Prevalence Symptoms and Interagency Healthcare Efforts

Introduction

Dementia is a medical condition affecting many people with statistics projecting its potential prevalence and escalation in the coming years. Being a chronic and lifelong medical condition, the patients may need intensive care to lead a painless life and love longer. Healthcare has been designed to focus on the needs and conditions of dementia patients. This essay examines the condition of dementia, its prevalence and symptoms and critically analyze the contribution of interagency efforts in providing healthcare.

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The nature of dementia

Dementia can be understood as a medical condition affecting the mental and cognitive functioning of the patients (Loy et al. 2014). This syndrome results in deteriorated memory, thinking and ability to perform daily activities. This shows that the condition has multifaceted impacts on the patient. A combined loss of memory, cognitive ability and affected physical body functioning shows the broad effects of the condition (Livingstone et Al 2017). Additionally, this implies that care accorded to dementia patients should be comprehensive and individualized.

Dementia condition has been identified to arise from primary or secondary mental illnesses and conditions such as Alzheimer’s, depression and anxiety (Livingstone et Al 2017). Dementia can also arise from stroke and this implies that individuals affected by dementia may be equally grappling with associated chronic medical conditions. Furthermore, dementia has been identified to be a major contributor to disability and dependency among the older people. Due to the dynamic nature of dementia and the fact that the condition often manifested in association with other conditions, there is often lack of awareness and understanding of the condition. (Dyer et al. 2016). Nevertheless, the effects of dementia go beyond the patient and are manifested in their families at large.

There are a number of manifestations of dementia. This, dementia is mainly manifested as Alzheimer’s disease which accounts for 60-70% of all the cases of dementia (Kivimaki et al 2019). Other forms in which dementia is manifested include vascular dementia, dementia with lewy bodies, and a group of diseases leading to frontotemporal dementia (Livingstone et al 2017).

Statistics project that about 50 million people across the world live with dementia with close to 60% of the affected living in low and middle income countries (Loy et al 2014). With regard to age, approximately 5-8% of the dementia patients are aged 60 years and above. Statistics further project that by 2050 the cases of dementia will have substantially increased and nearly 152 million people will be affected (Kivimaki et al. 2019).

Manifestations of dementia has been grouped into three stages, each exhibiting distinct symptoms. These symptoms are crucial indicators of the severity of the dementia condition. Early symptoms of dementia include forgetfulness, losing track of time and being lost in familiar places (McCormack et al 2010). These early symptoms serves as an indicator of the onset of dementia and seeking medical help will be crucial in monitoring and limiting the severity of the effects of dementia.

While the condition of dementia is largely gradual, its manifestation becomes clearer as time progresses. In the middle stage of dementia, there are particular symptoms manifested including forgetting peoples' names and recent events, becoming lost at home, increased communication difficulties, and behaviour change manifested through acts such as repeated questioning and wandering (Kivimaki et al 2019). The escalated condition of dementia is manifested through clear actions portraying deteriorated memory. The symptoms of the third phase of dementia include forgetting friends and relatives, difficulty walking, escalation in behaviour changes to aggression, and increased need for assistive self care (Loy et al. 2014).

The nature of dementia discussed above portray the seriousness of the dementia condition and the potential impacts it may have on the population. The health system is the main contact of dementia patients with health care providers and the patient centered care is a recommended approach for managing the patients living with dementia (Livingstone et al. 2017). There are agencies that play roles on the patient centered care of dementia patients. This section discussed the role of key agencies involved in the person centered care of dementia patients

Person centered care

The person centered care entails adopting an individualized approach in providing care to patients with healthcare needs. This approach has arguably been presented as an effective approach for enhancing quality healthcare in the hospitals setting as well as home care. This approach is premised on key principles that guide the service delivery. The proponents of person centered care for dementia patients believes that this approach is based on establishing partnerships between the patient, healthcare providers and the family in order to provide a combined and comprehensive approach to meeting the are needs of the patient (Fors 2015).

