Effectiveness of Dementia Intervention Programs

LO 1 Understand how to formulate a research specification

Introduction to research

The subsequent research process would be delving in to the analysis of the significance of the effective management of the particular disease of Vascular Dementia so as to highlight the most credible methods through which the quality of care could be improved for such patients. Furthermore, the research process would be also evaluating the challenges which the care professionals dealing with such cases could experience. The generated data would assist in the determination of the advantages and shortcomings regarding the existing Dementia care mechanism practiced at the various care institutions within the United Kingdom. This would also provide effective insights into the methods through which proper research procedures could be implemented within the working framework of clinical intervention based approaches to help the Vascular Dementia patients, alongside the need for healthcare dissertation help in exploring these complex issues.

Aims and objectives

Amador et al (2018) have defined the ailment of Dementia to be the specific pathological condition under which the human brain has to relinquish the ability to recall previously preserved memories as well as the ability to think and communicate in the proper manner. This ailment leads to the degradation of cerebral capacity of the patient to perform routine functions. To this effect, the particular category of Vascular Dementia affects the patients associated with this form of the disease and thus requires particular research attention regarding the determination of care specifics which would have to be devoted to assist the patients. According to Bonnici-Mallia, Barbara and Rao (2018), this is one of the most frequently occurring form of Dementia in which the blood flow to the brain gets hindered. In this context, the necessity to properly identify the methods of clinical interventions regarding cases of Vascular Dementia is paramount for the purpose of analysis of the efficacy of programmes of proper and qualitative medical intervention. To this effect, the corresponding research would be deliberative about the collection and analysis of data from multiple healthcare clinics and centres where patients with Vascular Dementia are under treatment.

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Research Objectives

To identify the particular clinical intervention programmes for patients of Vascular Dementia

To assess the impact of such intervention programmes on the patients of Vascular Dementia

To evaluate the dimension of effectiveness of existing clinical intervention programmes for Vascular Dementia

To recommend proper methods for future conduct of research in this perspective

Research questions

What are the particular clinical intervention programmes for patients of Vascular Dementia?

What are the impacts of such intervention programmes on the patients of Vascular Dementia?

What are the dimensions of effectiveness of existing clinical intervention programmes for Vascular Dementia?

What are the proper methods for future conduct of research in this perspective?

LO 2 Be able to implement the research project within agreed procedures and to specification

Rationale for research

The pressing significance, which also is indicative of the rationale of undertaking such a research, is to properly determine the quality of care which exists for the patients of Vascular Dementia within the targeted healthcare clinics.The research ofBrannelly (2016) has highlighted the fact that in excess of 670000 people in the United Kingdom alone suffer from various forms of dementia and the cumulative care expenditure, on part of the patients and their representatives, could amount to £19 billion since greater measure of attention and care have to be devoted to such patients and this process also requires extensive tolerance and patience on part of the care administrators. Such revelations have prompted this issue to become of prime significance in the context of six different aspects related to the appropriateness of curative care available for Vascular Dementia patients. Cooper et al (2015) have outlined the first one as the rate of mortality which amounts to 3% to 5% per annum due to Vascular Dementia within the UK which has propelled the country from the 24th to the 10th position in the global mortality index of Dementia related cases involving that of Vascular Dementia. Dewing and Dijk (2016) have suggested the second one to be the process of Diagnosis since this is the most profound issue as Vascular Dementia requires diagnosis at the earliest of stages. In UK, up to 45% of the patients suffering from this disease have been identified to have been diagnosed at the later stages when the disease had taken hold completely.Gibson et al (2016) have identified the third aspect as the proper hospital care requirement since the patients require considerably greater time to be cured and thus, their hospital admittance durations also get prolonged. Hallberg et al (2016) have specified the fourth aspect to be the numbers of carers since the high incidence of the Vascular Dementia requires an according number of professional carers and this would be one of the primary points of the research investigation. Iliffe and Wilcock (2017) have highlighted the aspect of fear to be one of the most significant aspects which could ensure a proper research project to be conducted in this perspective since people are mostly psychologically apprehensive of this specific disease. The final aspect has been determined byJones et al (2016)as the economic burden which prolonged treatment necessities could bring forth regarding the kith and kin of the patients.

