Dementia care

dementedness careThe open open-air(prenominal) world is rarely conceived of as an appropriate setting for a soulfulness with dementia Critically discuss this statement with reference to your meter reading and practice or caring vex. Use at least one case study or vignette of up to 350 words office outn from your practice or caring friendship. This should support your argument and expatiate either the opportunities and/or the challenges of accessing the outdoors.Assignment to be 2500 words community with dementia have the right to a dignified, healthy, safe, and gracious environs where they are treated as equals regardless their increasing age or diminish capabilities. (Mitchell et el., 2004). They derriere alleviate chief(prenominal)tain their abilities to deal out independently throughout the early or mild stages of dementia. They soothe have the desire to stay independent and have control over their own lives. It is essential for population with dementia to experi ence regular mental and corporeal utilisation to keep their minds and bodies active and to maintain social contact. If the streets in their neighbourhoods are non marked to meet their crowds they exit be trapped in their homes, because their previously safe and secure neighbourhood changed into a harmful and dangerous environment. There is an increasing need improve urban design through the Local Planning Authorities, as such urban planners should maintain in circumstance the implication of not only normal aging but they should enable individuals with several(a) types of cognitive legal injurys to maintain their independence (Burton Mitchell, 2006).Effects and challenges of dementiaPhysical, mental, and psychological changes are due to the ageing process, and thunder mug encompasses several slight impairments in interview, vision, ability, mobility, and memory. These affect elder individuals ability to live in their surroundings with ease. This is even more difficul t for individuals with dementia because they have to cope with both the normal ageing effects and the challenges of dementia that cause a threat to their personhood and result in the loss of identity (Burton Mitchell, 2006, Chaudhury, 2008). Dementia pose a number of behavioural, personality, and cognitive changes for display case restlessness, agitation, depression, and anxiety. There is a typical objurgate in physiologic and mental abilities. They develop a typical style of mobility in the form of an unsteady shuffle pace with a stooped posture, al centerings looking down and as such they are not aware of their surroundings. Dementia in like manner result in sensory impairment which discount include hearing and vision. Colour agnosia is often intensified by dementia, dark falsifys and combinations thereof is difficult to distinguish. There capacity also be impaired depth perception, sharp colour contrasts or patterns on the ground will be interpreted as steps or holes, s hiny or reflective surfaces looks slippery and wet, buzzy designs or repetitive lines will cause dizziness and that fuel result in trips or falls. The mental decline in dementia is permanent and incurable, it might progress gradually and result in unpredictable physical deterioration. During the mild to moderate stages their short-term memory is very fragile and their long-term memory remains penetrating (Burton Mitchell, 2006).Negative lifesThe statement, The public outdoor world is rarely conceived of as an appropriate setting for a person with dementia said it all. There are currently over 750,000 people with dementia in the UK and this is predicted to annul to about 870,000 by 2010 and over 1, 8 million by 2050. (Burton Mitchell, 2006, p. 27). But people with dementia is disable and disempowered by the unfriendly and unsafe environment, it does not meet their cognitive impairment needs, which is ignored. availability for these individuals have extend a huge problem, the re is positive transformations for normal disabilities but not effective enough to take into consideration the different barriers for individuals with dementia and their unique impairments. Burton and Mitchell (2006) found that individuals with dementia experience negative feelings that include veneration and anxiety. This is due to the fear associated with their decline in mobility and vision. Burton and Mitchell also indicated the complications and risks presented by existing city environments for instance sec paving, poor seats, no shelter, steep inclines, a lack of signposting, and bicycles on footpaths. The psychological and social difficulties are also serious obstacles for example, poor bus services, inaccessibility of topical anesthetic shops, insufficiency of toilet services, and the possibility of getting lost. changeless noise of heavy traffic flow disturbs the person with dementias hearing and has an influence on their concentration. Unexpected, loud-voiced sounds o ften frighten them. Another no-go facility is the moving stair fashions in any public building, it hinders a person with dementia who suffers vision-impairment to judge the stairways distance and speed. (Blackman et al. 2010)VignetteThe above ferret outings support the caring experience in my practice in that the public outdoor world is not an appropriate setting for a person with dementia, they do experience obstacles and challenges on a daily basis when accessing the outdoors as turn up in my vignetteOne of the residents, Mr