Person centered care also emphasizes that the patient plays a crucial role on the entire Care program and can make decisions in relation to the care accorded to them. Thus, health practitioners serve as guiders in the healthcare (Jayadevappa 2017). Patients with dementia have diverse characteristics in form of the manifestations and the dementia stage that affect them. Furthermore, their needs too differ from one patient to the other and are equally shaped by family background as well as cultural belief. Studies further indicate that’s substantial number of patients with dementia often grapple with two or more conditions of the disease (Finset 2011). For instance, a patient with Alzheimer’s may equally be grappling with stroke. The nature of dementia condition clearly point to the need for healthcare that is focused on the individual needs of the patients. The progressive nature of the manifestation of dementia implies that the needs of the patients will equally change as the condition progress.

The supporting literature for person centered care as the effective approach for providing holistic healthcare to the dementia patients is based on the principles of person centered care. Person centered care is value-based principle which emphasizes the respect of the cultural beliefs and rights when delivering care to patients with dementia (Valdes 2013). It is possible that patients with dementia may turn aggressive in the course of receiving care, or their perspectives may significantly hinder their participation in the healthcare, person centered care emphasizes that healthcare providers should appreciate and respect the views of the patients and adhere to treating the patients with dignity and respect throughout the care period (Fors 2015). The other principles of person centered care are coordination and integration of care, information and education, physical comfort, and emotional support.

Inter- agency efforts in championing for person centered care

Considering the magnitude of person centered care and the potential benefits associated with its implementations, there have been increasing efforts by different agents in healthcare to enhance the adoption of person centered care (de Bronkart 2015). Multidisciplinary or interagency approach in person centered entails partnerships among multiple healthcare providers through coordinated efforts in provision of healthcare. The players in the interagency team may comprise of nurses, doctors and healthcare regulatory bodies (Jayadevappa 2017).

One of the benefits of interagency approach in provision of person centered care is effective resource mobilization. Through the efforts of multiple agents, resources can be easily pooled together to enhance a comprehensive approach in the implementation of person centered care (Finset 2011). For instance, the Government through NHS England will provide funding for the implementation of person centered healthcare. The hospital administration will implement policies to enhance the effective roll out of the person centered approach in healthcare. On the other hand, doctors and nurses will be committed to providing person centered care. Through pooling of resources there is high chances of success in the roll out of person centered care. However, it must be emphasizes that due to the increased pressure in the healthcare, adopting an individualized approach in the care of patients with different medical conditions may require huge resource allocation through increased funding from the government, hiring and recruitment of more healthcare staff and increased pressure on the healthcare facilities (Leyshon and McAdam 2015)

The other benefit associated with interagency approach in person centered healthcare is the increased quality of healthcare accorded to patients with dementia. Bearing in mind the fact that patients with dementia required individualized care and have numerous needs that should be considered through the healthcare period, person centered care can be effectively utilized through the interagency contribution (de Bronkart 2015). Dementia patient’s conditions progressively manifest as the condition worsens with time. This also implies that the needs of the patients keep changing with the progression of the dementia condition. Multiagency efforts in managing dementia through a person centered approach will effectively address the needs of the patients through a focused approach (Finset 2011). However, seamless coordination between multiagency teams is almost impossible to achieve due to the possible conflicts between the agencies that may hamper effective rollout of person centered care (Valdes 2013). For instance, low budgetary allocation from the government to the hospitals creates a strain on the hospitals operations, as a result, the management may not fully commit to implementing person centered care. This lack of coordination hampers the effective rollout of person centered care.

Multi agency approach in implementing person centered care significantly boosts the quality of healthcare system if the country. By committing to prioritizing the needs of the clients when providing healthcare will significantly enhance the patient's experience and the quality of health care delivery from the health practitioners (Fors 2015). Quality service delivery is a commitment and an objective of healthcare on any country. In order to effectively manage the conditions of the clients and reduce the prevalence of dementia which is increasingly rising by each day, multi agency commitment to person centered healthcare will increase the service delivery of the healthcare system and eventual management of dementia patients (McCormack et al. 2010). It must however be pointed out that the current challenges in the healthcare system such as inadequate staff and strains in the healthcare facilities due to I’ll equipped health facilities in the hospitals that are unable to meet the growing number of patients (Valdes 2013).