Background Literature review

Various differential aspects could interfere with the process of treatment regarding cases of Vascular Dementia. According to Khan et al (2016), the primary of these is the issue of ensuring complete involvement of the members and representatives of the families of the patients. Kupeli et al (2018) have suggested the interventions are formulated through the involvement of multiplicity of programs which are designed to handle such problems and this research intends to evaluate the efficacy of these programmes. Livingston et al (2017) have determined the initial one of such programmes to be the institution of new learning methods to address the memory loss related effects in patients of Vascular Dementia since the patients of this ailment particularly tend to lose their ability to memorise basic functioning and routine duties. Manthorpe and Samsi (2016) have elaborated on this in the manner of formulating a repetitive process through which the patients would have to undergo identical set of actions on multiple occasions. Such set of actions are required to be inclusive of all of the daily routines associated with the patients. According to Mockford et al (2017), this would assist and enable the patients to instinctively memorise their daily routine based tasks in a methodical and sequential manner. According to Pink et al (2018), the monitoring of behavioural symptoms such as irritation, confusion out of the disability of remembering anything, frustration in failure to recall even the basic memories and resultant anguish as well as the expression of such anger in often intemperate language, would be of specific value to design effective policies of intervention and treatment. Furthermore, Poole et al (2018) have developed the proposition that such issues related to the patients of Vascular Dementia are to be addressed through educating the care providing professionals in terms of proper guidelines and instructions through which the care providers could control the behaviours of the patients and could communicate with them more effectively. This is also oriented towards the development of greater trust and faith in between the care givers and the patients.

The research of Robinson, Tang and Taylor (2015) have developed the idea of inclusion of the domestic care giving personnel in the overall treatment and care plans since the patients would have to be cared for continuously after their discharge from the care centres. Thus, it is of prime necessity to train the domestic personnel to properly handle the requirements of the patients through the developed measures of the disease management and clinical intervention mechanisms. Inclusion of the family members in the plan development could foster better cooperation especially in the cases where the patients require careful attention to assist them to adjust to the new atmosphere in which they can find themselves after their discharge from the care homes since they could not recollect anything of their previous memory. This could be further acknowledged to avoid the effects of prolonged suffering of the patients in a comprehensively organised format of operations. Under such perspectives, Shakespeare, Zeilig and Mittler (2019) have envisaged the development of a methodical and evidence based approach to better assist the care providers and the patients alike. According to Surr et al (2017), provisioning of proper feedback is essential regarding conditions and progress of the patients who could have been discharged from their care homes. This could provide greater perspective regarding the care method implementation and the associated results. T O'Brien and Thomas (2015) have propounded the necessity of providing reminders to the care providers regarding the necessity to improve the care guidelines and procedures. This process is also reflective of the necessity to properly educate the patients about the disease and the associated impacts so that the treatment procedure could become a definite success through garnering support from the patients.

Furthermore, Wotton and Goldacre (2017) have drawn attention to the necessity to provide monetary incentives to the patients since the treatments are prohibitively costly and require particular motivation in the form of financial supports and this could be performed through monetary incentive provisioning after the patients are discharged from their care homes.

LO 3 Be able to evaluate the research outcomes

Methodology and methods for secondary data collection

The significance of health and social care centres in terms of assisting the patients suffering from different diseases, such as Dementia, could be recognised to be paramount. Such clinical centres are oriented towards the improvement of treatment quality which is administered to the patients. The corresponding research process intends to evaluate the fruitfulness of such developed methods of medical interventions, particularly in respect to patients who have been suffering from varied forms of Dementia. In this context, the selected sample size involving the number of such clinics visited has been maintained to the optimum measure so that the research results regarding the secondary data collection could be achieved with acceptable measure of accuracy. Therefore, 10 different research centres have been visited in this regard. The research undertaking has been formulated on the Secondary data analysis alone to effectively manage the time limitation which the Researcher has been subjected to. To this effect, the utilisation of the Qualitative Secondary analysis of the collected information has been performed so that the constructive potency of the developed clinical intervention techniques for patients of Dementia could be evaluated. This has been a holistic approach involving disease based intervention management program analysis. The secondary research data collection has been completed through the process of targeted data and information gathering from a multitude of secondary resources. These have been the clinical intervention reports which have been enshrined in the data archives of the visited care homes throughout London and Greater London suburban areas, published books and journals which have been formulated on such the topic of the research, previously published and academically authenticated and endorsed research papers which have consummately dealt with the subject of Vascular Dementia and the care propositions which are associated with the same, reports from the Care Quality Commission and the Professional Standards Authority of Health and Social Care (PSA) and the internal medical administration logs generated by the care teams of the respective care institutions where the patients of Vascular Dementia have been treated.