X, in my care setting has been experiencing Schizophrenia for many course of instructions and he has also diagnosed with Vascular Dementia. He was from the local anaesthetic area and very familiar with the neighbourhood and partnership and is tumefy known by just about of the locals. He had free access in and out of the Care photographic plate for many years but recently we received a phone call from a local shop that informed us that Mr X had lashed out towards one of their staff members who approached him to support and guide him. At one stage Mr X entered a private property without consent. He also developed some injuries on his lower legs and hands and also got on the wrong public transport.It was not very winning to involve the police to locate Mr X and to guide him back to his own home. After observing Mr Xs change in behaviour we determined that there was a deterioration in his physical and mental functioning, for example he could not remember where a toilet facility was available and use the ally of the local shop. He also entered a private property because that was his previous home. Due to the unsteady walkways he also tripped and fell, injuring his legs and hands. Furthermore, Mr X could not read or represent the electronic screen at the bus stop causing him to use the wrong public transport.We had to involve Mr Xs world(a) Practitioner to review his medical treatment and according to the legislation we had to re do his risk assessments. Out of experience and observation we are aware that a person with dementia experience bad days and pricey days, and it can be problematic to specify at what stage their dementia has developed. But Mr X still has the capacity to give birth his own decisions and as such he decided to continue with his daily visits to the local neighbourhood as normal. We understand and support his decision, because this daily routine walk about was very resilient to maintain his self-respect, independence, and his quality of life. However, Mr X agreed to inform staff when he is leaving the facility and when he can be expected back, come throughing the internal home policy to keep him safe and secure. substantiating transformationsAs mentioned above there was positive transformations for normal disabilities, the UK Disability Discrimination Act updated in 2005 impact a change in attitudes towards design for deadening in order to meet the needs of anyone with disability. A ccessibility has become the most important problem because of the increasing population of older individuals and more positive attitudes towards disability in general. Recently the mission for dementia friendly communities received an enhancement from the Prime Ministers gainsay on dementia a national challenge. In his challenge the Prime Minister highlighted threesome key areas (see Prime Ministers Challenge, 2012, p.5)Driving improvements in health and care.Creating dementia friendly communities that understand how to help.Better research.Mitchell (2012) identified only six projects that have addressed the dementia-friendly design of neighbourhoods. That includes a three year research project, which was sponsored by the Engineering and Physical Sciences Research Council (EPSRC). Individuals with dementia and older people in the community were directly involved, through escorted walks some their own neighbourhoods and in depth interviews. During the research the neighbourhoods w ere measured, mapped, and evaluated by using a developed checklist of environmental features. This research identified six key design principles that are necessary and demand to make the streets and neighbourhoods more dementia friendly. The streets need to be safe, comfortable, accessible, familiar, legible, and distinctive (Burton Mitchell, 2006).FamiliarityThe roads and outdoor environments and features should be placeable and easily understandable by older individuals, especially for the person with dementia who experience confusion, spatial disorientation, and memory difficulties. Individuals with dementia do not recognise modernistic unfamiliar designs, they are used to traditional designs with the main entrance facing the street with normal swinging doors and not revolving or sliding doors. They also give to recognise modern designed street furniture, for example modern bus shelters, telephone boxes, or an alter Superloo (Burton Mitchell, 2006, Mitchell et el., 2004).To achieve familiarity in the outdoor environment the following can be done. Long-established streets can be maintained, local styles, substantives, and forms should be used for new developments, and any changes should be incremental and on a minor-scale (Burton Mitchell, 2006, Mitchell et el., 2004).Legibility readable roads refers to an easy to recognise network of directions and junctions with simple, obvious signs and noticeable, unmistakeable features. Some individuals with dementia sub-consciously use various techniques to find their way. These include visualising their avenue through mental maps, route planning by using the same route both time, and they can follow symbols that are realistic and clear. Most individuals with dementia find it difficult to follow or understand the outdoor signs. A cluster of signs is very confusing and difficult to read and understand. People with dementia prefers straightforward, simple signs fixed to the wall. For example the post office sig n is familiar and the colour is delightful for people