptoms and the medical history of the individual related to vascular dementia, for example, stroke. If symptoms are noticed early, it can be managed by taking medication to control conditions such as stroke or diabetes that are closely related to vascular dementia (Lidster & Wakefield 2018).

 

According to the study, 50% of vascular dementia cases are caused by high blood pressure, which can result in stroke and brain injury that can result in collapse. Also, it can lead to a sudden change in the behavior of a person. for instance, a person tends to be in low moods and get angry for no reason or overreact to minor things just as it is for Caroline’s case. Caroline walking her dog at 2 am, is an indication that she is experiencing difficulties in sleep, which is one of the symptoms experienced by most people (Gnjidic et al., 2018, pp. 1410-1417).

 

biopsychosocial factors

The first significant organ that is affected by vascular dementia is the brain. Brain damage due to dementia causes the cognitive disorder. Brain damage may be the root of Caroline’s behavior of walking with the dog during late hours. First, the disease affects the patient’s explicit memory. This affects the patient’s ability to remember simple things like the days of the week and months. Secondly, the disease affects the brain mechanisms of retrieval or implicit memory, which results in catastrophic changes in behaviors ( Nordstrom and Nordstrom, P  2018, pp.1). In Caroline’s case, the irrational, low mood, and anger may be due to damage in this part of the brain. Thirdly, the disease affects the movements of the patient as it affects the parietal lobe of the brain, which causes Apraxia. Apraxia is a disorder that affects the sequence of actions and may cause falls and dislocations in the limbs of patients. The disease may also affect the person’s ability to do some simple things like tying the shoelaces or even the shirt buttons (Revolta et al., 2016 pp. 1079-1089).

 

Psychosocial effects.

Having dementia affects simply every activity that a person was carrying out before the disease, starting from cognition to movement and emotions. Patients who are diagnosed with dementia are likely to have a range of emotions. They may begin behaving differently, for instance, having bursts of anger and discontentment (Gagliese, et., 2018, pp.207-215). They may also experience fear of the future. Their fear may become worse and result in other mental complications and may bring forgetfulness. These changes are mostly felt by people who stay around them. They are thus faced with the task of understanding them and taking care of them. For some patients, the emotions are very severe, and if they are not given proper psychological help, they may become depressed, which may lead to suicide. Supporting a person with dementia is essential in boosting their self-esteem and confidence. This helps slow down the progress of the disorder (Górska et al., 2019, pp. 1-13).

 Effects of illness on individuals and families

As people age, many changes occur in their bodies, including change in memory, which affects their ability to remember things. Physical changes also occur, making the person dependent on others. The majority of older adults rely on help from friends, health care providers, or family members, thus becoming a burden (McKeith et al., 2017, pp. 88-100). It also triggers the emotions of the patient and the caregiver due to increased decency. Sometimes dementia people can turn hostile to the caregivers and harm them physically, making it difficult for the family to care for them, thus deciding to take them to a nursing home where the individual may suffer loneliness, depression, and isolation. According to Erikson, people had a positive impact on their lives, and other people tend to have a sense of integrity even as they age near the end of life. The family does not despair to take care of the individual but instead, take care of him/her with the same integrity, thus happy Aging (Malone et al., 2016, p.496).

Kübler-Ross’s model of grief has at least five stages involved, although not every person experiences them, whether due to illness or loss of a loved one. Research shows that religious people can cope with death better due to religious beliefs of life after death and social support from religious members. For example, Caroline has help from church friends who keep visiting her in the hospital that making it easy for her and the family to cope with the condition (Macaulay et al., 2018, pp. 748- 759). However, there these who go through the following stages. When a sick person realizes his or her health is deteriorating, and death is near, they tend to become angry. They begin blaming health care practitioners and family members for what they are experiencing. This because they feel these people are surrounding them are not doing enough to protect them from death. There is a feeling of denial that overcomes a person even when they know everything is not ok; they pretend to be healthy and eliminate the thought of death due to fear. Sometimes a person can plead to God desperately to be given another chance to live to accomplish the set mission, and when they realize the situation is getting worse, they go into depression. The hope to survive is gone, and they may isolate themselves and start contemplating suicide. However, those who accept life is ending and begin making peace with people around them and plan for their death (Gnjidic et al., 2018, pp. 1410-1417).