Person centered care requires the partnership between the health provider, the patient and their family to be effective. Multi agency support to this approach for providing health care implies an emphasis on the involvement of the family in the healthcare of the dementia patients (Jayadevappa 2017). Family support significantly enhances the recovery and progress of the dementia patients and the family will contribute by managing some of the needs of the patients such as directing them around, reminding them of the things the clients have forgotten among other measures. Inter- agency teams may build on this partnership to device measures that encourage family support to dementia patients (Kivimaki et al 2019). However, there are some difficulties that may be faced by the dementia patients. For instance, regardless of the family support measures adopted by interagency teams to enhance family support, some patients with dementia can be neglected by their family members who may not be involved in the care and place all the burden on the health providers. This in turn causes serious psychological impacts on the patients who may become stressed and depressed on realization of the neglect (Finset 2011).

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Conclusion

Patient centered care is a value-based approach to provision of healthcare to the patients. This approach focuses on the needs of the patients and encourages healthcare providers to identify and address the needs of the patients when providing care. This approach of care is considered effective due to the focus it adopts and comprehensively managing the needs of the patients. As has been discussed above, dementia medical condition is a progressive long term condition that can affect both the physical and cognitive aspects of the patient. Bearing in mind the complexities associated with dementia and the diverse personal needs of the patients, response to the healthcare varies widely form one patient to the other. Person centered approach, as has been discussed above provides a promising approach to effectively manage the dementia condition of the patient. This can be achieved by adhering to the principles of person centered care in the management of dementia condition. However, despite the challenges, adopting an interagency effort in provision of patient centered care may increase the effectiveness of the approach and help in managing the dementia condition.

References

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. (2017). "Dementia prevention, intervention, and care". Lancet (Submitted manuscript). 390 (10113): 2673–2734. doi:10.1016/S0140-6736(17)31363-6.

Loy CT, Schofield PR, Turner AM, Kwok JB (2014). "Genetics of dementia". Lancet. 383 (9919): 828–40. doi:10.1016/s0140-6736(13)60630-3.

Kivimäki M, Singh-Manoux A, Pentti J, Sabia S, Nyberg ST, Alfredsson L, et al. (2019). "Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis". BMJ. 365: l1495. doi:10.1136/bmj.l1495.

Dyer SM, Laver K, Pond CD, Cumming RG, Whitehead C, Crotty M (2016). "Clinical practice guidelines and principles of care for people with dementia in Australia". Australian Family Physician. 45 (12): 884–889. PMID 27903038.

McCormack, Brendan; McCance, Tanya (2010). Person-centred Nursing: Theory and Practice. Wiley. ISBN 9781444390490

Fors, Andreas (2015). "Person-centred care after acute coronary syndrome, from hospital to primary care- A randomised controlled trial". International Journal of Cardiology. 187: 693–699. doi:10.1016/j.ijcard.2015.03.336. PMID 25919754.

Jayadevappa R (2017) "Patient-Centered Outcomes Research and Patient-Centered Care for Older Adults: A Perspective". Gerontology & Geriatric Medicine. 3: 2333721417700759. doi:10.1177/2333721417700759.

deBronkart D. (2015). From patient centred to people powered: autonomy on the rise. BMJ. 350: h148.

Finset A (2011). Research on person‐centred clinical care. J Eval Clin Pract. 17: 384–6.

Leyshon S, McAdam S (2015). Scene setter: the importance of taking a systems approach to person centred care. BMJ; 350: h985

Valderas JM (2013): Getting impatient about person‐centred health care. Eur J Gen Pract. 19: 141–2.

Larsson IE, Sahlsten MJ, Segesten K, Plos KA (2011). Patients’ perceptions of barriers for participation in nursing care. Scand J Caring Sci. 25: 575–82

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