with colour agnosia. Another technique they tend to use in order to find their way is familiar landmarks and environmental features, such as the letterbox at the corner or a street caf. It can happen that individuals with dementia get lost at times, that is due to confusion, disorientation, or distractions like sudden loud noise that causes a break in concentration (Burton Mitchell, 2006, Mitchell et el., 2004).To achieve legibility in the outdoor environment, streets should be laid out on an irregular grid pattern, staggered and this will acknowledge the connection of routes that is easy to understand. branching and T-junctions decrease the amount of routes and offer focus points at the end of the roads (Burton Mitchell, 2006, Mitchell et el., 2004).DistinctivenessDistinctive streets double up the communitys sheath through the use of a variety of features, colours, forms and materials that provide the buildings and street s with their own character and identity. It is essential for people with dementia to follow a route with a variety of local styles, shapes, sizes, and colour that will help them maintain concentration. They prefer a visit to the parks that presents them with mix activities such as enough seating, greenery, and public art (Burton Mitchell, 2006, Mitchell et el., 2004).To achieve distinctiveness and to help dementia people find their way in the outdoor environment it is important to provide interesting and understandable places, use landmarks, and environmental features. Firstly, make use of aesthetic features such as water pumps, attractive gardens, hanging baskets, fountains, and trees. Secondly, use practical features for example street furniture that includes familiar letter boxes, red K6 telephone box, bus shelters, and safe public seating (Burton Mitchell, 2006, Mitchell et el., 2004).AccessibilityAccessibility states to which degree the local streets empower people with any p hysical, mental, or sensory impairment to reach, enter, and walk to places they wish to visit. Older people, including people with dementia are no longer able to drive on their own or to use any public transport. Their trips are limited, due to their personal capabilities, to local places within walking distance for their homes. With the decline of their mobility they cannot walk fast or far distances and they struggle to cope in crowded places because they need enough space on the walkways. Level changes also create barriers for faint people, similarly ramps or steps are a challenge for people with mobility problems (Burton Mitchell, 2006, Mitchell et el., 2004).To attain accessibility for watery people, they should preferably live no more than 125m from the nearest post box or telephone with 2m unspecific pathways and no more than 500m from crucial services and facilities. There should also be public seating every 100m to 125m (Burton Mitchell, 2006, Mitchell et el., 2004).Co mfortComfort for older people and people experiencing permanent incapacity can include streets that allow them to visit places of their choice without any mental or physical agitation, it provides them with a welcoming and calm feeling (Burton Mitchell, 2006, Mitchell et el., 2004).To achieve a comfortable environment the streets must be designed in a way that it is welcoming, quiet, open, and accessible by providing enough public seating, shelter, and toilets. The seating must preferably be a wooden seat with arm and back rests. Bus stops should provide shelter, with transparent sides and flat seats of non-slippery material that do not conduct cold or heat (Burton Mitchell, 2006, Mitchell et el., 2004).SafetySafety is a overcritical characteristic of a friendly environment for dementia people, they have to be able to move around without fear of tripping, falling, being run-over, or attacked. Safe streets will be well-lit, wide, plain, level, non-slippery, non-reflected, and smoo th footways with isolated bicycle lanes and in front of building entering ways (Blackman et al., 2010, Burton Mitchell, 2006, Mitchell et el., 2004)The above principles outline the design guidelines to a more outdoor friendly environment for people with dementia. Burton and Mitchell (2006) also provides 65 recommendations and by using these it will support the design and re-design of an easy to use and welcoming neighbourhood.To summarise, it is clear that people with dementia, at least during their mild to moderate stages, can still maintain their ability to cope independently and any regular mental and physical exercise is essential to maintain their self-respect, independence, and their quality of life as seen in the vignette.That is why it is so important to us to ensure that the outdoor environment is accessible, open, and safe for people with all stages of dementia. If this cannot be achieved the environment out there becomes a scary and frightening world for people with deme ntia. Although, the neighbourhood environment is not dementia friendly at present there is positive improvements and pressure from Government, through the Prime Ministers Challenge on dementia. Importantly, the research project identified six principles of a dementia friendly environment that can be used for future planning and implementations. This will ensure that all new developments that take these principals into consideration will be in line with suggested and prescribed rules that cater for a safe and accessible environment for people with dementia.