 

 Factors that influence health beliefs of individual

Various factors trigger the health beliefs of an individual, one being culture. Culture determines how people perceive life experiences in connection to health and diseases. People have different faiths and customs about the cause of varying illnesses, including witchcraft and evil spirit. This makes it difficult for them to accept the diagnosis (Khan et al., 2015). Patients with depression are stigmatized in most cultures because they are perceived to be crazy, which makes it hard to seek medication. Some patient fails to comply with treatment recommended by a physician from a different culture belief because they believe the health practitioners do not understand their condition or they do not take it seriously (Pham et al., 2018, pp.949). For example, if the physician doesn’t give an injection, they believe the treatment is not complete. Culture affects health care through the influence of family, traditions, gender roles, and patterns of support. In some circumstances, a patient may not be willing to discuss symptoms with the physician in the presence of an interpreter. They believe in measures to prevent and control diseases is different and sometimes go against the professionals believe affecting how health system function (Michalowsky et al., 2018, pp.517-522).

Social and psychological factors are also vital to help a person to manage stressful situations. Support from family members, friends, and place of work has a significant impact on an individual’s physical and mental health, whereby unemployment result in low quality of life and mortality. One of the psychological factors of health is the stress that is most related to pressure from workplaces (Mayeda et al., 2017, pp. 761-769). This influence change in health behaviors such as smoking and drinking alcohol that some individual believes it away from relieving stress. The type of food people eats matters a lot in health because they affect immune and cardiovascular systems. This because some unhealthy diets, for example, foods rich in cholesterol, result in cardiovascular diseases.

Definition of Health and well-being

The health and well-being of an individual have different definitions depending on a person’s perspective. This has led to a lot of criticism of various views about the description of health and well-being. Health and well-being are the body being free from diseases, mental distress, and being physically fit. However, the World Health Organization defines health and well-being as not only being free from diseases but also as a state of absolute physical, mental, and social well-being. Research-based on mental Health and public mental Health claims that well-being is categorized outside the medical model of health because its presence or absence is not a diagnosis. This is because the State of well-being varies from one individual to another, depending on their perspective. While some researchers say well-being is feeling good and body functioning well. However, health and well-being are always related, and they influence each other (van der Krieke et al., 2017, pp. 213-223).

 

Health promotion

The nurses’ intervention in health promotion has led to improved health care services and lower symptoms of chronic diseases. Health promotion activities are influenced by individual perspective. Nurses help individuals and family to make health decisions. Nurses use various strategies to promote health, some based on recommendations from the World Health Organization. They also take directives from governmental organizations and professional bodies as they offer support to individuals and families (Baruch et al., 2017, pp. 863-867). Nurses involve community members in voluntary work to help in preventive measures. There are also patient-focused health promoters based on various patient groups who require high levels of care and treatment, for example, people with chronic diseases. It is also based on the three pillars of health promotion that help improve the health sector (Mohammed and Mohabeer 2017, pp. 1). This pillar includes:

Healthy literacy

Health literacy is crucial for both patient and the clinician to ease the flow of medical information and its implementation: health literacy helps prevent poor or underutilization of resources such as vaccination (Blackie 2019, p.148). Therefore, to create understanding for all, knowledge is passed through social mobilization to raise awareness of health care requirements and help in the delivery of resources and services to attain a healthy community as clinicians ensure patients understand medication instructions, especially for chronic conditions such as blood pressure. This is meant to remove the illiteracy barriers to improve health services (Contador et al., 2017, pp. 112-119).

 

Good governance

Distribution of resources and decision making in these sectors affect the health of people and determine the mortality rate. Therefore, strengthening of health policies and other health systems to ensure accessibility and affordability of health services is vital. Some of the resources and conditions required for good health include peace, food, income, shelter, social justice and equity, education, and a stable ecosystem.

Healthy cities

According to research, green environment influences physical activities. Through a green background, chronic diseases can be prevented by eating healthy and practicing regular physical activities. Natural environments encourage walking. Thus, there is a need for urban planning to make a designed neighborhood that has become a significant factor in the health sector (Sabia et al., 2017, pp.75).

Conclusion

Due to increased dementia cases and its impact on the nation, every country has come up with ways to deal with it. For instance, each State in the United Kingdom has strategies for dementia, where nurses play major role in helping the nation achieve the set standards. This strategy helps to ensure the rights and freedom, especially of the older person with dementia, are not violated. Nurses ensure that dementia is noticed and managed early to avoid further damage. The impact of dementia is not only felt by the individual but by the entire community. The individual’s decency rate is a burden to the family and care givers who are required to meet the patient’s demands. Due to this, World Health Organization developed programs to pass knowledge and skills to caregivers and family living with dementia patients.

 

 

References

Baruch, N., Allan, C.L., Cundell, M., Clark, S. and Murray, B., 2017. Promoting early dementia diagnosis: a video designed by patients, for patients. International psychogeriatrics29(5), pp.863-867.