Expected outcomes

The analysis of the data has been conducted on the premise of identification and determination of the thematic constructs of the collected secondary data. The issues related to the survey of the extensive literature had been resolved through the development of construction of particular categories under which the synthesised conclusions could be enlisted so as to align the same with the research objectives and aim. Furthermore, extensive cross referential comparison with the supporting documentation and medical procedural literature available within a wide array of publications has been undertaken to ensure optimisation of authentication and reliability of the data and to reduce interpretation based errors to the extent which could be logically possible. One particular problem which had been encountered in this regard was that utilisation of secondary data is properly not oriented towards the utilisation. Ultimately, the Researcher also had to concentrate on the handling of the research errors such as bias, omitted links regarding two different yet interconnected formats of information, factual inaccuracies which could lead to misplacement of the interpretation with vacuous outcomes, rates of occurrences of certain frequencies of the data and information such as the improvement statistics related to admitted and discharged patients and their recovery measures and finally, the ability of the secondary research to be cross referenced with previously undertaken definitive studies.

Finally, the Researcher has consistently strived towards establishment of the accuracy and reliability of the source information through which the secondary data has been collected and this has led to the review of the processes of documentation in the targeted clinics for Vascular Dementia patients as well as the protocols through which previous primary and secondary research process had been culminated. This involved different research inquests, the materials through which coding of research data outcomes and categories had been defined and the associated conclusive observations as well. Apart from these, new additions to the existing data sets have also been studied by the Researcher to have the most wide evaluative context to the collected secondary information. Another significant challenge was gaining access to the clinical archives in order to gather the necessary literature and the supporting documents as well.

Limitations

The limitations of the research involved the time and budgetary constraints since the limited measure of time did not permit the visitations to expand to greater number of health clinics and the acquisition of greater measure of secondary data was also hampered in this regard. The availability of the necessary records and updated reports regarding the treatment regimens administered to the patients and the conditions after their release from the care centres has been another serious limitation.

Recommendations

The most significant recommendation which could be considered by the Researcher is to develop the programs of Vascular Dementia disease intervention with greater focus on the prospects of formulation of the necessary guidelines of medication administration by the care personnel while having to contend with personnel suffering from Vascular Dementia. This would be necessitated on the purpose of making the care professionals aware that proper utilisation of medicines at the opportune time is the best policy. This is significant from the identified policy at the care centres that high doses of sedatives are administered to the patients when they become behaviourally unmanageable. There are certain negative side effects of such practices which would be required to be addressed through development of the guidelines under which the care providers could control the utilisation of sedatives.

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Temporal plan of the research

The research process involved careful progression on all of the research objectives in terms of the gathering of the study material and evaluation of the same to reflect the core research objectives in the derived research conclusions. This involved the particular and significant specifications such as permissions and time and schedule management related responsibilities. The research process involved the permission acquisition from all of the visited Vascular Dementia healthcare centres. This process also involved the ensuring of confidentiality and ethics related considerations and responsibilities regarding the handling of the medical history related information of the patients under consideration. As the research process was completely focussed on the care professionals and the management based decisions at the clinical centres and hospitals, it was also necessary that the daily routine functioning of the care centres could remain unaffected during the visitations of the research team. Permission was sought from the patients and their representatives as well regarding the utilisation of their medical history related data and legal approval was obtained from the National Health Institute. Budgetary considerations were managed through careful calculations regarding the expenses associated with the visitations and travelling to different health clinics and in obtaining legal permissions as well.