Blackie, C., 2019. Health Education and Promotion. Learning to Care E-Book: The Nurse Associate, p.148.

Booker, A., Jacob, L.E., Rapp, M., Bohlken, J. and Kostev, K., 2016. Risk factors for dementia diagnosis in German primary care practices. International psychogeriatrics28(7), pp.1059-1065.

Cadar, D. and Steptoe, A., 2019. OP17 Biopsychosocial determinants of cardiovascular and dementia risk: an examination of differentials in a representative study of the english population.

Contador, I., Del Ser, T., Llamas, S., Villarejo, A., Benito-León, J. and Bermejo-Pareja, F., 2017. Impact of literacy and years of education on the diagnosis of dementia: A population-based study. Journal of clinical and experimental neuropsychology39(2), pp.112-119.

Gagliese, L., Gauthier, L.R., Narain, N. and Freedman, T., 2018. Pain, Aging and dementia: Towards a biopsychosocial model. Progress in Neuro-Psychopharmacology and Biological Psychiatry87, pp.207-215.

Gnjidic, D., Agogo, G.O., Ramsey, C.M., Moga, D.C. and Allore, H., 2018. The impact of dementia diagnosis on patterns of potentially inappropriate medication use among older adults. The Journals of Gerontology: Series A73(10), pp.1410-1417.

Górska, S.M., Maciver, D. and Forsyth, K., 2019. Participation as means for adaptation in dementia: a conceptual model. Aging & Mental Health, pp.1-13.

Macaulay, B., Roy, M.J., Donaldson, C., Teasdale, S. and Kay, A., 2018. Conceptualizing the health and well-being impacts of social enterprise: a UK-based study. Health promotion international33(5), pp.748-759.

Malone, J.C., Liu, S.R., Vaillant, G.E., Rentz, D.M. and Waldinger, R.J., 2016. Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health. Developmental psychology, 52(3), p.496.

Mayeda, E.R., Glymour, M.M., Quesenberry, C.P., Johnson, J.K., Pérez-Stable, E.J. and Whitmer, R.A., 2017. Survival after dementia diagnosis in five racial/ethnic groups. Alzheimer’s & Dementia13(7), pp.761-769.

McKeith, I.G., Boeve, B.F., Dickson, D.W., Halliday, G., Taylor, J.P., Weintraub, D., Aarsland, D., Galvin, J., Attems, J., Ballard, C.G. and Bayston, A., 2017. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology89(1), pp.88-100.

Michalowsky, B., Kostev, K., Hoffmann, W. and Bohlken, J., 2018. Indicators of an increase in dementia diagnosis rate in primary care. Zeitschrift fur Gerontologie und Geriatrie51(5), pp.517-522.

Mohammed, A.A. and Mohabeer, B.F., 2017. Health Promotion and Health Development “Mental Health and Later Life”. European Journal of Sport Sciences and Public Health4, p.1.

Nordström, A. and Nordström, P., 2018. Traumatic brain injury and the risk of dementia diagnosis: A nationwide cohort study. PLoS medicine15(1).

Pham, T.M., Petersen, I., Walters, K., Raine, R., Manthorpe, J., Mukadam, N. and Cooper, C., 2018. Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clinical epidemiology10, p.949.

Lidster, J. and Wakefield, S., 2018. Student practice supervision and assessment: a guide for NMC Nurses and Midwives. Learning Matters.

Revolta, C., Orrell, M. and Spector, A., 2016. The biopsychosocial (BPS) model of dementia as a tool for clinical practice. A pilot study. International psychogeriatrics28(7), pp.1079-1089.

Sabia, S., Dugravot, A., Elbaz, A. and Singh-Manoux, A., 2017. RISK FACTORS TRAJECTORIES PRIOR TO DEMENTIA DIAGNOSIS: BMI AND PHYSICAL ACTIVITY. Innovation in Aging1(Suppl 1), p.75.

van der Krieke, L., Blaauw, F.J., Emerencia, A.C., Schenk, H.M., Slaets, J.P., Bos, E.H., de Jonge, P. and Jeronimus, B.F., 2017. Temporal dynamics of health and well-being: A crowdsourcing approach to momentary assessments and automated generation of personalized feedback. Psychosomatic medicine79(2), pp.213-223.

Khan, O., Shah, A., Escudero, S.L.Z., Moriarty, J., Jutlla, K., Goodorally, V., Milne, A., Smith, J., Watkins, J., Wahab, S. and Manthorpe, J., 2015. Dementia, Culture and Ethnicity: Issues for All. Jessica Kingsley Publishers.

 

 

 

 

 

 

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