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References

Amador, S., Goodman, C., Robinson, L. and Sampson, E.L., 2018. UK end-of-life care services in dementia, initiatives and sustainability: results of a national online survey. BMJ supportive & palliative care, 8(4), pp.424-427.

Bonnici-Mallia, A.M., Barbara, C. and Rao, R., 2018.Vascular cognitive impairment and vascular dementia. InnovAiT, 11(5), pp.249-255.

Brannelly, T., 2016. Citizenship and people living with dementia: A case for the ethics of care. Dementia, 15(3), pp.304-314.

Cooper, C., Lodwick, R., Walters, K., Raine, R., Manthorpe, J., Iliffe, S. and Petersen, I., 2015. Observational cohort study: deprivation and access to anti-dementia drugs in the UK. Age and ageing, 45(1), pp.148-154.

Gibson, G., Newton, L., Pritchard, G., Finch, T., Brittain, K. and Robinson, L., 2016.The provision of assistive technology products and services for people with dementia in the United Kingdom. Dementia, 15(4), pp.681-701.

Hallberg, I.R., Cabrera, E., Jolley, D., Raamat, K., Renom-Guiteras, A., Verbeek, H., Soto, M., Stolt, M. and Karlsson, S., 2016.Professional care providers in dementia care in eight European countries; their training and involvement in early dementia stage and in home care. Dementia, 15(5), pp.931-957.

Iliffe, S. and Wilcock, J., 2017.The UK experience of promoting dementia recognition and management in primary care. ZeitschriftfürGerontologie und Geriatrie, 50(2), pp.63-67.

Jones, L., Candy, B., Davis, S., Elliott, M., Gola, A., Harrington, J., Kupeli, N., Lord, K., Moore, K., Scott, S. and Vickerstaff, V., 2016. Development of a model for integrated care at the end of life in advanced dementia: a whole systems UK-wide approach. Palliative medicine, 30(3), pp.279-295.

Khan, A., Kalaria, R.N., Corbett, A. and Ballard, C., 2016. Update on vascular dementia. Journal of geriatric psychiatry and neurology, 29(5), pp.281-301.

Kupeli, N., Leavey, G., Harrington, J., Lord, K., King, M., Nazareth, I., Moore, K., Sampson, E.L. and Jones, L., 2018. What are the barriers to care integration for those at the advanced stages of dementia living in care homes in the UK? Health care professional perspective. Dementia, 17(2), pp.164-179.

Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S.G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J. and Cooper, C., 2017.Dementia prevention, intervention, and care. The Lancet, 390(10113), pp.2673-2734.

Manthorpe, J. and Samsi, K., 2016. Person-centered dementia care: current perspectives. Clinical interventions in aging, 11, p.1733.

Mockford, C., Seers, K., Murray, M., Oyebode, J., Clarke, R., Staniszewska, S., Suleman, R., Boex, S., Diment, Y., Grant, R. and Leach, J., 2017. The development of service user‐led recommendations for health and social care services on leaving hospital with memory loss or dementia–the SHARED study. Health Expectations, 20(3), pp.495-507.

Poole, M., Bamford, C., McLellan, E., Lee, R.P., Exley, C., Hughes, J.C., Harrison-Dening, K. and Robinson, L., 2018. End-of-life care: a qualitative study comparing the views of people with dementia and family carers. Palliative medicine, 32(3), pp.631-642.

Robinson, L., Tang, E. and Taylor, J.P., 2015. Dementia: timely diagnosis and early intervention. Bmj, 350, p.h3029.

Surr, C.A., Gates, C., Irving, D., Oyebode, J., Smith, S.J., Parveen, S., Drury, M. and Dennison, A., 2017. Effective dementia education and training for the health and social care workforce: A systematic review of the literature. Review of educational research, 87(5), pp.966-1002.

Wotton, C.J. and Goldacre, M.J., 2017. Associations between specific autoimmune diseases and subsequent dementia: retrospective record-linkage cohort study, UK. J Epidemiol Community Health, 71(6), pp.576-583.

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